Just over a week ago, I stumbled across a piece on childfree women in The Guardian, after a couple of women I follow on Twitter were sharing it, outraged by its contents. The piece, part of a 'Childfree' series, was essentially a conversation between Guardian editors Summer Sewell and Jessica Reed, who, having read Sheila Heti's Motherhood, discussed their own personal reasons for not having children over drinks.
Talking to Ana Maria Escobar has a similar effect to drinking a coffee and getting a workout in before breakfast. Her energy is dynamic and infectious, and somehow makes you feel you're ready to accomplish anything. Which is hardly surprising, when you glance at her CV.
The former GM and Creative Director of accessories powerhouse Oroton, Ana knows her way around a boardroom as well as she does a moodboard. In 2018 she founded LMND, a women's label that boasts what Popsugar calls "the best white shirt you've ever worn". And as if a Bondi Beach shopfront and a thriving online presence wasn't enough to manage, Ana also designs capsule collections for brands like Tigerlily, and consults for brands like Ksubi.
There was only one job description that didn't come easily to Ana: motherhood. Now mother to seven year old Emilio, Ana and her husband endured years of IVF before her doctor gave her the strangest announcement of her life: "I'm so excited, you have a tumour in your head!" While the diagnosis was confronting, it explained why her fertility journey had been so challenging, and meant she was able to finally fall pregnant once the tumour has been treated.
Tell us a little bit about your work…<p>I do a little bit of everything. I was GM and creative director for Oroton for nine years. From there I moved to work for Woolworths for about three years in private label, and that was a great learning curve for me as well. It was a pretty amazing space to learn. And then from there I decided to start LMND and do my own consulting. Right now I'm working with Ksubi, as well as with Tigerlily on accessories but also helping them with strategy.</p>
And was your background in design originally?<p>It's funny because I started as an industrial designer, and as an industrial designer you're more of a 360 degree designer. You're very close to supply chain, to factories, and close to price and materials in that space. So it makes you think in almost more of a numbers way, more of an engineering of design.</p><p>From there I did fashion and textile design at UTS. So, merging the two, that's where I appreciate numbers and business development and that kind of structure, but I love the creative narrative story bringing products into life. I guess working for Oroton for nine years, very close to the CEO and being a public company, gave me that real view and appreciation for numbers and results.</p>
Is that quite unique to have those two perspectives?<p>I think designers are more methodical than people think, to be able to get product end to end. It doesn't matter if we tell a lot of stories and have a lot of narrative around it – that's part of what actually sells, and more so now with social media and everything we have around it.</p>
Tell us about your family…<p>I was born in Australia and I grew up in South America, in Colombia – that's where the crazy surname comes from. I came back to Australia on my own when I was 19. My whole family is in Colombia. Then I got married – my husband is Colombian as well and I've known him forever. And so it's my husband, our seven year old son Emilio, and me. The three of us.</p>
Did you always want to be a mother?<p>I always wanted to be a mum. We grow up thinking we're going to fall pregnant in a second. So it's always in the back of your mind. I thought 'oh, when I'm 32 maybe that's when I'll start'. It happens for some people, but they never told us that for other people that doesn't happen. I'm a planner, so I thought 'I'll do this and that and then I'll have a baby'.</p><p>I remember when I started and it didn't work, I was always really pragmatic about the process. I thought 'okay, no, it will happen'. I started doing IUI, and it didn't work, but I thought 'this will happen' and I was really positive about it.</p><p>But I remember going through IVF and one day I called my mum crying. I just said to her "mum, I never wanted anything more than to be a mum. I really want to be a mum." And she said something that has stuck with me. She said "Ana, I don't know the way and I don't know how, but I know that you're going to be a mum. You have to remember that everything you have done in your life has had a narrative and a story, and I don't think pregnancy is going to be any different. Whatever happens, I know that you're going to be a mum."</p><p>I believe everything my mum says, so that moment made me feel 'okay, I'm definitely going to be a mum.' It was a really hard journey but those words gave me strength. I've said it to a lot of my friends who have been through IVF since. Just think, regardless of what happens, of your journey or your story, you're going to be a mum if that's what you want.</p>
At what stage did you decide it was time to start trying IVF?<p>I moved into it fairly quickly because I did feel in my heart that it wasn't going to be that easy. Trying naturally hadn't worked, IUI didn't, then I did acupuncture – I did everything you can imagine. And in my personality, I'm very action-based. I don't procrastinate or stay thinking on things for too long. So I thought look, IVF is there, and we are so lucky that we have access to it. Let's see how we go.</p><p>I remember I used to finish the cycle and they would call me to tell me it didn't work. Every time I hung up the phone I'd try to think okay, I'm not sick, I'm fine. Everything is going to be fine. And I still have another one that I can go for straight away. And the doctor would be say, 'are you sure you want to do another one?' I just felt, let's do it. I stayed really positive.</p><p>But then I had a moment in the middle where I thought, 'this actually is not going to happen, or maybe there's a possibility that it's not going to happen', and that really scared me.</p><p>So I changed doctors. I remember my first appointment with my new doctor – he said to me, 'have you ever had an MRI?' And I said no, thinking, 'that's a funny conversation.' And he said, I'm going to send you before I do anything else. We need an MRI because I'm looking at your blood and there's something happening with prolactin here.'</p>
What did the MRI reveal?<p>I came to the doctors office and he said to me, "I'm so excited, you have a tumour in your head!"</p><p>I was like, 'I'm sorry?' In that moment all I could think was 'what am I going to tell my husband?'</p><p>But the doctor said to me, "look, the word tumour sounds really scary, but it's not necessarily. You have a growth or a tumour in your pituitary gland, and that's putting pressure on your hormones. So that's what was making all your hormones go crazy. If we manage to suppress or manage that little tumour, then that will give us more possibility with the cycle."</p>
How did your IVF journey continue once the tumour was dealt with?<p>So as he said, the quality of the cycles was better, but it still didn't work. So from there, my doctor said to me, "look, we are actually doing a research piece. It's called the Bondi protocol. And we would like to try it on you, if you're open to do it."</p>
Did you want to try it?<p>My instinct was – do I want to be a human guinea pig? That's a bit scary, I'm not sure. So I talked to him about it, and he explained "it's all about the immune system. So we just want to suppress your immune system, do a cycle and see if it works. But first we have to check if you are eligible for it." They checked my immune system and saw that I had really high levels of certain cells, which act like natural killer cells. It's basically your immune system being really powerful. So the doctor said to me, "I think you're perfect for this – let's try it."</p><p>They did the cycle and I fell pregnant straight away.</p><p>I think that was my eighth cycle of IVF.</p>
And how did you eventually find out that you were pregnant?<p>Because I was doing the trigger injections, I knew that it could give me a false positive on a home pregnancy test. So I remember the doctors told me, it's 14 days until we can test you, so don't test at home before that. And I didn't. I went and saw the doctor at 14 days and he said "yes, you're pregnant, but this is the first one. It can be a false positive, so come back again in a week and we'll re-test." It wasn't until I actually heard his heart beating that I went, "Oh my gosh, this is actually happening."</p>
How did you feel in that moment?<p>Very, very scared. After hearing his heartbeat I realised "I don't think I can deal with anything going wrong". It was quite confronting, for me and my husband.</p>
Did that fear and anxiety ease with time?<p>From there it's just getting used to the fact that it's a normal pregnancy. You normally see yourself as a patient, the doctors can see you every two days, you're getting phone calls. You almost got used to that so to hear the doctor say "no, you're done, I don't need you to come next week. You're pregnant. I'll see you for normal checkups" – that was just crazy.</p><p>It was quite funny because when I was three months pregnant, because I went through all those cycles, I still didn't believe I was pregnant. I remember my appointment with the doctor. I walked out the office and I had to come back again to ask him "so, can I tell people?" The doctor said "yes of course. Ana, you're pregnant. It's like any other pregnancy now". But of course for three years I was training myself not to get too excited. You're always waiting for the worst to happen, and the worst kept happening.</p><p>When it finally happened I just had the best pregnancy. I had no problems whatsoever, worked through my pregnancy, no issues at all. Emilio was super healthy and it was pretty incredible.</p>
Had you shared much of your IVF journey with the people in your life?<p>At the beginning, for my South American family it was a little bit hard to comprehend, and to go through the whole conversation of IVF. My mum was super supportive after I explained it to her and told her exactly how it worked.</p><p>I was GM and Creative Director of Oroton at the time and so hearing people blaming my job for me not having a baby was hard. People would say 'oh, you work too hard and you travel so much.' But I love what I do. So I found it quite confronting to have to defend that it was okay for me to work really hard, because I truly loved it. Sometimes I felt I was being blamed for having a passion, or that it was almost my fault that I work too much and that's why I had no baby. I thought there was a little bit of an unfair conversation, the implication that I had to slow down, that I've been too stressed. I thought 'well, no, I'm really not stressed.' Being busy is ok. And of course every now and then we all have to stop regardless anyway, but it doesn't mean that because I work really hard and I do what I love to do, that's the reason why I don't have a baby.</p>
What was the hardest part of IVF for you?<p>I think everyone describes it perfectly as an emotional roller coaster. You've gone for the big prize and you have to go into it positively, you have to have your mind completely open because no one goes into a process thinking they're going to fail. So you go through the cycle with these emotions, thinking 'this time is it, I can feel it, I can absolutely feel it.' And then the universe preps you wrong again and again and again and you start getting a little bit disheartened. And then you're dealing with the idea that maybe this is actually not going to happen.</p><p>But I think the hardest part is that phone call to tell you. You're waiting and waiting and they call you in the middle of the day, so you walk out of a meeting and then you have to come back smiling, sit back down, and no one knows exactly what you just went through. That's really hard.</p>
What was your husband’s experience like?<p>I think for you partner or husband, it's quite tough as well. My husband said to me "at the end of the day, you're the one that is putting needles in your tummy and doing all these things and all I can do is stand here and help you. But I don't want to end up without a baby and with you sick as well." So for him it was quite tough, but he was super, super supportive. He didn't let me give up, but he also never made me feel like 'we need a baby'. So I had so much support in that space that it was amazing.</p>
You thrive on your work and you're so passionate about it - did you find the shift into newborn life challenging?<p>For me, it's not necessarily about the newborn, but it's about the toddler. When Emilio was born, I had my mum, I had everyone – we actually had to create a timetable for my family to come! One sister in law, who lives in New York, came for two months, another for three weeks… so between us all it was perfect for bonding time, and perfect for me as well. I was really lucky to be able to manage that.</p><p>I went back to work when Emilio was four months, so it was quite quickly, and I had the best time! My husband took time off as well to spend time with him, and he absolutely loved that. They have an incredible relationship, and we really did share that time between my husband and I, and then my family and his family.</p><p>Because what I do is so much of who I am, it was a very seamless for me to get home and continue with Emilio, and my energy was the same. It wasn't like I was coming from a job that I hate, to be able to then find my spark and be happy with my baby. I didn't ever feel that one was taking something away from the other. And I did have incredible help and people around me that gave me that space as well.</p>
And has that continued as he’s gotten older?<p>Now, after working in corporate and doing work that was quite heavy, that's when I felt that I was missing time with him. He would be having Halloween, or something was happening at school, and I wasn't there. And it was more that he was aware that I was away, or he understood that I missed something.</p><p>So now I have that flexibility and that's why I started my own business and started to do things in a different way – so I can have that little bit more balance with him.</p>
So many women end up starting their own businesses when they become mothers because they want to create that flexibility…<p>Yes, women by nature are creators. We can create things from nothing, and it's quite empowering that we are able to do that. And I think it's very important that we change the narrative and the conversation. A day is long, there's time to do many different things and be good at all of them. You can be this <em>and</em> that. I think the more we just have it as a normal conversation, the more young people will be able to think it's just a natural thing to be able to work and have a baby.</p><p>I've been very lucky to be able to transform things and move things around a little bit to adapt. Of course, it hasn't been easy. Oh my gosh! Going from a stable job knowing this is where I go every day, to 'I'm just going to do it on my own' – that's been so, so hard. But that's just life and it's exciting!</p>
Since founding LMND and working on all these capsule collaborations, how do you find the time to fit it all in?<p>It's been quite organic for me because they're all good things and all good moments during the day. I've been able to work with incredible creative people and I'm in a very different space as a creative, because I see things more from a business point of view, and then I can adapt to a brand and understand what they need. And then working with very diverse types of consumers or different types of brands or stories – I feel that I've been able to add more value and that's where I'm at now. After 40 is an age where you just go, 'I just want to add value'. So that's been really nice.</p>
Do you think that having to wait so long to eventually get pregnant changed the way that you see everyday motherhood?<p>You do just feel so grateful to be waking up at one o'clock in the morning! You can do a four o'clock in the morning feed and all those little things that maybe you would have taken for granted otherwise – I was just so grateful to have him with me.</p><p>Of course, when you have the first one, everyone asks you when the second one is coming. But that's not for us because now, I do have a lot to lose. Now I would lose time with Emilio, because I'd be emotionally attached to this new journey trying to have another baby and I can't do that. I'm so happy and complete with him.</p>
Do you have any advice for anyone starting an IVF journey?<p>Gain perspective on your health and understand it. The call they give you to tell you that it didn't work is not the end of the world. I think you have to know that you're going through a process that, as much as it's managed by doctors, it has this natural element to it that if it's going to happen it will happen. So I think people need to almost see it with a positive heart, more than saying 'I had to do IVF' and it's all very negative.</p><p>What resonated with me when my mum spoke to me, was the idea that if you want to be a mother, there are different ways of being a mother. Your journey is your journey and is unique, and you just have to enjoy it. It's all part of your life story.</p>
Tell us about Emilio…<p>Oh, he makes me laugh every day. He just came back from camp and usually he talks a lot, like me. So I asked him, "why are you so quiet?" And he says, "mum, don't talk to me. I'm jet lagged". He was one hour away! He's hilarious.</p>
Ask any woman who has been through fertility treatments, and they will likely tell you that the hardest part is the waiting and the unknown...
Which is why any technology that can lessen that emotional load is welcomed with a huge sigh of relief. Case in point? Genea's world-leading IVF technology, which not only includes an embryo incubator (which has been proven to increase the number of high grade embryos created each cycle), but also contains time-lapse cameras, so Genea can capture photos and videos of each embryo as it develops. Sent directly to patients through the Grow by Genea app, it's a welcomed addition to many couples' fertility journey.
What have been your biggest learnings about fertility?<p>That it's never a one-way street and there are a lot of misconceptions out in the community regarding fertility. Fertility is also not just about one particular person or gamete, it's the culmination of many things such as lifestyle, health and genetics.</p>
What do you wish more women knew about fertility?<p>I definitely feel women need to be educated to be empowered regarding their fertility. Your current lifestyle and health not only impacts your gametes (eggs) but it also impacts those of your children and grandchildren. When it comes to fertility treatments like IVF, I'd like women to understand the fact that the number of eggs we retrieve does not equal the number of eggs we can freeze or the number of viable embryos.</p>
What lead you to become an embryologist?<p>I decided to take the Embryology path because I've always been fascinated by trying to understand the medicine and science relating to fertility and embryology. Knowing that my work in the lab every day is helping couples achieve their dream to become parents is the biggest thing that has driven me to be an embryologist.</p>
Can you talk us through what a day in your life looks like – what are the main tasks you work on each day?<p>My day can vary, every day is different. Some days it will be very patient facing with procedures such as egg collections and embryo transfers. Other days it's mostly spent in the lab looking after the embryos and making sure all the checks are complete for the day.</p>
Can you explain what is involved with ICSI?<p>ICSI stands for intra cytoplasmic sperm injection. It is an insemination method, usually for couples where the male partner has low sperm count, or where a straightforward IVF insemination has failed. We catch a single, normal-looking sperm to inject into each mature egg from the female partner. We do this by striking the sperm on the tail to stop it from moving, and then drawing it up into a fine injection needle and passing it into the egg to hopefully create an embryo.</p>
What is involved in embryo biopsy?<p>Embryo biopsy is a part of the pre-implantation genetic testing process for day 5 or 6 embryos. Once an embryo reaches day 5/6 it has over a hundred cells. The biopsy process itself involves safely removing 5-8 cells to run the genetic testing on. I like to call it a 'chromosomal health check' for the embryo.</p>
What is vitrification and why is it done?<p>Vitrification is the process used to freeze oocytes or embryos for later use. The embryo goes through a number of solutions for about 15 minutes to prepare it for the freeze and then it is placed in liquid nitrogen. It is an ultra-rapid process that transforms the cells into a 'glass like' state preventing ice crystal formation. By preventing ice crystal formation, we can protect the cells of the embryos to give them their best chance at survival and pregnancy later on.</p>
Talk us through the level of care that goes into patients’ embryos?<p>Patients' gamates and embryos are handled with the utmost care as we like to call ourselves the 'first babysitter'. At Genea we aim for uninterrupted culture using our Geri time lapse incubators. This means we leave the embryos undisturbed for as long as possible to give them the best chance to develop to maximise their outcome. Our staff are highly skilled and trained and are constantly participating in quality assurance schemes to ensure that we meet the requirements to handle and grade embryos. We always ensure all our equipment is tested routinely to ensure that patients' embryos can develop to their maximum potential.</p>
What interactions do you have with the patient?<p>We interact with our patients via face to face or phone conversations throughout their IVF journey. The first time we meet a patient is on the day of oocyte (egg) collection. We chat to them about our role in the procedure and how we will look after their embryos for the week. We then speak to them on day 1 and day 3 to update them on embryo development and we see them when they have an embryo transfer on day 5. I definitely enjoy interacting and passing my knowledge onto patients. It is important they have insight and understand what is happening in the lab and with their gametes.</p>
What is the most challenging part of your job?<p>The most challenging thing for me as an embryologist is delivering bad news or telling a patient that their cycle is over. No one wants to hear that their IVF journey has been unsuccessful whether it be a failed fertilisation or the news that there is nothing suitable to transfer or that we have not been able to find sperm for an insemination. Not knowing what has gone wrong for these patients is quite tricky and there is never a definite answer when it comes to science.</p>
And what is the most rewarding part of your job?<p>The most rewarding would be when a patient has had unsuccessful cycles where they have had no embryos to transfer and through our technology and scientific expertise we finally get them to a point where they can have a transfer and they end up having a baby. Giving patients the baby they have long awaited is by far the best thing about this job.</p>
Can you share a memorable experience since beginning with Genea?<p>It would have to be when a couple had a testicular sperm aspiration (TESA) to see whether we could retrieve sperm. For over five hours, it was all hands on deck with four scientists searching. We managed to inject most of the females eggs and she ended up having an embryo for transfer. She is currently pregnant and expecting a baby sometime this year.</p>
What are some of the biggest changes to the world of IVF since you began?<p>Time lapse technologies and the fact we can now assess embryos without disturbing them is one of the biggest changes. Having the footage of embryos as they develop to review and make assessments as to which ones are best to use has been amazing.</p>
Can you take us through the IVF technology developed at Genea and why it makes a difference? Why is it unique?<p>The introduction of Geri, Genea's inhouse developed time-lapse incubator has been amazing. As our Scientific Director says, it's closer than ever before to mimicking the undisturbed natural environment of a woman's body – where a human embryo would normally grow. The Geri incubation system has seen an increase of 46.7% in the number of high grade embryos per cycle when compared to the tradition incubator and culture medium system*, as well as a 24.3% increase in the number of pregnancies when compared to the traditional incubator and culture medium system**. In Geri, each patient has their own individually controlled incubation chamber with a time lapse camera to allow scientists to continuously monitor embryos without disturbing them. Giving patients access to these images and videos of their growing embryos has made a big difference to them. Grow by Genea is the only app of its kind in Australia, giving patients the chance to see and share these images during the five days they spend growing in an incubator in the embryology lab. <a href="https://www.genea.com.au/GEN/media/Genea/PDF/Genea-Grow-by-Genea-brochure.pdf" target="_blank">Grow by Genea™ </a>allows many patients to feel more connected and involved in the process. 94% of patients agree Grow by Genea™ improved their IVF experience***.</p>
How important is team work?<p>Team work is crucial to the day to day running of any business and by far the Embryology team at Genea is one of the best teams I have worked with. We work like a set of gears and we are always there for one another when we need assistance. When the team is effective and efficient we all work towards our ultimate goal: our patients.</p><p><em>Go to <a href="https://www.genea.com.au/" target="_blank">www.genea.com.au</a></em></p><p><em>* When compared to the traditional incubator and culture medium system. Study performed at Genea's flagship Kent Street, Sydney CBD laboratory. Data presented at Fertility Society of Australia Conference, October 2017. Adelaide.</em><br><em> ** Foetal heart pregnancies. Study performed in Genea's Canberra laboratory, 2015-2018.</em><br><em> *** Based on responses to Grow patient survey between May – October 2017 (91 patients). Data presented at Fertility Society of Australia Conference, October 2017. Adelaide.</em></p>
"I think the hardest part is actually making the initial appointment to see a Fertility Specialist. The whole fertility/IVF pathway can seem quite daunting until you actually realise that we will support you the whole way through the journey." If there were any words to hear before embarking on IVF, these are it...
Comfort and reassurance from Fertility Specialist Dr Rachael Rodgers from Genea, who has simplified and explained in detail how the entire IVF process works and what you can expect when you make your first appointment with a fertility doctor.
Can you explain IVF?<p>IVF stands for in vitro fertilization. It refers to any procedure in which we fertilize an egg outside of the body, with the later transfer of an embryo back into the uterus. In IVF, we stimulate the woman to encourage her body to produce as many eggs as possible before collecting them in a short procedure in day surgery. Once we've collected the eggs and then the sperm from the man, we bring them together in a dish in our lab and then develop the resulting embryos in our world-leading incubation system, Geri.</p><p>The right time to consider IVF is different depending on each individual's situation. I generally encourage couples to come and see me after a few months of unsuccessfully trying to conceive. This allows me to do a full fertility workup to make sure that there is no obvious reason that a couple would have difficulty conceiving. For example, I always check that the fallopian tubes are unblocked, that a woman is ovulating regularly and that there is an adequate amount of sperm in the male partner's semen analysis. If there is a problem with any of these factors, conceiving naturally would be difficult (or impossible in some situations) so medical treatment – which may or may not involve IVF – would be immediately indicated.</p><p>If there is no problem found, it might just be that the couple needs to try naturally for a little longer. They may also want to enrol in Genea's ovulation tracking program, so they can track three menstrual cycles for free to find out exactly when the woman is ovulating so the couple can ensure that they are having intercourse at the right time in order to conceive. It's important to note that only 50% of patients who see a Genea Fertility Specialist actually need IVF to get pregnant.</p><p>An early fertility assessment means that couples aren't going to waste time trying to conceive when the likelihood of natural conception is very low. If all the results are acceptable then, as a general rule, I would suggest couples under 35 years of age try to conceive for 12 months, and couples over the age of 35 years trying to conceive for six months before we start talking about interventions.</p>
Take us through the stages/steps of IVF at Genea?<p>The first step is always to see a <a href="https://www.genea.com.au/specialists" target="_blank">Genea Fertility Specialist</a> for a full fertility assessment of both partners. If the decision is made to proceed with IVF, your <a href="https://www.genea.com.au/specialists" target="_blank">Fertility Specialist</a> will write a personalised treatment plan which is sent through to your Nursing Team at Genea. A Genea treatment co-ordinator will then be in contact to arrange an appointment so the couple can meet their nurse and see one of our specialist Fertility Counsellors.</p><p>The actual IVF cycle involves the woman having a series of fertility medication injections, with monitoring of blood tests and ultrasounds over a period of approximately 10 days. Once the woman's follicles have reached the right size and number, her nurse will instruct her to have the trigger injection. Two days after the trigger injection, the woman will come into our day surgery for a short egg collection procedure. The male partner provides a sperm sample on the same day. We then combine the eggs with the sperm in the lab before developing any resulting embryos in an undisturbed environment in our unique incubators called Geri. These incubators are installed with time-lapse cameras, allowing our patients to see photos and short videos of their developing embryos through the <a href="https://www.genea.com.au/blog/october-2017/grow-app-imaging-technology-to-patients" target="_blank">Grow by Genea™ app</a>. After five or six days of development, the embryos are ready to be implanted into the uterus and then we wait two weeks before sending the woman for a pregnancy test.</p>
What stage do women typically find to be the most challenging and how do you help them through this stage?<p>I always allow a full hour for the initial appointment, as it not only allows me to take a detailed medical history from both partners, it also provides time for the couple to ask all questions they need to and for us to discuss any hesitations or concerns they have regarding the fertility treatment process.</p><p>Many women are initially apprehensive about having daily injections, but most of our hormone injections can be given by an injecting pen (a bit like the injecting pens that people with diabetes use). Often patients tell me that the injections were not nearly as bad as they thought they would be.</p><p>Other people find that the most challenging time is the five days in which their embryos grow in the lab as they are no longer playing an active role and instead simply have to wait. <a href="https://www.genea.com.au/blog/october-2017/grow-app-imaging-technology-to-patients" target="_blank">The Grow app</a> helps with this time, as it gives our patients a greater connection and understanding of what's happening with their precious embryos in the lab.</p><p>The other really challenging period for patients is what's known as the 'Two Week Wait'. That's after all of the treatment has taken place and the patients are waiting until it's the right time to do a pregnancy test. I encourage my patients to focus on themselves during this period, to spend time doing things that they enjoy and find relaxing, rather than constantly worrying about the pregnancy test result.</p>
What is the typical success rate of IVF?<p>This is a question that I frequently get asked and can be very difficult to answer. A couple's chance of having successful fertility treatment largely depends on the age of the female partner and the reason they are having difficulty conceiving. The likelihood of success for one couple may be very different to the likelihood of success for another couple. I can provide general statistics such as that at Genea, women under the age of 30 years have a 45.8% chance of having a baby per embryo transfer, and that many couples only require one IVF cycle to generate all the embryos they require to have their whole family, but couples want to know their individual likelihood of success and for me to provide this I need to do a full assessment first.</p><p>Rather than focusing on exact figures, the aim I have when caring for a couple is to do everything medically possible to maximise their individual chances of having a healthy child. There are numerous components to this – taking a detailed history, fully investigating all the possible causes of a couple's difficulty conceiving, and making sure I have the best possible IVF lab to back me up, as chances of success can differ significantly depending on the quality of the lab. Genea is well known as a world leader in fertility treatment, having developed the Geri incubators with time-lapse photography which mean we don't have to disturb (and potentially damage) embryos by taking them out of the incubator each day to check their development.</p>
What should you expect out of the IVF process?<p>You should expect that we will do everything medically possible to optimise your chances of having a healthy child. You can be assured that we will support you throughout the process and treat you in a respectful and compassionate manner.</p>
Are there any other risks to know about?<p>There is a degree of risk with every medical treatment. Usually the risks associated with fertility treatment are very low, however, I discuss the specific risks with every couple to ensure they completely understand the treatment they're about to undertake.</p>
Is there anything important for men to do in preparation for IVF?<p>The saying "it takes two to tango" is very true when it comes to both natural conception and IVF. The health of the male partner is very important. Difficulty conceiving can be due to either men or women (or both) having problems. Both men and women should try to optimise their health prior to attempts to conceive. Basic steps such as ensuring they are a healthy weight, they eat a balanced diet with lots of fresh fruit and vegetables, they don't drink excessive alcohol and they don't smoke are important.</p>
Why is age such an important factor in IVF? Do you imagine there will be other options for women beyond IVF in the future?<p>Age is a big issue for fertility. Women are born with all of the eggs they will ever have and those eggs decrease in both quantity and quality as the woman gets older. Sadly, we can't yet overcome the damage that ageing causes to eggs. The age of the male partner is also important although it is much easier to achieve a pregnancy in which the male partner is older than for couples in which the female partner is older.</p><p>There have been many attempts worldwide to overcome the impact of older female age on egg quality, but unfortunately, none of these attempts have been successful. I'm not convinced that we will ever overcome age as being a significant factor, that's why women who want to defer pregnancy until later in life should seriously consider freezing eggs whilst they are in their twenties or thirties. When we freeze eggs for a woman, the eggs are effectively 'frozen in time', they don't continue to age whilst frozen.</p>
Where is IVF research headed?<p>One of the reasons I love working as a Fertility Specialist is that our knowledge regarding fertility and how to effectively treat infertility is constantly evolving. Genea has always been committed to research, with a whole division of the company (Genea Biomedx) dedicated to constantly improving our patient outcomes at our clinics here in Australia and across the globe.</p><p>I've been actively involved in research for several years. I'm currently halfway through a PhD at the University of NSW where I'm using a hormonal treatment to try and protect the ovaries from damage during chemotherapy.</p>
‘He asked me what it was I really wanted. “To be a mother” I said’ – How Marnie Goss Learned No Two Roads To Motherhood Are The Same
Marnie Goss had only been with her partner for six months when she felt the need to have 'the talk'. Her biological clock was ticking, and she knew that her time to fulfil her dream of becoming a mother was limited. She had no idea that that conversation was about to take her on a journey that would last years…
With a PCOS diagnosis complicating things, Marnie was advised to start IVF. "I remember the first night that I took the medication", she recalls. "I sat on the bathroom floor for what felt like hours, trying to pluck up the courage to put those needles into my stomach. While Scott sat out in the loungeroom watching the news, unaware of what I was going through, I finally found my courage and put the needles in while the tears rolled down my cheeks. I am not sure why I cried that night but it was the first of many tears I shed on our journey."
One thing that I have learned over the years is that no two roads to motherhood are the same...<p>Some have accidents and fall pregnant without even trying or wanting the baby, while others make the decision to try for a family and fall pregnant relatively easily on their own. There are others who take years and years filled with doctor's appointments, miscarriages, blood tests, scans, needles, medication, vitamins, acupuncture, herbs and many, many tears. And then there are the women who experience the most heartbreaking and gut wrenching journey of them all. The journey where despite all of their best efforts and intentions, they fail to ever fall pregnant.</p><p>My journey to motherhood started a little later than most. While my friends were settling down and having babies, I spent my twenties living abroad and travelling the world, and my early thirties focused on my business. I always knew that I wanted to be a mother one day, but I always thought that I had time. It never occurred to me that falling pregnant was going to be difficult and may not be an option. When I think back to those days, I shake my head at how naïve I was.</p><p>I dated a lot of lovely guys during those years (some not so lovely) but there was never anyone I could see a future with or could imagine having children with. It wasn't until I met Scott one Sunday morning, at a friend's birthday celebrations, that things changed for me. We got off to a slow start but the more time I spent with this kind and gentle soul who always made me laugh, I knew he was the one for me. The more time I spent with Scott, the louder the clock started ticking in my ear. Given my age, I knew we would need to act soon if children were in our future – but how do you tell someone you have only been dating for 6 months that you need to start thinking about children? He would either run for the hills or he would join the conversation. Thankfully, my kind and gentle soul joined the conversation. I had been told years earlier that due to PCOS, my only chance of having children would be through IVF. So whilst Scott wasn't quite ready for children, he agreed to undergo a round of IVF to freeze embryos for when he was ready.</p>
The Grace Tales is a global lifestyle platform for mothers searching for style, substance, and solidarity. Driven by creating content, community and connection, we celebrate the paradox of modern motherhood; the struggle and the beauty, the joy and the relentlessness.
Alexandra Kimball is changing the conversation surrounding infertility with her new book, The Seed: Infertility is a Feminist Issue...
As a pro-choice feminist who has endured a history of miscarriages and infertility, Kimball discovered that femininity had a long way to go in accepting and supporting the notion of work that goes into conceiving, gestating and birthing babies not the in the "natural" form.
Why is infertility such a marginal and misunderstood issue within mainstream feminist discourse?<p>It's a complicated answer, but the first point is feminism's longstanding critique of the motherhood mandate (the idea that women are culturally pressured to become mothers). Challenging the motherhood mandate was a big part of feminist work to make birth control and abortion safe, legal, and accessible. An issue here is feminism has been largely white and middle class, and thus erasing the concerns of women of colour and poor women, many of whom faced barriers to pregnancy and motherhood and wanted access to those experiences as much as they wanted birth control and/or abortion. Supporting women who want to be mothers but can't was a raced and classed issue in feminism as much as it was about fertility (and infertility affects some groups of women of colour more than white women).</p><p>A second piece is the feminist critique of reproductive technology. Most infertile women who want to have babies want access to reproductive technology like IVF, which put them at odds with feminists who understood this technology as a male incursion into women's bodies. There's a lot of feminist criticism still about the patriarchal nature of reproductive technology, but virtually nothing about what they think infertile women should actually do if access to these technologies were restricted. Though some come right out and say "your grief over your infertility is patriarchal conditioning, learn to get over it."</p><p>All of this has deeper roots in the idea — which is bog-standard misogyny — that women are passive vessels for pregnancy. That we're impregnable, that we sort of have pregnancy just happen to us instead of striving for it and making conscious decisions towards it, which is what all infertile women have to do. Mainstream feminists have deconstructed this partway with regard to birth control and abortion but never got there with infertility, because (I think) it would mean having to go beyond this black-and-white thinking around reproductive technology and desire for motherhood.</p>
You explored what the silence around infertility in feminism tells us about how we understand motherhood - what did you find?<p>Motherhood isn't an identity — it's a practice, it's work. An ongoing theme in feminism is about validating the invisible labour of women, things like housework and pregnancy and childcare and emotional labour, but when it comes to infertility, in which we are working to conceive, there is still this stigma and invisibility that feminism hasn't really challenged. What does it mean that we, as a nominally feminist society, validate the work of pregnancy and caring for one's child, but not conception? It's a very powerful example of how we understand motherhood, still, as something that just happens to women, that motherhood is an inevitable and essential part of femininity. I don't think we're ever going to truly understand the "work" of motherhood unless we include conception in that conversation.</p>
You’ve said infertility was a very isolating and difficult experience for you - what can you share about that time in your life and how you got through it?<p>I think being very open about what I was going through with everyone—even people who found it uncomfortable—helped me resist completely socially isolating as much as I could. I decided early on that no matter what happened, I was not going to contribute to the stigma around infertility or pregnancy loss, and that helped me maintain some dignity through a very debasing process. I'm also lucky to be in a great partnership and my partner and I were constantly communicating about what was going on.</p><p>The most important thing I think I did though, is read the stories of other people who had faced challenges in starting families. Not just infertile women, but gay and lesbian couples who need to use technology, single people, and people who had decided to move on from treatment and be childfree. There are so many when you look for them, and all made me feel not only a little less alone but part of a community of pretty wonderful, strong people. I'm still grateful for everyone who shared their story, because I think this sharing is the most healing thing.</p>
Despite the occasional insensitive "he just looked at me and I fell pregnant" comment and also what you might see on various Instagram feeds, fertility is rarely a straight-forward journey for many women...
And it has been anything but straightforward for nutrition and wellness advisor and founder of Krumbled Foods Keira Rumble, who has inspired women all over the world with her honesty and openness. Over the past five years, she has experienced four pregnancy losses.