The Whole Pineapple

Change is hard, especially when they involve endings of things we're sad to see go. And we're definitely sad to see The Whole Pineapple go.  In this very special, final (for now?) episode, Ruby, Anne, Jamie, and podcast producer Shannon Perry reflect on how difficult it can be to say goodbye. But as A.A. Milne says in the voice of Winnie the Pooh, “How lucky I am to have something that makes saying goodbye so hard.” Given how hard this is, we've clearly been very lucky indeed. Then stay tuned for Jamie's meditation on letting go so you can move forward. This podcast has been a labor of love, and there has been a lot of joy in talking with amazing guests, hearing from listeners how much you've gotten from the episodes, and diving deeper into how fertility appears in research, books, and even popular culture. We hope The Whole Pineapple has helped listeners learn more about the fertility journey and the options that exist for those who are having challenges building their families. But we also hope it's helped open the discussion — the stigma that still exists around infertility, and the reluctance many of us feel when talking about bodies and reproduction can make it tough to talk. But these are necessary conversations, and sharing podcasts like The Whole Pineapple can be a gentle way to introduce the topic. Finally, we have to say “thank you.” Thank you for listening and supporting this podcast. Thank you for sharing episodes and the things you've learned. Thank you for coming with us on this journey. Please know that the episodes will continue to be available, and our email, thewholepineapple@gmail.com is still live, if you have comments or questions. We love and appreciate you. Have a delicious week. Resources:  Kahlil Gibran: On Joy and Sorrow Find Jamie Mammenga on her website, Sound Perinatal and Fertility Counseling, PLLC: www.soundcounseling.org Audiotocracy Podcast Production: audiotocracy.com

Sorry, folks, it's official: it's the end of sex.* Henry “Hank” Greely, Professor by courtesy of Genetics at Stanford School of Medicine, Deane F. and Kate Edelman Johnson Professor of Law, and Director of the Center for Law and the Biosciences, is very interested in how new biomedical technologies impact assisted reproduction. He's authored two books: The End of Sex and the Future of Human Reproduction in 2016, and CRISPR People: The Science and Ethics of Editing Humans, which published in 2021, and is Chair of the Steering Committee of the Center for Biomedical Ethics, among other impressive mouthfuls. In this episode, Ruby, Anne, and Hank dive into the changes that are already happening in human reproduction — and the possible changes to come. In addition to the scientific challenges, what are the ethical and legal questions we'll need to tackle as the landscape changes? Many of us became aware of genetic questions with Dolly the cloned sheep and the controversy over stem cells and how they might be used to repair damaged bodies. But Hank took the question even further, asking, What happens when we can make eggs and sperm from skin cells? Does that signal the end of human reproduction as we know it? Hank can pinpoint the origin of his curiosity to October 19, 2010 in Muenster, Germany — a conference talk on how induced pluripotent stem cells (iPscs) could be used to make other cells, including, the speaker said off-handedly, sperm and eggs. Wait, what? Science fiction? Maybe not. If you're curious about the possible future of fertility (and sex), this is the episode for you. Be sure to check out the book as well. There's not only theory about what the future could hold but also a well-researched history of how we've gotten here  As always, please rate and review, and most of all, share the episode and show with anyone you think could benefit.  *Spoiler: New technologies might mean the end of sex for reproduction and the start of sex purely for pleasure. So the news isn't bad after all.  Learn more about Hank Greely on the Stanford Law School Directory: https://law.stanford.edu/directory/henry-t-greely/ Find more episodes from Ruby and Anne at https://thewholepineapple.com.   Resources mentioned: Purchase the book from the Harvard University Press: https://www.hup.harvard.edu/catalog.php?isbn=9780674984011 Episode 29: My Embryos are Mosaic? https://thewholepineapple.com/episode-29-my-embryos-are-mosaic-interpreting-your-pgt-results/  

Fertility preservation for those undergoing gender-affirming transition is an important area of reproductive medicine. In this episode, Anne and Ruby are talking with Dr. Lynn Davis about how fertility options may be dependent on age, the gametes involved (i.e. sperm or eggs) and the stage of gender-affirming care.  Dr. Davis started her educational journey with a double major in Biology and Psychology from the University of Virginia, followed by her MD from the University of Colorado and OB/GYN residency from Harvard. She concluded her training with her REI Fellowship at Stanford University, where she also completed a postdoctoral Fellowship at the Stanford Agency for Healthcare Research & Quality, and served as Clinical Instructor in the Department of OB/GYN. Dr. Davis developed and now leads SRM's Fertility Preservation Program, a specialized approach that assists those who need assisted reproductive technology to efficiently delay family building. Sometimes it's a question of timing. For example, those born with testicles do not begin producing sperm until puberty (a process known as spermatogenesis). So if an individual with testes chooses to go on gender-affirming puberty blockers, they may not yet produce sperm. While puberty blockers can prevent bodies from undergoing unwanted physical changes (development of facial hair, lower voice, etc.), it may also mean little or no sperm to freeze for fertility preservation.  For those who have undergone natal puberty, it is possible to interrupt gender-affirming hormones in an attempt to resume spermatogenesis and freeze sperm for later use. However, there is a chance the process may not result in viable sperm. The experience coming off gender-affirming hormones also needs to be considered; for some, it can be a distressing, dysphoric experience.  Options for those with ovaries are also dependent on puberty and stage of gender-affirming treatment. Dr. Davis discusses the options for ovary stimulation, egg retrieval, ovarian tissue cryopreservation, and all the nuanced considerations along the way. Be sure to tune in for this important and fascinating conversation.   You can learn more about Dr. Lynn Davis and reproductive endocrinology at www.seattlefertility.com.  You can also find Anne and Ruby there. Hear more episodes of The Whole Pineapple at thewholepineapple.com.

A diagnosis of cancer or other serious condition is bad enough — dealing with tests, treatments, insurance, uncertainty, as well as the illness — but knowing that the condition or its treatments can also cause infertility…. It just feels so horribly unfair. The good news is for many, that diagnosis doesn't have to equal the end of fertility. The landscape for patients has changed. In this episode, Ruby and Anne talk with fellow Seattle Reproductive Medicine provider and reproductive endocrinologist Dr. Lynn Davis about options for preserving fertility. Dr. Davis started her educational journey with a double major in Biology and Psychology from the University of Virginia, followed by her MD from the University of Colorado and OB/GYN residency from Harvard. She concluded her training with her REI Fellowship at Stanford University, where she also completed a postdoctoral Fellowship at the Stanford Agency for Healthcare Research & Quality, and served as Clinical Instructor in the Department of OB/GYN. Dr. Davis developed and now leads SRM's Fertility Preservation Program, a specialized approach that assists those who need assisted reproductive technology to efficiently delay family building. So, what are some of the options? Gamete freezing — sperm, eggs, maybe even embryos — may provide additional options for post-treatment family building. If the patient is pre-menarchal (hasn't had their first period), then stimulating the ovaries to freeze eggs is not possible, but ovarian tissue freezing may allow options for future fertility and hormone function. The best option for anyone in this position is to talk with your care team and a fertility expert to learn what the possibilities are for you. As ever, please do share this episode with anyone you know who might need both the knowledge and the hope this conversation brings! You can learn more about Dr. Lynn Davis and reproductive endocrinology at www.seattlefertility.com.  You can also find Anne and Ruby there. Hear more episodes of The Whole Pineapple at thewholepineapple.com.

The Whole Pineapple welcomes back Dr. Lee Hullender Rubin, specialist in acupuncture and integrative East Asian Medicine, this time to talk about herbs and East Asian medicine in general. While acupuncture may be the most well-known, East Asian medicine incorporates many different modalities of treatment. So let's talk integrative medicine.  As Dr. Lee says, “integrative” means that many different treatments and providers come together to collaborate and support patients. In the US, we don't always reach this goal, as Western medicine has traditionally been less open to collaboration, but with more providers welcoming alternative therapies and more patients advocating for holistic wellness care, it's getting better! That said, because the herbal industry isn't regulated the same way prescription medication is, you'll want to be as informed as possible before you start adding things to your treatment plan. Some things to expect: Your provider will likely ask you to get your labs done before starting treatment. This is so they can understand how your body functions at baseline. You'll probably answer a lot of questions. Again, your provider needs to know a lot about you — sleep, stress, diet, goals, etc. — before designing your treatment plan. There will likely be continued tweaking of your plan. These formulae can be complicated, so it takes some time to get things just right. Then as your body and/or circumstances change, more tweaking may be necessary. You should keep your entire care team apprised of all the changes you're making and any new treatments (including herbs!) that are added or removed from your program.  There's so much to learn in this episode, and you may want to have some of this information handy when you talk with your care team, so be sure to bookmark or favorite the episode! And as always, please share with anyone else who could benefit.  Learn more about Dr. Lee and schedule an appointment at Rosefinch Health at rosefinchhealth.com Learn more and hear more from The Whole Pineapple at thewholepineapple.com. 

Dr. Lee Hullender Rubin wants you to understand acupuncture and how it can aid all kinds of issues, including infertility.  The founder of Rosefinch Health, Dr. Lee is an award-winning doctor of acupuncture and a leader in the field of integrative reproductive medicine. She blends compassionate care with over two decades of clinical experience specializing in fertility, IVF support, pelvic and vulvovaginal pain, and cancer-related support. She is also a teacher and researcher in acupuncture and integrative East Asian medicine and founded Rosefinch Academy to help other providers learn more.  But about that “being poked with needles” thing: In unskilled hands… well, just don't be in unskilled hands. Acupuncture can seem random to the unfamiliar, but it's a highly specific process developed, literally, over thousands of years.  If you've avoided acupuncture because you're needle-phobic, here's a big tip: acupuncture, in the right hands, doesn't and shouldn't hurt. In skilled hands, you won't feel the needle going in, only the results.  So, here are a couple of tips for assessing an acupuncture provider: Ask to see their license for your state or look them up on your state's medical board.  Your specialist will perform an assessment of you involving lots of questions. You should do the same. Ask about their training and experience until you're confident about their professionalism. Your acupuncturist is part of your care team. Make sure this provider is complementary to and cooperative with the rest of your care.  Your acupuncturist should understand your goals and have experience dealing with fertility issues, so ask about their work in fertility in particular. Check with aborm.org (aborm.org) but realize not everyone who is qualified has taken this optional test. Ask: if this isn't the cycle for me, how will you support me? What can acupuncture do for you? At the very minimum, acupuncture can help you feel more relaxed and have better energy. And that can be super-helpful at a difficult time. Acupuncture may increase your chances of a clinical pregnancy or live birth. Acupuncture can relieve stress and help you sleep better. Acupuncture may help your body ovulate more consistently.  Acupuncture may help control blood sugar levels. This is just the tip of the iceberg of this conversation among Ruby, Anne, and Dr. Lee, so be sure to listen to hear all the science behind acupuncture. This ancient treatment method has so much to offer us here in the present! Learn more about Dr. Lee and schedule an appointment at Rosefinch Health at rosefinchhealth.com And as always, learn more and hear more from The Whole Pineapple at thewholepineapple.com.   The Acupuncture and TCM Board of Reproductive Medicine (ABORM): aborm.org

Note: This episode contains news on the future of The Whole Pineapple podcast, so be sure to tune in! There's a difference between “letting go” and “giving up,” right?  Giving up is relinquishing control; letting go is making the decision that this path isn't serving you right now and it's time to make a change. But even if letting go is your decision, it isn't necessarily easy or painless. In this very special snack, Ruby joins Anne and Jamie to talk about balloons and balls and dandelions and whirligigs in a way that we promise will make sense when you hear it. And they remind us that letting go of something that isn't working leaves a hand free to take hold of something else. And of course, the discussion is followed by Jamie's gorgeous voice giving us the peace to let go, even if just for this moment. As ever, find more meditations and more information at thewholepineapple.com, and find more from Jamie at soundcounseling.org.

For women athletes, it can sometimes feel like the playing field is so tilted, they're constantly running uphill to reach their goals. (Seriously, could this analogy BE any better?) There's been progress, say our guests for this episode, OL Reign players Lu Barnes and Nikki Stanton, but parity is still a long ways off. The way women are (mis)treated in sports is a microcosm for the way women are often treated generally. So even for the non-sporty among us, the stories Lu, Nikki, Ruby, and Anne share will probably feel familiar – and the life lessons to be gained relate to us all! In this episode, we hear the realities of being an athlete in a female body: not just the realities of dealing with a cycle or having a more limited window for having a family, but also the cultural limitations (just wait until you hear Nikki's story about the “shared” ice/hot baths in Chicago, oooof). The biggest battles often aren't against an opposing team. Players in women's sports generally make considerably less money than their male counterparts, they may not get the sponsorship offers men get, and their access to the best resources in terms of arenas, gear, coaches, medical support, health insurance, etc., is much more limited, generally. It's important to understand how the barriers and inequities impact performance on the field; when you have to work year-round to pay the bills, you simply don't get the time to recover. This episode is rich in great advice from players who've been around a while — how to stand up for yourself, how to have a life outside soccer, how to forge ahead while still protecting your health mentally, emotionally, and physically. It's time to take gender out of the equation when it comes to paying ALL people fairly and treating people fairly, and we thank women athletes for helping bring attention to this issue! Learn more about Lu and Nikki and the OL Reign:  olreign.com  Nikki Stanton bio Lu Barnes bio Hear more from Ruby and Anne and listen to all the episodes of The Whole Pineapple at thewholepineapple.com.

If, unlike Anne, you're not already a season ticket holder for the OL Reign, and you do live in the Seattle area, maybe consider grabbing your seats now. Like most women's sports, tickets are less expensive than the men's and certainly less than they're worth! In this episode, we hear from OL Reign players Lu Barnes and Nikki Stanton on the joys and challenges of being a professional athlete. This episode came about because Seattle Reproductive Medicine is the OL Reign's official fertility partner, providing education, fertility advice and care to preserve fertility options. Chances are, if you're listening to this podcast, you know why it's important for players to have a fertility partner, but if you don't, for women, peak fertility years often coincide with peak athletic years. Options such as egg freezing can extend a female athlete's career by enabling her to postpone family building. So what are the challenges of being an athlete in possession of a uterus? (And heads up – these issues often affect the careers of any professional, not just athletes!) Depending on her cycle, there are times when women's bodies are more injury prone. Uniforms often don't take into account the realities of women's bodies — white shorts, y'all? Really?? Unlike for men, a woman's sports career usually has to at least pause for becoming a parent. Double standards exist. And they generally suck for women. Society often “expects” women to simply quit their sports careers in favor of family. Men have never EVER had to deal with “the period lady.” Just like the fathers, mothers would like their kids to be able to see them play and to provide that same inspiration. And this isn't a fantasy that biology makes impossible; more research, more investment, more conversation on the subject has already resulted in improvement — there's no reason to assume the status quo is “good enough.” Nikki and Lu are brilliant on and off the field, so once you've listened to this awesome conversation, check out their bios at the OL Reign: Nikki Stanton bio and Lu Barnes bio, and then buy those tickets! Get Tickets HERE! And as always, help us end the stigma around infertility and bodies with uteruses and vaginas by sharing this and other episodes. You'll find all the episodes at thewholepineapple.com.

First, we'd like to apologize for the joke that starts this episode. This is what happens when good vegetables go bad…. ;) In this delicious snack, Ruby and Anne are chatting with Judy Simon and Angela Thyer about their new book, Getting to Baby: A Food-First Fertility Plan to Improve Your Odds and Shorten Your Time to Pregnancy. If you are considering starting or building your family, it's great for everyone involved to get in their best possible health, whether you'll be carrying the child or not! And this plan can help everyone attain optimal health. Get your answers to: What is a “food-first approach” to fertility, and does it actually help? How do nutrition and lifestyle affect fertility? Is nutrition a one-size-fits-all? (spoiler alert: no.) Should I focus more on plants? (spoiler alert: probably) Are you all about weight loss? (nope) And so much more.  One thing we love about this plan is that it focuses on making progress, not on being perfect. And there's no shame here: nutrition can be challenging, especially when life is busy. But the great thing is even small improvements can yield great, noticeable benefits.  Cooking and eating well don't have to be stressful, and that's what this book is all about. Let Angela, Judy, and your own body guide you to explore new foods and reach your health goals! As always, we hope you'll share this episode with anyone who could benefit! More about our guests: Angela Thyer, MD, is a reproductive endocrinologist and infertility specialist and one of the founding partners at Seattle Reproductive Medicine. She is triple-board-certified in reproductive endocrinology, infertility, obstetrics, and gynecology, and lifestyle medicine, and her special interests include polycystic ovary syndrome (PCOS), nutrition and fertility, lifestyle medicine, and reproductive aging.  Judy Simon, RDN, is a registered dietitian nutritionist who specializes in reproductive health. She is the founder of Mind Body Nutrition, LLC, clinical instructor, and staff dietitian at the University of Washington. Judy has held leadership roles in the American Society of Reproductive Medicine Nutritional Special Interest Group, and is a Fellow of the Academy of Nutrition and Dietetics. Resources: Book website: gettingtobabybook.com Judy's website: mind-body-nutrition.com  Instagram: @fertilenutrition Order on Amazon Judy's previous full episode: Disordered Eating & Fertility  Snack: Health & Fertility at Every Size  Find more from Anne and Ruby at thewholepineapple.com.   

OK, we knew the human gut had one of these, but the vagina too? What's actually going on in there? Microbiomes are incredibly diverse ecosystems: we are more bacteria than we are human. Yep. Read that again — there are more bacteria in us than human cells. You, my friend, are a moving, breathing microcosm that is incredibly cooperative when you're healthy. Don't panic. Katy Bradbury is back to explain what all this means and how we can use this knowledge to be healthier. Things to know: A healthy gut is NOT free from bacteria. We need the friendly bacteria to survive. Yes, it's a bit icky to think about, but it's important.  “Bad” bacteria is opportunistic, like weeds in a garden, says Katy. You need to keep your “good bacteria” healthy and plentiful so the bad can't get a foothold. We want a diversity of good bacteria in both the gut and the vagina, but these are not the same critters. Lactobacilli are best for the vagina, so knowing how to protect lactobacilli by keeping the vaginal environment at the right pH is a good thing. This is important for fertility but also for avoiding infections like yeast infections and UTIs, so care is a life-long need. Douching and using other “cleaning products” is NOT vaginal care unless you have a specific medical reason. These products disrupt the natural vaginal pH and aren't necessary for this self-cleaning organ. There's so much good information in this episode, so please give it a listen and share with others. While it may be difficult to overcome the traditional shame around our bodies, this shame is, frankly, not helpful. Sharing information and talking openly are the best way to erase the shame and be healthier. Ready to learn more? Listen up! More about Katy Bradbury: Katy is founding member of the Fertility Nutrition Centre, a clinical advisor at Fab Fertile, a content provider for women's health platform Xena, and a clinical supervisor for nutritional therapy students at the University of West London. You can find her at Katy Bradbury.com. Be sure to check out the robust back catalog of episodes from her podcast Fertility and the First 1000 Days: katybradbury.com/podcast To hear more from Anne and Ruby, find all their episodes at thewholepineapple.com.

Scheduling to record with this guest was a bit of a journey of its own, but the end result was totally worth it!  Registered Nurse, nutritional therapist, and former fertility patient Katy Bradbury understands the fertility journey as thoroughly as anyone can. But her own difficult experience had a genuine bright side: it led her into her career in fertility-centered nutrition. As nutrition often isn't included in fertility advice or treatment in many places (looking at YOU, USA), this episode can be particularly useful for those who want to optimize their health and physical condition to support a healthy pregnancy. Fertility treatment in the UK is, as Katy says, a bit of a “postcode lottery” meaning that where you live can determine the level of treatment you receive, and there's not a national level of service. Some people may wait a year or longer to start, which can be really tough when age is such a factor. Fortunately, improving nutrition can start (and ideally should start) well in advance of that first round of IVF or before treatment begins.  Here are some tips to keep in mind! Those first 1000 days — conception to age 2 — are so important to a child's development and health. It's best to work with all partners to fully understand the issues and be proactive about health and nutrition. Get ready to work on your gut! Gut health is so important and often so ignored. “Bespoke” nutritional guidance is best: bodies, lifestyles, tastes, etc. are all different. A fertility nutritionist can help you learn the foods that work best for you.  Ready to learn more? Listen up! More about Katy Bradbury: Katy is founding member of the Fertility Nutrition Centre, a clinical advisor at Fab Fertile, a content provider for women's health platform Xena, and a clinical supervisor for nutritional therapy students at the University of West London. You can find her at Katy Bradbury.com and be sure to check out the robust back catalog of episodes from her podcast Fertility and the First 1000 Days. To hear more from Anne and Ruby, find all their episodes at thewholepineapple.com. Resources: Fertility Nutrition Centre: fertilitynutritioncentre.org Xena: xena.life Katy's website: katybradbury.com Fertility and the First 1000 Days podcast: katybradbury.com/podcast

As anyone born with a uterus will tell you, living in a body equipped with one of these and all that goes with it comes with a special set of challenges. And many of us don't really know all we need to know, so think of this episode as a sort of Owner's Manual. So what do we need to know through the decades of our life? TEEN YEARS: Irregular periods are normal, but if they're super problematic or painful, a discussion with your primary care provider or a gynecologist might be in order. Time to start screening for sexually transmitted diseases if you're sexually active. TWENTIES: Is it time to consider protecting your future fertility? This is prime time for fertility, but if you're not ready yet, it might be good to at least consider what's ahead. THIRTIES: Do you know how large of a family you want? As you get into your mid- and late-30s, fertility can be more challenging — definitely know your options! FORTIES: Celebrities having babies in their 40s should not convince you that you have plenty of time, especially if you're wanting to use your own eggs to conceive. “Time is eggs!” as Anne says. HINT: talk to a menopause specialist at this point – perimenopause is a critical stage of life for protecting your future health! FIFTIES: Pregnancy is still possible, but celebrities at this age are most likely using frozen eggs or donor eggs.  SIXTIES: Pregnancy is probably not a concern, but STIs are, so protect yourself! Obviously, this is just a hint of what Ruby and Anne have to share at each stage, so make sure to listen and share! And find more from our hosts at thewholepineapple.com.

Ectopic pregnancies may be rare, but given how devastating and dangerous they can be, taking steps to prevent them is never a bad idea! For those worried about ectopic pregnancies, remember they generally amount to only 1-2 percent of pregnancies. For those who have had an ectopic pregnancy, that number may go up to 10 percent, but it's still unlikely. That said, it's understandable that those seeking to be pregnant want to ensure the safest, healthiest, and most viable pregnancy. Guest Dr. Amy Criniti suggests taking a look via tubal imaging, called an HSG. This procedure can give the doctor an idea of the status of the fallopian tube. Listen to our previous episode on uterine/tubal evaluation for more details:  Snack 6: The Camera Goes Where? Assessing the Uterus and Tubes  Additionally, an ultrasound can tell you which side you're going to ovulate on, so you can aim for trying to get pregnant when the egg is traveling on the side with a functioning, healthy fallopian tube. Patients may also opt for IVF, which has a lower (but still not zero) chance of resulting in an ectopic pregnancy. Quick quiz: True or False: ovulation switches sides each month, so if it's the left fallopian tube in January, it'll be the right one in February.  True or False: smokers have a higher chance of ectopic pregnancy. True or False: if you've had an ectopic pregnancy, there's nothing doctors can do to decrease the risk next time. True or False: a fallopian tube can be repaired and returned to full function after an ectopic pregnancy. True or False: having your “tubes tied” for contraception is an easy surgery to reverse. Listen up to hear the answers! If you've had an ectopic pregnancy and would like to share your story, we'd love to hear it. Please send us a message at thewholepineapple@gmail.com.  As always, please be sure to share this episode with anyone who can benefit, and please subscribe, rate, and review. You can find more information about our medical team at seattlefertility.com, and you can hear more episodes at thewholepineapple.com.

Ectopic pregnancy is when the pregnancy implants outside the uterus, most often in the fallopian tubes. As much as 1-2 percent of pregnancies end up in this category, even when the pregnancy results from IVF. In this episode, Ruby and Anne talk with Dr. Amy Criniti, another member of the Seattle Reproductive Medicine team, about some of the questions (and myths) out there about ectopic pregnancies.  Why are they so dangerous? If not caught early, the embryo can grow inside the tube. Unlike the uterus, the fallopian tubes aren't meant to stretch to accommodate a growing embryo. Eventually, the tube will rupture and cause internal bleeding. Left untreated, an ectopic pregnancy can endanger the life of the pregnant person. Can an ectopic pregnancy be “relocated”? Despite wishful thinking among some non-medical persons, no. An ectopic pregnancy, once disrupted, cannot reimplant elsewhere. Does a “pregnancy of unknown location” always mean an ectopic pregnancy? Not necessarily, says Dr. Criniti; sometimes blood work can indicate there's a pregnancy, but it's not yet visible on an ultrasound. If the embryo can't be located, the patient will be closely monitored until they're sure the fertilized egg has implanted where it should. How does an “implanted” pregnancy (like IVF) end up in the wrong place? We don't entirely understand how the fertilized egg moves around before implantation, and short of attaching a tiny Go Pro, we may never know. But even an “implanted” pregnancy can move before attaching, though like ectopic pregnancies generally, the risk is pretty low. In this age of conflict over reproduction, it's important to know about the risks of ectopic pregnancy and what your choices are if you find yourself in that 1-2 percent.  More about Dr. Criniti: Dr. Criniti joined the medical team of SRM in 2006. Her clinical interests include fertility assessment, PCOS, age-related infertility, as well as the entire spectrum of fertility treatment. She currently teaches University of Washington medical students and is the Medical Director of the donor egg team. She was recognized in 2013, 2015, 2022 and 2023 as one of Seattle Magazine's Top Doctors in infertility, as well as Seattle Metropolitan Magazine Top Doctor in 2014, 2015, 2018, 2019 and 2021. Be sure to share this episode with anyone who can benefit, and please subscribe, rate, and review. You can find more information about our medical team at seattlefertility.com, and you can hear more episodes at thewholepineapple.com.

x Sooooooooo…. Whether it was your choice or not, whether it's for a happy reason or a difficult one, starting over can be one of the most difficult things we do as adults.  New job, new home, new realities can mean uncertainty and disruption. So how do we get our heads and hearts ready to take on the challenges of change? In this episode, Anne and Jamie are discussing exactly this topic, as Jamie announces a big and exciting change in her life (and yes, you'll have to listen to find out what it is, but it's good).  One big takeaway here is that there are two coping strategies most of us tend to fall into when confronted with big change: avoidance and control. Do we duck the change that's coming until we realize we really can't breathe with our heads in the sand? Or do we take control (maybe a bit too much, sometimes)? Or do we vacillate between the two, making ourselves and those around us a little bonkers? And how is any of this related to The Good Place? (If you haven't watched it, we recommend you do, and you're welcome.) There are stages of change when starting over, and it's important to give yourself grace and acceptance. You might be, as Jamie talks about, “solidly moving forward,” only to find yourself set back and frustrated.  But knowing your strengths under stress can be so helpful. Concentrate on those to get your self-confidence back and make progress. Or take a break! Let your energy renew, so you can re-engage from a healthy place.  Hear more about the ways you can stay afloat during the chaos of starting over in this episode, get the mental headspace from Jamie's soothing meditation, then go back and listen to all Jamie's episodes at thewholepineapple.com.  Stay tuned for more information on Sound Perinatal and Fertility Counseling and how you can work with Jamie!  

Phew! Ruby, Anne, and counselor Suzi Mohn are going to fix All The Things today, so the rest of us can relax by the pool. OK, maybe not, but they certainly can help, so listen up! Today's question is: How can you support your partner in a difficult fertility journey? Often, the one who will not be carrying the baby feels a little helpless and useless during the process. (For ease of communication, we'll call this person “the partner.”) Partners want to support the one who will bear the child, but they don't know how, and it seems everything they say gets tangled up with all the big emotions and the hormones and does nobody any good. Though attention generally focuses on the one hoping to get pregnant, partners are suffering too. They're sad and scared and hurting, but their attempts to help are perhaps a bit clumsy because they often can't understand the ramifications of fertility treatment on the body, the heart, and the psyche.  And the one going through the fertility treatments may not have the time or language or mental space to teach their partner how to help. Because of this, a couple of Suzi's therapy groups undertook the task of creating a list — a list of what those hoping to carry a child wanted to hear so that their partners could truly be as supportive as they wanted to be.  All the points on the list are powerful and valid. Here are some of the highlights: “Tell me you love me and know why I'm sad.” “Share with me your vision of our child.” Take my fears and doubts seriously, but also remind me that we're a team and we'll work this out.” If you want someone to climb into the cab and stare at the ground with you (and that'll make a lot more sense after you hear the episode), ask them to listen to this episode. Share with them the list (with your own additions and subtractions) to help open those critically important lines of communication and mutual support.  You can find out more about Suzi Mohn and get her contact information at the HERE. You can find more from Ruby and Anne at thewholepineappple.com

Individual and family couples counselor Suzi Mohn has helped families navigate crises for years, and she knows how important support can be during a fertility journey.  Infertility can put a huge strain on relationships — stress, financial worries, blame and guilt, turning pleasure into obligation, differing expectations or goals, etc. etc. are all legitimate concerns. Ironically, in the quest to build a family, the family you already have can be put at risk. Fortunately, there are counselors and therapy groups to help couples overcome the difficulties, together. In this episode, Suzi, Anne, and Ruby discuss the struggles people face when dealing with infertility. Younger couples may find infertility one of the first major crises they face together — they may not have been married long; they may not have dealt with the trauma of losing a parent or losing a job — and suddenly something they thought would be simple and natural … isn't.  Also, people may believe they've done All The Things right: they waited until they were financially and emotionally ready. They established their lives before preparing to welcome children into it. And their reward for such responsibility? Trouble conceiving or maintaining a pregnancy. Couples may be on different timelines, too. One partner is ready to go to the doctor TODAY; the other isn't feeling the same urgency. And that can make both of them feel like they're taking this journey alone instead of together. What do you do when you're facing so much, and the one person you turn to in difficult times is dealing with their own concerns? What do you do when the person who is usually a big part of your solution is suddenly a big part of your problem? (or so you think…) There's help! Listen up for ways couples can navigate the challenges of infertility. Then, please share this episode with anyone you think could benefit. You can find out more about Suzi Mohn and get her contact information HERE. You can find more from Ruby and Anne at thewholepineappple.com.

July 25, 1978 was a great day, and not just because July 25 is Ruby's birthday. This particular day in 1978, the first IVF baby, Louise Brown, was born! IVF is a lot different now than it was then — a lot was learned on the way to this first successful human pregnancy, and a lot has been learned since. In this snack, Ruby and Anne are talking about the research and experimentation that got us where we are now. One of the biggest changes (and dare we say, improvements) from the experience of Lesley and Peter Brown is how much less invasive (physically and frankly, of the Brown family's privacy) the process is now than it was then.  Early hurdles included getting past people's notions of whether or not IVF was ethical. And IVF cycles were so much more involved, including blood draws every four hours. Egg retrieval was a surgical process back then, it involved a single egg, and it was much more often unsuccessful. Transfers were done in the middle of the night until one didn't and it worked out fine, and that was (thankfully) abandoned. The fact that Louise Brown was later able to conceive without medical intervention helped allay fears that IVF would create a generation of people unable to reproduce on their own.  So Happy Birthday, Louise Brown, and thank you, Lesley and Peter Brown and Elizabeth Carr (first IVF baby in the US) for going through so much to get us where we are today.  Learn more about All Things Fertility at our website: thewholepineapple.com!

With laws and regulations changing so fast and all over the place, it can feel overwhelming and futile to try to do anything at all. But it's important that we don't give up and let decisions be made for us. What can people who aren't professional lobbyists do to make our voices heard? According to Sean Tipton, you can do exactly that – you can make your voice heard. Register to vote and then vote. Talk to candidates for political offices, especially when they're in an election season, as they're most likely to listen at that time. You have a right to be heard, so get in there and get talking. Have anecdotes to share (with permission, of course): if you can tell a relevant story, that is often much more effective than straight data. Faces, stories — those are the ways to get folks to listen. Showing how your policy position will solve problems is also effective. Most of us don't like being presented with problems, so come at policy makers with solutions. Be sure to check out the Resolve website (resolve.org) for tools to help you get started. Please share resources, including this episode, with anyone who is looking to help preserve medical fertility assistance and reproductive rights in general. Sean's organization, ASRM (American Society for Reproductive Medicine), is also a great resource: asrm.org. And of course, please rate, review, and share this podcast to help others be informed about All Things Fertility, including advocacy. thewholepineapple.com.

Content warning: there are mentions of abortion, incest, and rape in this episode. Advocacy is on the menu for today's episode — and to quote our Season One guest Lara Hayden in episode 13, listen up to learn how we can all “be prepared, not scared.” Sean Tipton, Chief Advocacy and Policy Officer for the American Society for Reproductive Medicine (ASRM), is a fantastic resource for getting prepared. Mr. Tipton formulates and executes media and government affairs programs for ASRM, the country's leading organization for professionals involved in reproductive health care and infertility. In this role, he has worked in policy venues ranging from local zoning boards to the United Nations. Sean has degrees in political science from Transylvania University and The Ohio State University. As he says, part of his role is being a translator: explaining healthcare to policymakers and media, and explaining law and changes in policy to healthcare professionals and laypeople. So how do we “be prepared”? First, Sean says, know your rights. The First Amendment guarantees us freedom to petition our government for redress of grievances. We all have the right to complain to our elected officials when we have a genuine grievance. As Anne says, she needs a tee shirt that says, “I have legitimate grievances.” Be informed and operate from a position of knowledge. There's a lot of fear surrounding the Dobbs decision: how will it affect women's choices and health? How will it affect assisted reproduction? For legislators, it can be a minefield: they often don't really know enough to debate the topic from an informed position, and they may not know what their constituents or party will accept. Information genuinely is power. Listen carefully to language and interpretation. A lot of terms are being thrown around, sometimes by people who aren't careful or expert enough to handle those terms. Be sure you understand what someone is truly saying when they talk about reproduction, and the technology and the rights involved. Are legislators listening to the experts and passing on accurate information? If not, there may be an opportunity to challenge and educate. What has changed with the Dobbs decision? 8:51 How does personhood laws impact IVF? 13:30 How to promote access to reproductive care. 24:58 The complexity of IVF and abortion bans. 30:40 To stay informed and engage in advocacy, check out ASRM at asrm.org. Find Sean Tipton on LinkedIn (linkedin.com/in/sean-tipton) and check out his episode on the ASRM Today podcast. As always, find more from Anne and Ruby on thewholepineapple.com, and don't forget to rate, review, and share this episode with anyone who can benefit!

How do you stop “catastrophizing”? And if it's not clear from context, “catastrophizing” is the art/science/self-destructive spin-out of getting stuck in what Bridget Jones referred to as a “negative thought bog,” like getting mired in a swamp of despair. Like “doom scrolling,” catastrophizing is that rut of negativity you just can't seem to fight free of. Not to make this a list of metaphors, but Anne's Roomba story in this episode is perhaps the most perfect example of catastrophizing. But you'll have to listen to get the joke.

We often refer to fertility as a “journey” — but sometimes it can feel like a slog through disappointment, bewildering medical terminology, treatments, surgical termination, physical and emotional pain, and more horrors that you really don't need us to list out.   One of the hardest parts may be feeling so isolated, like no one's journey has been as complicated and fraught as yours, and no one will truly understand what it feels like to be you. In this episode, reproductive psychology expert Dr. Julie Bindeman tells her story. It is a roller coaster that will probably feel all-too-familiar to many: miscarriages, bad news from the ultrasound, medical professionals who don't have a proper sense of urgency (to put it politely, though we're screaming on the inside).  But there are two very important takeaways here: You are not alone. And you deserve to have safe spaces to talk about your experience with others who understand. You need to advocate for yourself. It sucks. It really sucks that sometimes you may feel you're the only one taking your concerns seriously, but if it happens, you have the right to stick up for yourself and insist on being heard. A bonus takeaway: even professionals in the field find the fertility journey really tough. If someone in your life (maybe even you?) tries to make you feel you're being “high-maintenance” or “too sensitive” or “hyper-vigilant” or any of the other ways we dismiss the concerns of those with uteruses, just refer to the takeaways above. You know your body best We also urge everyone to know the reproductive rights (or lack thereof) in the state where you live. You can find up-to-date information on The Center for Reproductive Rights website: reproductiverights.org/maps/abortion-laws-by-state.  To learn more about Dr. Bindeman and find a whole host of resources, be sure to check the Pregnancy After Loss Support website: pregnancyafterlosssupport.org/author/juliebindeman. Find out more about hosts Anne and Ruby, and listen to more episodes, at thewholepineapple.com. And of course, we hope you'll share, rate, and review this episode. If you're listening on a podcast app, you can rate and review right now! We hope you will; it makes it easier for others to find us.  

Content Warning: This episode focuses on pregnancy loss and termination of pregnancy for medical reasons. If you're not in the right head space to hear this episode, we suggest you skip ahead and come back if and when you're ready. Please take care of you. Worst-case scenarios suck. There's no way around that. But one way to make it suck slightly less is to be sure everyone involved is invited into the tough conversation about termination of pregnancy (TOP) for medical reasons. When the bad news is fresh is a really tough time to make a decision; having a planned path can at least remove some of the pressure. And not to get too political (but it's hugely relevant), legislation around “personhood” and abortion are making these decisions much harder and limiting the choices patients have regarding their health, their bodies, and their fertility. Everyone needs to know the options available in their state and the risks they may be taking by virtue of where they live. Enter Dr. Julie Bindeman. Dr. Bindeman is a licensed psychologist specializing in reproduction and fertility psychology. She is Founder and Co-owner of Integrative Therapy of Greater Washington, an organization focused on helping people navigate fertility challenges, including pregnancy loss and TOP. Given the sensitivity of the topic, we've included some timestamps for anyone who prefers to skip around and listen only to what's most relevant to them. What you'll hear in this conversation: How Dr. Bindeman got into the field of perinatal mental health. (3:23) The limits of our knowledge on infertility. (9:08) The importance of talking about miscarriages and abortion. (11:45) Abortion and the downstream effects. (15:26) The problem with using euphemisms to describe prenatal testing. (20:50) Framing the decision to terminate a pregnancy. (26:43) Weight loss medications and fertility. (35:10) Mirror Syndrome and delivery. (37:52) Risk of multiples and miscarriage. (42:54) Pregnancies that cause fertility difficulties. (48:44)  Resources: Integrative Therapy of Greater Washington: greaterwashingtontherapy.com greaterwashingtontherapy.com/some-resources More about Dr. Bindeman:  Dr. Julie Bindeman received her Doctorate from George Washington University. She has served on many professional committees including in the Mental Health Professional Group of American Society for Reproductive Medicine (ASRM). She was elected to the Executive Committee in 2021. She is the former board member of the Maryland Psychological Association for 10 years and was appointed by the Governor of Maryland to serve on its Maternal Mental Health Task Force. She was recently awarded the Karl Heiser Award for her legislative efforts on behalf of the field of psychology. She has also authored and published several book chapters and articles pertaining to Reproductive Psychology.  You can find Dr. Bindeman at the Integrative Therapy website: greaterwashingtontherapy.com/julie-bindeman-psyd. You can find Anne and Ruby at thewholepineapple.com.

Q: What is a cyst?  A: It's a pocket of fluid.  Q: Why do I have cysts?  A: Because you have ovaries. Q: Is it bad? A: Great question. Let's talk. Not all cysts are bad news. In fact, bodies with ovaries generate cysts pretty regularly as part of the menstrual cycle. For example, what you see on an ultrasound isn't the egg; the egg is inside a “follicular cyst,” which is what's big enough to see and measure on an ultrasound. As you listen to the episode, you'll hear about “functional” cysts that have a job to do and are good things to have. So if you hear the word “cyst,” that's not necessarily cause for alarm.  That confusion is what this episode is all about — there are different kinds of cysts, some good, some less positive — and knowing what kinds of cysts there are and what they do can help you know what's happening in your body. In this episode, Ruby and Anne talk about: Different kinds of cysts What you can do about them (if they need something done) Symptoms of cysts What impact cysts can have on your cycle, fertility, and fertility treatments What you or your doc might see on an ultrasound and what that might mean What a “dermoid” cyst is and why it's … wow. You'll just have to listen. PCOS (polycystic ovary syndrome)   The good news is, cysts are largely benign. They can cause some issues, but if you get a diagnosis of a cyst, it's time to ask more questions, not to panic! Have a listen, then pass the episode along to others with ovaries — it's such important information for everyone to know! To hear more from Ruby and Anne, check out thewholepineapple.com. Please rate and review, to make the podcast easier to find for others!

Welcome back to Dr. Kelly Casperson, urologist, author, and expert in sexuality, and not to jump in, but let's “fix” sex already! It's really challenging to get even our own ideas on sex straight, given what we were taught (or weren't) and how societal and cultural “norms” around sexual behavior are … often not about sex. Controlling sexuality is a time-honored tradition for controlling women in particular, and Dr. Casperson is ready to help women claim their bodies and their sexual responses through education and by  shedding stigma. In this episode, Dr. Casperson, Ruby, and Anne talk about how participants can improve their sex lives, including…. What “should”s might be crowding our brains and how to get to our own genuine ideas about sex. (Sex should be about procreation; sex should occur X times per week; you should be having sex to keep your heart healthy, even if it's not pleasurable.) What is “sex etiquette”? Is it OK to talk about the quality of the encounter while you're cuddling, or should you save it for later? How do you introduce something new to the bedroom (or the kitchen floor or the back of the Volvo)? What tools are out there for easing into uncomfortable conversations? Gently educating men on women's bodies (if we weren't taught much about our own, how much education do you reckon THEY got? Hint: porn is NOT educational.) How bodies and preferences change over time. How sex is like coding. :)  Erotica for telling your brain, “Hey, this is sexy time.” Be sure to check out Dr. Casperson's website and book for LOTS more information: kellycaspersonmd.com/home, and be sure to share this episode. (It might be kind of embarrassing upfront to share an episode on sex tips, but just imagine how grateful the receiver will be!) Find more from Ruby and Anne at thewholepineapple.com  Resources: Sssh.com Quinn AudioDesires  

Beware the 7-year itch, says Dr. Kelly Casperson. Around that mark (or so the thought goes), many of us start getting a little bored in our careers and in our relationships. But sometimes it works out perfectly: Just as she was getting a little itchy, Dr. Casperson met a patient who was finding her sex life as uninspiring as, well, moldy lettuce. (You'll get that reference in a minute.) That led to a whole new direction, and one you'll appreciate! Many of us now approaching potentially “itchy” times are finding out where the gaps were in our sexual education. We were taught the sex = unintended pregnancy and STDs version of human sexuality, and now, with the stress and physical changes of fertility treatment, having sex can start to feel like a job — one we don't remember signing up for and desperately need a vacation from. Women's sexuality in particular is hugely overlooked and under-discussed. Did you know the clitoris looks like a wishbone (oh, the irony…)? Why does the clitoris keep getting lost and rediscovered? Have we ever “lost” the penis and had to rediscover it? (spoiler: no.) Here's another jaw-dropper: only 30% of those with vaginas orgasm from having a penis put in them.  As Dr. Casperson says, it's not necessarily true that those with vaginas don't like sex — it's far more likely they just don't like the sex they're having. And that can usually be fixed. In this episode, Dr. Casperson talks with Ruby and Anne about how couples can work together toward good, satisfying, enjoyable sex. As the doc says, you don't say, “I don't like movies” when you only watch horror films, right? So maybe it's time to try some different varieties. Dr. Kelly Casperson is a board certified urologist and a founding member of Pacific Northwest Urology Specialists in Bellingham, Washington. She is an expert in comprehensive urology care, treating all genders for a wide range of conditions. She also specializes in urogynecology including things like stress urinary incontinence, pelvic organ prolapse, vaginal atrophy related to menopause, and sexual health.  Be sure to check out Dr. Casperson's podcast, You Are Not Broken. Find her on her website: kellycaspersonmd.com and order her book! You Are Not Broken: Stop “Should-ing All Over Your Sex Life As always, please rate, review, and share The Whole Pineapple (AND You Are Not Broken) and find out more about our hosts at thewholepineapple.com.   

Did you know: We can take cells from the outside of an embryo and test them?  Formerly, “embryo biopsies” were done only if there was a risk of serious disease like cystic fibrosis. It wasn't routinely done because taking a cell or two from an embryo that is only 8 cells brought with it the possibility of damaging the embryo.   Nowadays, the cells are taken later and aren't part of the inner cell mass that becomes the actual fetus. These cells still have the information embryologists are looking for (does it have the correct number of chromosomes), but the procedure doesn't incur the same risk. Why do it at all? This level of testing gives doctors and patients more information about the health of the embryo and its possibility of yielding a successful pregnancy. Let's talk about “assisted hatching” — it may make Anne and Ruby think of Austin Powers, but come on, Jurassic Park, right? Remember the dino egg hatching during the tour?  These days, assisted hatching is done with a laser on Day 3 (it used to be done with acid and THE EMBRYOLOGIST'S MOUTH). Basically, the idea is to create a tiny hole in the “shell” so cells can ooze out during development and be collected for testing. Rest assured, hatching is a normal part of the process of implantation, laser-wielding Embryologist or no.  For more fascinating science (and movie references), you really need to listen to this episode. It's seriously jaw-dropping how far we've come in fertility treatment.  Get more information on Julia, Ruby, Anne, fertility, Embryology, and treatment at www.seattlefertility.com. And learn more of the amazing science of fertility at thewholepineapple.com. Find more information in these previous episodes: [Bonus] Snack 56.5: What is PGT? Episode 29: My Embryos are Mosaic? Interpreting Your PGT Results  

Content Warning: There is discussion of animal testing some listeners may find difficult.  Continuing our digital/audio tour of a fertility clinic, we're stopping off at the Lab, a place full of lovely humans, according to Ruby and Anne. One of those lovely humans is Embryologist, Julia Aliabadi. Julia graduated from the University of Washington in 1992 with a Zoology degree (which apparently is a common path for folks who end up in Embryology). She first worked in andrology before joining Seattle Reproductive Medicine in 2005. So, what actually happens in the lab with the sperm and eggs and embryos? Well, life in the lab has changed as technology has evolved. For example, Embryologists used to test sperm's penetrative abilities by introducing it to animal eggs and see if it could get through. These days, there's a process called ICSI (intracytoplasmic sperm injection) where a tiny needle injects the sperm directly into the center of the egg. Why do this? Well, as Anne says, “Life is a struggle!” and there's a lot more involved in reproduction (no matter how it's achieved) than most of us know.  If you're curious what goes on in a fertility lab, this is a great introduction and tour. It's also a great mini-tour of some of the history of fertility treatments: imagine making your own pipettes! Or doing all your embryo freezing at one time because the freezer took three hours to complete a cycle. Or realizing embryos actually do better when we look at them less. So since we no longer get a daily update, what happens between Day Zero and Day Five? And how do strippers work into all this??? Take a listen to hear how far Embryology has come and what life is like in the lab now. And find out more about Julia Aliabadi and hosts Anne and Ruby at Seattle Reproductive Medicine: www.seattlefertility.com. As always, listen and share episodes of The Whole Pineapple at thewholepineapple.com.

You've decided to give IVF a(nother) try: what should you do or not do during treatment? And how does this relate to Miami vs Pacific Northwest “chic”? Well, let's just say, it really helps to know the rules in advance…. There are a lot of mythunderstandings (misunderstandings + myths!) out there about IVF, so in this snack, Ruby and Anne are going to talk about the things you genuinely need to know. Here's what you'll learn: (and yes, you need to listen to get the full answer!) Exercise: yes, no, decrease, increase, and why? Alcohol: can you have a glass of wine? Caffeine: please o please, Mother Nature, may I? Tobacco/nicotine: spoiler — NO. For so many reasons… Bath, hot tub, sauna? Sex during an IVF cycle? As always, please consider sharing this information with anyone you believe could benefit. It not only helps that person, it helps make The Whole Pineapple more discoverable on podcast apps, which could help a whole lot of people. Find more at thewholepineapple.com.

NOTE: Yes, Roaring Adventures is focused on helping first responders and active military find funding to support fertility journeys. For you “Too Long/Didn't Read (TL/DR)” people, even if you're NOT either of those, keep listening! There is a lot of great information here about resources for anyone needing help with infertility treatment. In order to qualify for Roaring Adventures, you need to meet a few criteria: one partner should be diagnosed with infertility. You should also be a firefighter, nurse, paramedic/EMT, EMS, law enforcement (police officer), or a 911 dispatcher. Be sure to listen to the full episode for a detailed rundown of who qualifies. Roaring Adventures knows how challenging it can be to fund fertility treatments. So in this discussion with Ruby and Anne, Mollie offers some very sound tips for anyone. Rule number one — be cautious sharing a lot of personal information and paying a fee when you apply for a family grant. Make sure the organization you're approaching is legitimate. Here are a few questions that might indicate red flags: Is the application fee fair and reasonable? Is the org a genuine 501(c)(3)? Have they had actual recipients in the past? Are they working with respected doctors, clinics, etc.? Can they answer your questions about their processes? A “no” answer to any of these questions might mean you should keep looking or for sure delve a little deeper.  So, let's say you qualify for a grant — how do you apply? Roaring Adventures' grant is open to submissions once a quarter. You'll find an application and a list of FAQs on their website, www.roaringadventures.org.

You're a soldier, a firefighter, an EMT, a 911 dispatcher, a nurse, a cop; you're used to taking control and getting things done, even in enormously stressful situations. So where do you turn if your own body just won't “follow orders”?  Mollie Huyck is the Founder and President of Roaring Adventures, a non-profit organization supporting first responders and active duty military members who need help building their families. Seven long years and nine devastating losses before finally having a daughter inspired Mollie to help military and first responders with family building. Why this population in particular? First, her daughter's story includes ties to the military, and second, this population tends to suffer infertility at higher rates than civilians. And often fertility treatments — even for our military and first responders — are not covered (or fully covered) by insurance. We all know stress can impact fertility in many ways. Can you think of many professions MORE stressful on a daily basis than the ones listed at the top of these notes? Their professions can also expose them to toxic substances. How do we serve those who protect and serve in such critical ways? Roaring Adventures supports these folks in their fertility journeys by helping them access financial resources through family building grants. But it's not just financial assistance, it's also education, support, and other services. Roaring Adventures supports many family building channels, including medical treatment and adoption services. PS Just wait until you hear the origin story of the company name…. More about Mollie: Mollie is also co-founder of My Fertility Health, Inc. Her company created Navie, a comprehensive software platform designed to provide tools and support to those navigating their reproductive health. Her book I Became Your Mama was created as a resource for parents to share their personal stories with their children.  Mollie is an advocate for family building causes in Oregon and across the United States. Find out more about Mollie and her organization at Roaring Adventures: www.roaringadventures.org. Learn more about Navie at navieapp.com. And as always, find more episodes from Ruby and Anne at thewholepineapple.com.

Just relax: Jamie's back! OK, no one ever relaxed because someone told them to. In fact, being told to calm down or relax may be one of the most blood-pressure-elevating things that can happen to us.  How do you feel when fertility issues come up at work? Someone puts a baby photo on their desk, a colleague is pregnant, invitations to a baby shower or to contribute to a baby gift float around — these can be hurtful for those dealing with fertility challenges, but asking someone to put their baby photos away or refusing to participate in a celebration are often just not an option.  And often those who don't understand the issue may think saying “just relax” or “just ignore it” is a “solution.” (Spoiler: It's not.) In this episode, Anne and Jamie take on how to have (or avoid) awkward, super-personal conversations at work and how NOT to carry those conversations home with you.  Bonus: if someone consistently asks inappropriate questions, share this episode with them as a gentle way to open the conversation.  These situations can be so specific to the people involved and the climate at work, so we'd love to hear how YOU handle awkward moments like this at work or after it. Do you ask, “Why do you ask?” when someone asks you why you don't have kids yet? Do you come up with a cover story to avoid revealing more than you want to (and have you ever been caught out)?  Share with us on Instagram @thewholepineapplepod or email us at thewholepineapple@gmail.com and let us know if we can share your story! Find more wisdom from Anne and Jamie at thewholepineapple.com! Article: My Co-Worker's Baby Photo Gallery Put Me Over the Edge  

Kay-gulls? Kee-gulls? How do you pronounce it, and are they the end-all-be-all solution to pelvic floor issues? Yeah, not so much. Kegels can help, for sure, but as Dr. Abby Dunning says in this snack, “there's a time and a place for them.”  So what can you do to get “better functional coordination” in the very complicated network that is the pelvic floor? Well, first, it's important to know what you're working with, says Abby. (NOTE: The best way to do this is work with a PT so you learn all the things correctly!) But one way to start is to pay attention to your breathing. Where is the expansion and contraction happening? The pelvic floor needs to move, not just grip and contract, which is why Kegels or vaginal trainers alone aren't really enough. Crunches don't really do all the things either, and doing a ton of them can actually be more of a problem than a solution.  To learn more about how the pelvic floor works and get some info on how you can correctly engage it in exercise, have a listen, then find a pelvic practitioner near you (see resources below!). And as always, share the wealth (of information) by rating, reviewing, and sharing The Whole Pineapple podcast! (thewholepineapple.com). Resources: APTA Find a PT near you Pelvic Rehab: Find a pelvic rehab practitioner near you Pelvic Rehab Blog  Pelvic Floor Therapy: What to Expect Top 5 Pelvic Floor Exercises with Dr. Kristie Ennis Yoga For Pelvic Floor - Yoga With Adriene 

With a fertility expert and a pelvic floor expert in the same family, one can only imagine the discussions over the dinner table at family reunions…. But fortunately, in this episode, Ruby, Anne, and guest Dr. Abby Dunning are letting us have a little listen-in. And please do listen in, because this is a VERY important conversation for anyone with a pelvic floor. (Hint: that's ALL of us – even those who weren't born with a uterus.) Dr. Abby Dunning is a Doctor of Physical Therapy from Ruby's own home state of Montana. She received her bachelor's degree at Carroll College and her doctorate degree at the University of Montana. She specializes in treating pelvic pain conditions, pelvic organ prolapse, bowel and bladder dysfunction, orthopedic conditions of the pelvis, hip, and spine; as well as specific concerns unique to pregnant and/or postpartum individuals and the pediatric population.  The pelvic floor supports a whole lot of important organs and functions, and yet most of us really need to learn how to keep this part of the body strong and healthy. Of course pregnancy involves the pelvic floor, but it's also critical to waste retention and release, orgasm, core strength, posture, breathing, and more, so it's pretty important to know how to exercise it and treat it well. As with all complicated things, there are ways things can go pretty wrong: pelvic pain, incontinence, prolapse. That pain may be associated with penetrative intercourse, but it can also occur at other times or just exist as a lingering, consistent discomfort. And for many people, having pelvic exams is uncomfortable enough for so many reasons, including past physical or emotional trauma, so the idea of seeing a physical therapist for treatment seems impossible. Which is why it's important to find a PT you connect with and trust. Many people believe that pelvic floor issues are limited to people who have had multiple pregnancies, but that's just not true. Everyone can benefit from being in tune with that part of their body and checking with a PT for the right way to keep the pelvic floor healthy (hint: not just Kegels, and NOT CRUNCHES). Find out more about Dr. Dunning at Lone Peak Physical Therapy lonepeakpt.com - Dr. Abby Dunning and about our own Anne and Ruby at thewholepineapple.com. And as always, please rate, review, and share the episode so others can find The Whole Pineapple podcast! Resources: APTA Find a PT near you Pelvic Rehab: Find a pelvic rehab practitioner near you Pelvic Rehab Blog  Pelvic Floor Therapy: What to Expect Top 5 Pelvic Floor Exercises with Dr. Kristie Ennis Yoga For Pelvic Floor - Yoga With Adriene 

Secondary infertility is, as Anne says, a “unique subset of the journey.” What is it like to have a child and then experience difficulty conceiving or carrying subsequent pregnancies? In this special episode, a Whole Pineapple listener shares her journey and struggles through secondary infertility.  There are lots of special concerns in this situation: when you have a first, people don't worry about asking when you're going to have another the way they might hesitate to ask about a first. There's guilt about potentially having a “lonely only.” And what about as parents age, is it “wrong” to leave all the responsibility of caretaking on one child?  As Anne, Ruby, and Amy tell us, healthy families can take a whole lot of different shapes and come in many different sizes. If you're worried about the concerns above, there are ways to prepare: have a response or exit plan in place for insensitive questions, find ways to involve your kiddo in peer-group activities, plan and save for your own aging as best you can. Hear more about Amy's challenges in finding a support group for secondary infertility, dealing with insurance demands, working through the pressure this can place on relationships, and navigating the well-intended but painful questions from friends and family.  If you or someone you care about is experiencing a secondary infertility journey, please share this episode. This particular challenge can be terribly isolating, and we always want people to know they're absolutely not alone.  Find out more and hear more episodes at thewholepineapple.com.

When you've tried ALL THE THINGS to get pregnant, what's left to do but make a rap about it?  It's a bit of an unconventional snack, but then, many of the things Meirav Zur has tried are pretty “out there” as well. Reflexology? Peeled almonds? Toe magnets? Mantras? And what the hell is a fertility “magician”?  In this episode, Meirav refers to “Fertility OCD” – an obsession with making sure you do everything and do all the things exactly right, coupled with the consciousness that the clock is ticking – and how it can rule your life. And as Anne says, seeing others getting pregnant “easily” can be extremely isolating. Of course, as you're juggling all these things, feeling the pressure of time and expectation, watching test after test come up negative and holding onto hope with the tiny tippy top of your fingers, someone will undoubtedly barge into your life and tell you to “RELAX.” Sigh. Humor is a coping strategy for many, and you are “allowed” to laugh at the ridiculousness of it all. And on those days when it really just isn't funny, you're allowed to feel that too and to ask others to respect those feelings.  If this is one of those OK-to-laugh days, be sure to check out Meirav Zur on her website: meiravzur.com. And as always, find out more about Ruby and Anne on their website, thewholepineapple.com. If you enjoyed the episode, please rate, review, and share to help others find us!  

“Infertility” and “Humor” don't really seem like they go together, at least not if you're going through fertility struggles or care about someone who is. But in this episode, Ruby and Anne and their guest Meirav Zur take us on a tour of the absurd side of fertility and fertility treatment. Meirav Zur is an actor, producer, writer, and humorist who has dealt with unexplained infertility. As someone who communicates for a living, she was surprised to find herself so unable and unwilling to talk about the situation she was in.  When she was finally ready and able to share, her friends encouraged her to turn her experience into a show. A year later, she shared her personal, private, impossible-to-talk-about experience with a room full of strangers with Inconceivable: The Totally True One-Woman Semi-Fertile Quasi-“Musical.” Like many others have said on this podcast, fertility challenges are just too hard to talk about. The feelings of shame and embarrassment that haunt couples mean that we don't talk about it even with our closest friends and family, leaving people to struggle alone.  But that has to change, and sharing shows like Inconceivable can be a way of breaking the ice and normalizing what is, after all, a very common experience. (Hint: sharing this podcast works too…) Check out Meirav Zur and see excerpts from shows on her website, meiravzur.com. And get more Pineapple episodes from Ruby and Anne at thewholepineapple.com. Please rate, review, and share, and help more folks join the conversation here at The Whole Pineapple.  

Should fertility be a sub-plot? The prefix “sub” is already a bit problematic, since those going through it often feel it's THE CENTRAL PLOT right now, but that aside, how should we deal with fertility in fiction? Well, say our hosts, if writers are going to take on the topic, they really could at least (a) handle it sensitively, and (b) do their research.  In this snack, Ruby and Anne look at several examples of fertility “tropes” that show up again and again in drama, and we reckon a lot of them will feel familiar to you. From Phoebe, who could never be a gestational carrier (or “GC”) because she's never been pregnant, to “How I Met Your Mother” where Robin has a good life despite never having children, shows run the gamut from insultingly silly to admirably accurate. Trope #1: if characters want to get pregnant in fiction, they'll have all kinds of problems. If characters don't want to get pregnant, and use eight kinds of birth control, *bingo.* These shows are rife with inaccuracies about human biology and the science of fertility treatments, and for those dealing with fertility journeys of their own, it can be infuriating and painful. (Seriously? Miranda with her uterine issues and her boyfriend with ONE TESTICLE? SERIOUSLY?) If you're just not ready to be confronted with fertility issues in your media (whether it's accurately represented or not), check out the Infertility Safe Media Database, linked below. The site tells you which books, movies, etc. deal with infertility. Your peace of mind matters, so give yourself the grace to skip this month's Book Choice with your book club or pass on an invitation to a film that might mean risking crying in the theater. And, as always, check https://thewholepineapple for more episodes and information on our awesome hosts, Ruby and Anne. And don't forget to rate, review, and share to help others find the podcast! Resources:  TVTropes.og  Law of Inverse Fertility Article Clip - Finding Out I'm Infertile - Hasan Minhaj's Netflix Comedy The King's Jester Slate Article by Noreen Malone The Fertility Plot is the New Marriage Plot Infertility Safe Media Database Infertility on TV: Part 1 - Chasing Creation  

What does famine data teach us about epigenetics? (Note: Anne and Ruby are not “pro-famine” — they just provide some fascinating and useful information!) What about twins? And how did bees get in there? We're on a total science-nerd learning path today, and it's great fun.  Our environment can turn genes off and on, so it's not “nature vs nurture,” it's “nature AND nurture.” How genes and our environment work together or at odds has real impact not just on our individual health but potentially on our offspring and theirs! Why are famines, devastating as they are, useful for study? Because while the stress and nutritional deficits profoundly affect those suffering, they can also cause cascading epigenetic effects that continue or appear generations later. Which brings us to now and what we can learn: One, what you eat now may matter 100 years from now, even if you're no longer around, so maybe sideline the sugar and processed stuff for occasional consumption? And two, issues you're experiencing now may be at least partly caused by what your great-grandmother ate and the environment she lived in. This is such a fascinating conversation and it sheds light on struggles of mental health, weight, fertility, disease, and more. We hope you'll take a look at the resources included below for more information. And as always, we encourage you to share this episode with anyone you believe could benefit. Find more about Ruby and Anne and The Whole Pineapple at https://thewholepineapple.com/! Resources: Anne's References  Dutch Famine info from Nature Epigenetics: Tales of adversity | Nature NYT article about it, showing differences in methyalation with samples taken 70 years after  The Famine Ended 70 Years Ago, but Dutch Genes Still Bear Scars - The New York Times (nytimes.com) True scientific article  Prenatal famine exposure and adult health outcomes: an epigenetic link | Environmental Epigenetics | Oxford Academic (oup.com) And the citation for it: Prenatal famine exposure and adult health outcomes: an epigenetic link - PubMed (nih.gov) Irish potato famine and growth of the asylum system, was increase in schizophrenia (in the high risk age ranges right timeline post famine) to blame?  Irish Potato Famine: Date, Cause & Great Hunger - HISTORY - HISTORY The Great Irish Famine (1845-52) and the Irish asylum system: remembering, forgetting, and remembering again - PubMed (nih.gov) Did the Great Irish Famine increase schizophrenia? - PubMed (nih.gov) Ruby's references:  What it takes to make a queen bee  New York Times Dutch Famine Article: NYT article Longevity Article on The Great Hunger https://vocal.media/longevity/the-irish-potato-famine-and-epigenetics The China Study:  https://nutritionstudies.org/the-china-study/ Goodreads page: https://www.goodreads.com/book/show/178788.The_China_Study Amazon: https://a.co/d/aV7zA1p Nurses Health Study American Journal of Public Health article  

Why do some identical twins have different fingerprints? Oh the 90s, era of the Hale-Bopp Comet and the Human Genome Project in science. Mapping the human genome was A Big Deal, and everyone from then-President Clinton to your high school biology teacher was pretty excited.  The genome project eventually led to the lesser-known but also very important Human Epigenome Project — health impacts beyond our genetic code. How are we impacted by environment and behavior, in addition to (or despite) the effects of our genes? Ruby and Anne are having this critical nature/nurture conversation with Kent Thornburg, PhD, Professor of Medicine, Division of Cardiovascular Medicine, School of Medicine at Oregon Health & Science University (OHSU).  Just FYI, Dr. Thornburg's list of credentials, accomplishments, and accolades are far too long to reproduce here, but you can learn more about him and watch his Tedx Talk on the OHSU website: https://www.ohsu.edu/people/kent-l-thornburg-phd. We have so much technology, so much information — why are we sicker and with lower life expectancies than earlier generations? Because technology is a tool, much like a hammer. You can build with it, but you can also destroy. We've actually caused epigenetic changes through processed foods, decreased physical activity, increased stress, and other poor choices. Learn what the science of epigenetics actually studies and what we've discovered so far (including that fingerprint-twin question). And learn to take action that can help you be healthier and pass on better health to future generations. Learn more about Dr. Thornburg at OHSU and from the resources listed below, and of course, find Ruby and Anne and more episodes of The Whole Pineapple at https://thewholepineapple.com/. Kent Thornburg at Tedx Portland George Fox Journal: The 100-year effect with Kent Thornburg You Are What Your Grandparents Ate: What You Need to Know About Nutrition, Experience, Epigenetics and the Origins of Chronic Disease, By: Judith Finlayson, Forward by Kent Thornburg  Pregnant While Black: Advancing: Advancing Justice for Women's Health in America Link to Amazon Guest contact info: Bernadette Battilega (Kent Thorburg's assistant): battileg@ohsu.edu

If you, like 113 million other people, watched the Super Bowl in February, you probably saw singer Rhianna's pregnancy announcement reveal. While Rhianna's excitement about being a mom is understandable, it's kind of tough for those dealing with infertility to be involved in the celebration – especially when they aren't expecting it. So how do you handle triggering situations? If you found yourself dealing with big emotions in the middle of a Super Bowl party, what did you do? And how do you handle it when someone unintentionally asks you a hurtful question about your own family building? In this episode Anne and Jamie Mammenga talk about how to gently, politely extricate yourself from a situation where you don't feel safe or supported. Whether you went to get more nachos you really didn't want, or remembered a task or meeting you urgently needed to attend to, Anne and Jamie said to give yourself permission to walk away. It's OK to tell a white lie, it's OK to cut someone short, it's OK to suddenly get much more interested in the score, it's OK to enlist a sympathetic friend to jump in and help you remove yourself. It's also OK to treat this as a “learning opportunity” for a person who clearly isn't being sensitive to others — replying with “That's an odd question to ask” is also completely fine. If this conversation has you back in one of those unpleasant moments, we gotcha. Jamie leads us on a really lovely meditation exercise that will re-center you and help you chase obtrusive thoughts away. Hear more from Jamie and from The Whole Pineapple podcast from our website: https://thewholepineapple.com/.  

If you haven't yet listened to the longer episode with Ellen Trachman, please do. In that episode, Ruby, Anne, and Ellen talked about many of the larger legal issues surrounding assisted reproductive technologies (ART). In this snack, hosts and guest are tackling specifics around frozen embryos: who do they belong to, how did the Dobbs decision change the laws, do people need to be shipping their embryos to states that are more aligned with their needs and beliefs? The future of ART and legislation around genetic materials such as frozen embryos is very hard to predict, says Ellen Trachman, so it's important to keep up to date on changes as best you can. There are legitimate concerns here, so it's important to know what your state legislators think on topics such as reproduction — and what they're likely to enshrine in state law. There is cause for cautious hope. Even some of the most restrictive states where privacy and choice are concerned are making efforts to preserve fertility choices. That said, legislators are not health care professionals (no, you can't “move” an ectopic pregnancy from the fallopian tube to the uterus). It's important that legislators understand the ramifications of the decisions they're making at a legal level, so if you're interested and able to do some advocacy and educating, take a look at options for activism in your state. You can find Ellen Trachman at her website, https://www.trachmanlawcenter.com/, and as always, hear more episodes and learn more about Ruby, Anne, and Seattle Reproductive Medicine at https://thewholepineapple.com/. Resources mentioned:  I Want To Put A Baby In You podcast: https://iwanttoputababyinyou.com/ Ellen Trachman's website: https://www.trachmanlawcenter.com/ https://www.facebook.com/iwtpabiy/  https://www.brightfuturesfamilies.com/

Is sperm from sex “donated”? Welcome to a crossover episode with podcaster Ellen Trachman, host of I Want to Put a Baby in You. Lawyer by trade, reproductive technology advocate at heart, Ellen Trachman is the founder and managing attorney at Trachman Law Center LLC.  Ellen founded her firm in order to bring dedicated and compassionate legal representation to those wishing to build a family or to help others to build a family through assisted reproductive technology (ART). She co-founded the Colorado Fertility Advocates, a nonprofit group dedicated to supporting Colorado families and fertility advocates. The laws around reproductive technology have never been simple, and they are becoming increasingly tangled as politics encroaches on health care. It's important for everyone to understand what's happening and how it may affect access to ART. Some cases Ellen's seen included a birth mother who was being considered a “surrogate” for her own child and in danger of losing her parental rights. In another case, the state sued a sperm donor for child support. And whatever you do, if you plan to use a sperm donor, don't have that donor “donate” their sperm in the … traditional manner, because sperm from sex isn't considered a donation. Ooof.  For those who may need assistance from reproductive technologies, or who may have genetic material already in reserve (eggs, sperm, or embryos), recent legal changes may already have impacted the choices that are available to you. How do you protect yourself and your genetic material? Will you need to move to another state simply to build the family you've always hoped for? This is an incredibly important episode for anyone who is interested in or in need of ART. Please share and find ways to get involved locally, if you are willing and able.  You can find Ellen Trachman at her website, https://www.trachmanlawcenter.com/, and as always, hear more episodes and learn more about Ruby, Anne, and Seattle Reproductive Medicine at https://thewholepineapple.com/. Resources mentioned:  I Want To Put A Baby In You podcast: https://iwanttoputababyinyou.com/ Ellen Trachman's website: https://www.trachmanlawcenter.com/ https://www.facebook.com/iwtpabiy/  https://www.brightfuturesfamilies.com/

Puberty in reverse – Welcome to menopause! Like those tumultuous adolescent years, you may feel like a tourist in your own changing body. And it's not necessarily a fun destination, with hot flashes, mood swings, weight gain, and the longer-term dangers of osteoporosis and increased heart disease risk. But are we thinking about menopause all wrong? In this episode, Ruby and Anne welcome back TWP alum Dr. Michelle Tollefson. Board certified OB-GYN, professor, advocate for lifestyle medicine and women's health, and co-author of PAVING a Woman's Path Through Menopause and Beyond, breast-cancer survivor (and thriver) Michelle Tollefson knows how dramatic the effects of menopause can be. Even worse, there's not much out there in terms of good, science-based information to help women navigate the changes in their bodies.  Menopause is a profound change — it's not just the end of periods — and women can begin the process much sooner than they think. Knowing that, women can start preparing for menopause much sooner; this can, for many, make the transition easier and healthier. And for those already in the thick of it, it's not too late — there are ways to ease the physical, mental, and emotional impacts. The “PAVING” in the title stands for physical activity, attitude, variety, investigation, nutrition, and  goal-setting. These tools, plus the PAVING “STEPSS” (stress reliance, time outs, energy management, purpose, social connection, and sleep) really can help women experience menopause in a healthy, supported, goal-centered way. Maybe menopause isn't something to dread, and maybe there's more joy to be had than the ability to wear white jeans any day of the month?  Learn more about Dr. Tollefson, the PAVING process, and the whole team behind it at https://www.pavingwellness.org/. And as always, please listen, rate, review, and SHARE the podcast with others you think can benefit as well. You can find more about hosts Ruby and Anne and Seattle Reproductive Medicine at https://thewholepineapple.com/. Want to learn more about the Seattle Reproductive Symposium in April 2023? Early bird pricing through March 27 at seattlereproductivesymposium.com.  

OK, we have to start off with a caveat here: If you did a 23andMe or similar genetic test at home, no medical professional can use the results to diagnose or treat a medical condition. The test may indicate something really important, like you're a carrier of cystic fibrosis, for example. But to start treatment or make any medical decision, the result must first be validated through a clinical, diagnostic laboratory. In this snack, Ruby, Anne, and guest genetic counselor Rachel Donnell tackle the question: What's wrong with a commercial test? Answer? There's nothing wrong with it, as long as you treat it as a fun way to learn more about yourself, and NOT as a medical diagnosis.  To begin with, at-home tests are likely nowhere near as rigorous. The test just isn't as sophisticated as a medical test, and commercial tests may not come with a professional who will sit with you and go over the results. Interpretation of the results can be as important as the results themselves — what are the full implications to you and any future children?  Rachel describes how these tests are often far less accurate than medical tests, so please, have fun with them, but don't use them as a basis for making important decisions about your health. If information comes up that concerns you, follow up with a medical-grade test from a healthcare professional.  And please, don't assume that just because the test claims you're not at high risk for heart disease or some other concern, that you're “safe.” Continue to discuss everything with your health provider, no matter what that at-home test told you. OK?  We know people are relying on these commercial tests already, so we hope you'll share this episode with others.  ​​Find more about Rachel, Ruby, and Anne at Seattle Reproductive Medicine (seattlefertility.com) and hear more episodes of The Whole Pineapple at https://thewholepineapple.com/.  

Rachel Donnell is back! However, unless you're up on your genetic-testing-of-embryos science, you may want to hold off on this episode until you've heard the bonus episode (“56.5”) released a few days before this one. It gives you some background information that will make this episode a lot easier to follow. In this episode, Ruby and Anne are talking with one of SRM's genetic counselors: Rachel Donnell. Rachel is a certified genetic counselor with 7 years of clinical experience in the infertility setting and a whole lot of experience explaining genetics and genetic testing to patients. Why are counselors necessary? Testing has never been a simple science, but it's gotten increasingly complex in recent years as technology has made so much more possible. When someone comes in for IVF, they may be recommended testing to screen for abnormalities in their embryos. Rachel helps patients understand why they might (or might not) want to test, what the tests involve, what the results mean, and what their choices are. Sometimes the result is an embryo with mosaicism. What is it, and what does it mean for the health of the pregnancy and the health of the baby? Well, with a name like “mosaicism” you can probably imagine it's a pretty complex picture. For those considering IVF and PGT (preimplantation genetic testing), this episode can really help you understand mosaicism and what it might mean for the embryo. More about Rachel Donnell: Rachel has a bachelor's degree from the University of Missouri and a Master of Medical Science in Human Genetics and Genetic Counseling from Emory University School of Medicine. At Seattle Reproductive Medicine, she counsels patients seeking PGT for aneuploidies and inherited genetic conditions. She is also involved in the American Society for Reproductive Medicine and was the Past Chair of the Genetic Counseling Professional Group.  Find more about Rachel, Ruby, and Anne at Seattle Reproductive Medicine (seattlefertility.com) and hear more episodes of The Whole Pineapple at https://thewholepineapple.com/.

PGT or "preimplantation genetic testing of embryos" – even the name is complicated. But, as we're having a genetic counselor come in to talk about testing and what the results mean, we thought a little primer on the science would help everyone understand the longer episode better. And who better to help us than the genetic counselor herself? We'll give you her full bonafides with the full episode, but Rachel Donnell is a certified genetic counselor with a Master of Medical Science in Human Genetics and Genetic Counseling and more than seven years of clinical experience under her belt. Best of all, we're in for a three-for with Rachel: this bonus snack to help us get ready for the full, then a full episode on mosaicism, and finally, another snack on the far side on commercial genetic testing (think 23andMe). It's a lot of science, but Rachel's job is — literally — helping people understand genetic testing. She's very, VERY good at it. In this bonus snack, Ruby, Anne, and Rachel talk about the categories of possible genetic diseases, the different kinds of tests, what testing can reveal, what testing can't reveal (or guarantee), and what patients can do with the results. They also talk through the process, so patients can rest assured that testing is safe for the embryos. If you're considering PGT or if it's been recommended to you, this is a great way to add to your understanding of what the testing involves and what testers are looking for. As always, we hope you'll share it with anyone you know who can benefit! Find more about Rachel, Ruby, and Anne at Seattle Reproductive Medicine (seattlefertility.com) and hear more episodes of The Whole Pineapple at https://thewholepineapple.com/.

Hosts Ruby and Anne have been talking about IVF for over a year now and recently realized they never fully defined the term! We know you can Google it, but we thought it'd be helpful to hear what it is from healthcare professionals you know you can trust. And if you're only too aware of what IVF is, but you're really tired of explaining it to others, we suggest you send them a link to this episode, and let Ruby and Anne do the heavy lifting for you. In this short snack, Ruby and Anne talk about what IVF or in vitro fertilization is, and how it works if you and your fertility provider decide it's the best treatment path for you.  IVF might be what most folks think about when they think of fertility treatment, but it's not necessarily the most common solution for fertility challenges these days. There are lots of possible paths for people to take when they're hoping for a healthy pregnancy, both “high tech” (like IVF) or “low tech” (medications to induce ovulation). We hope this snack helps you (or your well-intended friends and family) have a better understanding of IVF and its place among the many options for fertility treatments.  Learn more — or help educate others — by visiting and sharing The Whole Pineapple website and hearing ALL THE THINGS from Ruby and Anne! (https://thewholepineapple.com/) References: https://resolve.org/learn/what-are-my-options/in-vitro-fertilization/assisted-reproductive-technology-myths/ IVF in Washington State | The In Vitro Fertilization Process - Seattle Fertility https://www.sart.org/news-and-publications/news-and-research/press-releases-and-bulletins/more-than-73-thousand-babies-born-from-assisted-reproductive-technology-cycles-done-in-2020/  

What can fertility clinics do to help neurodivergent patients be more comfortable when seeking treatment?  Patients know that advocating for themselves can be necessary to getting the best medical care, but it can be really difficult for some to be understood when they express themselves — hence this very important conversation! Neurodivergent peoples may communicate their discomfort differently, so it's truly helpful if clinics are more educated and neurodiversity-friendly. For example, offering multiple ways to make an appointment can really help people who find phone conversations challenging. Secure portals, text, emails, etc. — as long as it can be made HIPAA compliant, why not offer it for those who would prefer it? Have you heard of the “double empathy problem”? It's the belief among neurotypical people that neurodivergent people have difficulties communicating. In fact, says guest Dr. Kristin Chambliss, neurodivergent people communicate just fine with one another. The challenges lie in the space between neurodivergent and neurotypical people. Because neurotypical is the most common communication type, everything else is seen as “abnormal.” In this episode, hosts Ruby and Anne and guest Kristin explore the ways fertility clinics (and society in general) can help make the world a little more empathetic and equitable. Seeing and celebrating our many differences enriches everyone, after all! Learn more about Kristin Chambliss on her website (https://kristenchambliss.com/), and find more episodes of The Whole Pineapple on the website (https://thewholepineapple.com/) or your favorite podcast app!  References: The Atlantic: Neurodiversity, Harvey Bloom (1998) article   Damian E.M. Milton (2012) On the ontological status of autism: the ‘double empathy problem', Disability & Society, 27:6, 883-887, DOI: 10.1080/09687599.2012.710008  Sasson NJ, Faso DJ, Nugent J, Lovell S, Kennedy DP, Grossman RB. Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments. Sci Rep. 2017 Feb 1;7:40700. doi: 10.1038/srep40700. PMID: 28145411; PMCID: PMC5286449.  Saxena P. Assisted reproductive technology and its Association with autism in children. Fertil Sci Res 2021;8:20-4  Singer, J. (1998). Odd People In: The Birth of Community Amongst People on the Autistic Spectrum: A personal exploration of a New Social Movement based on Neurological Diversity. Sydney: Faculty of Humanities and Social Science University of Technology, Sydney.  Periods & Autism - Chloe Hayden Youtube video  Autistic Doctors International website  From Autistic Doctors International: Williams, G. L., Adams, J., Bull, P., Cave, H., Chown, N., Doherty, M., Forrest, K., Foster, R., Fricker, R., Godfree, B., Keaveney-Sheath, K., Knight, J., Marrable, T., Murray, R., Shaw, S. C. K., Ventour-Griffiths, T., Wood, J. (2022) More than words: Supporting effective communication with autistic people in health care settings. Economic and Social Research Council. Available at:https://www.boingboing.org.uk/more_than_words/

“Neurodiversity,” says Ruby, is basically a term explaining the unique ways people's brains work. And Ruby knows. In this episode, she's “taking down the mask” to talk about her own unique brain! Although neurodiversity is a much more common topic than in days past, it's still pretty misunderstood. And when you pair it with fertility challenges, well, finding research or even conversations becomes really challenging. But few are as tenacious as these two when it comes to sharing important information. They found a licensed psychologist who works in fertility and who is looking to make fertility clinics more neurodiverse-friendly. In this conversation with Dr. Kristen Chambliss, Ruby, Anne, and Dr. Chambliss tackle many of the misconceptions rooted in our culture when it comes to a diversity of neurotypes.  It's a critical conversation. After all, as Dr. Chambliss says, neurodiversity may be as crucial to the human race as biodiversity. Or, as Anne put it so well: “Variety is not a disability.” Neurodivergence is not the same as intellectual disability or mental illness. And the more we understand, the less we'll have to fear. There are many strengths that come with being neurodivergent, though sadly, most of what we hear about are the struggles. Fertility can be a particular problem for the neurodivergent individual. Fertility treatment can be especially difficult for individuals who find sensory experiences problematic, for example. Recognizing the many challenges humans as a whole struggle with means more folks get the kind of help they need, offered in the way they need it. And that's just plain good.  Dr. Kristen Chambliss is a licensed psychologist specializing in treating individuals coping with infertility, in vitro fertilization, relationship concerns, and anxiety. She currently practices in Friendswood, Texas. Not only is she an infertility specialist but she is also actively working with our professional organization, the American Society for Reproductive Medicine on a proposal to make clinics more neurodiverse friendly.  References:  Website for the Bloom (1998) article from The Atlantic https://www.theatlantic.com/magazine/archive/1998/09/neurodiversity/305909/ Damian E.M. Milton (2012) On the ontological status of autism: the ‘double empathy problem', Disability & Society, 27:6, 883-887, DOI: 10.1080/09687599.2012.710008  Sasson NJ, Faso DJ, Nugent J, Lovell S, Kennedy DP, Grossman RB. Neurotypical Peers are Less Willing to Interact with Those with Autism based on Thin Slice Judgments. Sci Rep. 2017 Feb 1;7:40700. doi: 10.1038/srep40700. PMID: 28145411; PMCID: PMC5286449.  Saxena P. Assisted reproductive technology and its Association with autism in children. Fertil Sci Res 2021;8:20-4  Singer, J. (1998). Odd People In: The Birth of Community Amongst People on the Autistic Spectrum: A personal exploration of a New Social Movement based on Neurological Diversity. Sydney: Faculty of Humanities and Social Science University of Technology, Sydney.  Youtube clip for Chloe Hayden: https://www.youtube.com/watch?v=vP84_OHOCzM  From Autistic Doctors International: Williams, G. L., Adams, J., Bull, P., Cave, H., Chown, N., Doherty, M., Forrest, K., Foster, R., Fricker, R., Godfree, B., Keaveney-Sheath, K., Knight, J., Marrable, T., Murray, R., Shaw, S. C. K., Ventour-Griffiths, T., Wood, J. (2022) More than words: Supporting effective communication with autistic people in health care settings. Economic and Social Research Council. Available at:https://www.boingboing.org.uk/more_than_words/