1 00:00:01,400 --> 00:00:03,533 ♪ 2 00:00:05,800 --> 00:00:09,800 ♪ 3 00:00:09,833 --> 00:00:12,366 {\an1}This is what I.V.F. looks like. 4 00:00:14,666 --> 00:00:15,800 Wow. 5 00:00:15,833 --> 00:00:18,800 {\an1}This is what my life is going to be consumed of. 6 00:00:18,833 --> 00:00:21,766 {\an1}All these meds in 20 days, 7 00:00:21,800 --> 00:00:23,766 {\an1}thousands of dollars. 8 00:00:23,800 --> 00:00:26,766 This is I.V.F. 9 00:00:26,800 --> 00:00:28,400 (birds chirping) 10 00:00:28,433 --> 00:00:31,733 ERIN LEVIN: Infertility just feels like a special little corner of hell 11 00:00:31,766 --> 00:00:34,900 {\an1}that just goes on and on and on. 12 00:00:34,933 --> 00:00:37,066 TIFFANY HARPER: Every community has that taboo subject, 13 00:00:37,100 --> 00:00:39,566 {\an1}that thing they just don't talk about at the dinner table, 14 00:00:39,600 --> 00:00:41,700 {\an1}and fertility is ours. 15 00:00:41,733 --> 00:00:43,533 {\an1}STACEY EDWARDS-DUNN: Black women are struggling with infertility 16 00:00:43,566 --> 00:00:45,433 {\an1}at almost two times the rate as 17 00:00:45,466 --> 00:00:47,833 {\an1}our Caucasian brothers and sisters. 18 00:00:47,866 --> 00:00:49,666 {\an1}AIMEE EYVAZZADEH: I think there's an infertility pandemic. 19 00:00:49,700 --> 00:00:50,933 {\an1}And I think it's getting worse. 20 00:00:50,966 --> 00:00:53,033 {\an1}Infertility rates are quoted as one in eight 21 00:00:53,066 --> 00:00:55,766 {\an1}but I think it's much higher. 22 00:00:55,800 --> 00:01:00,400 SHANNA SWAN: Men from the general population, we found that their sperm counts 23 00:01:00,433 --> 00:01:03,733 {\an1}had dropped 50% in 40 years. 24 00:01:03,766 --> 00:01:06,733 JAMES GRIFO: There's no embryo that has all normal cells. 25 00:01:06,766 --> 00:01:08,533 {\an1}Mother Nature's all about spectrum. 26 00:01:08,566 --> 00:01:10,500 {\an1}If you want to see the belly, 27 00:01:10,533 --> 00:01:13,500 {\an1}I'm actually wearing a whole, like, belt underneath my shirt. 28 00:01:13,533 --> 00:01:15,366 {\an1}One thing that people would always say 29 00:01:15,400 --> 00:01:16,666 {\an1}is that two men can't make a baby. 30 00:01:16,700 --> 00:01:17,666 {\an1}And so, I'm sort of like, 31 00:01:17,700 --> 00:01:19,000 "Watch us." 32 00:01:19,033 --> 00:01:20,200 (laughs) 33 00:01:20,233 --> 00:01:22,066 CINDY DUKE: No one likes hearing 34 00:01:22,100 --> 00:01:23,733 {\an1}that you take Black women from America, 35 00:01:23,766 --> 00:01:26,433 {\an1}put them in other countries that are supposedly 36 00:01:26,466 --> 00:01:29,866 lower resourced, and they do better. 37 00:01:29,900 --> 00:01:30,900 {\an1}That is shocking. 38 00:01:30,933 --> 00:01:32,766 ♪ 39 00:01:32,800 --> 00:01:34,700 {\an1}I don't like to say that it's a miracle. 40 00:01:34,733 --> 00:01:37,666 {\an1}Because that doesn't have the smack of truth to it. 41 00:01:37,700 --> 00:01:39,766 {\an1}She is the spoils of war. 42 00:01:39,800 --> 00:01:42,300 {\an8}♪ 43 00:01:42,333 --> 00:01:45,000 {\an8}(baby fussing) 44 00:01:46,133 --> 00:01:49,200 ♪ 45 00:02:06,500 --> 00:02:10,700 ♪ 46 00:02:10,733 --> 00:02:13,233 CASSIE JOSEPH: I met Zack and he was a guy 47 00:02:13,266 --> 00:02:16,200 {\an1}that I just found myself falling in love with. 48 00:02:16,233 --> 00:02:19,833 {\an1}And he brought out the best of me. 49 00:02:19,866 --> 00:02:20,900 ZACK JOSEPH: You just get excited 50 00:02:20,933 --> 00:02:22,900 {\an1}about the prospect of having a family 51 00:02:22,933 --> 00:02:25,300 {\an1}and you meet the girl of your dreams 52 00:02:25,333 --> 00:02:27,366 {\an1}and then you decide, you know, to get married. 53 00:02:27,400 --> 00:02:29,933 {\an1}And you hope that kids are the next step. 54 00:02:31,100 --> 00:02:34,733 ♪ 55 00:02:36,666 --> 00:02:39,766 {\an8}CASSIE JOSEPH: In my family, my sisters got pregnant right away, 56 00:02:39,800 --> 00:02:41,733 {\an7}my mom got pregnant right away. 57 00:02:41,766 --> 00:02:44,700 {\an7}So, I never thought that infertility would be a word 58 00:02:44,733 --> 00:02:47,233 {\an7}that I would have to use in my own personal life. 59 00:02:47,266 --> 00:02:48,600 {\an8}ZACK: And we tried for years. 60 00:02:48,633 --> 00:02:50,633 {\an7}Everybody gave us advice-- 61 00:02:50,666 --> 00:02:51,700 {\an7}"Well, you just need to relax 62 00:02:51,733 --> 00:02:53,700 {\an7}"and, you know, it'll happen. 63 00:02:53,733 --> 00:02:56,566 {\an7}Just... you guys are just too stressed." 64 00:02:56,600 --> 00:02:59,500 {\an7}And we kept trying 65 00:02:59,533 --> 00:03:01,566 {\an1}and eventually we both reached a point 66 00:03:01,600 --> 00:03:03,033 {\an1}where we said something's wrong. 67 00:03:03,066 --> 00:03:06,033 CASSIE: After a year, I went in to the doctor. 68 00:03:06,066 --> 00:03:08,233 {\an1}They took my labs, a few days later they called me back 69 00:03:08,266 --> 00:03:10,833 {\an1}and said you know, "You ovulate regularly, 70 00:03:10,866 --> 00:03:13,866 {\an1}all your labs, hormonal-wise, are in check." 71 00:03:13,900 --> 00:03:16,433 {\an1}And so the next step would have Zack go in. 72 00:03:16,466 --> 00:03:17,433 Of course, 73 00:03:17,466 --> 00:03:19,400 {\an8}my husband did not want to go in 74 00:03:19,433 --> 00:03:21,466 {\an8}to the doctor. (both chuckle) 75 00:03:21,500 --> 00:03:23,433 {\an8}So, he waited for about six more months. 76 00:03:23,466 --> 00:03:25,233 {\an1}So, I thought there's nothing wrong. 77 00:03:25,266 --> 00:03:27,233 {\an1}There can't be anything wrong. 78 00:03:27,266 --> 00:03:30,133 {\an1}That would be crazy that something was wrong. 79 00:03:30,166 --> 00:03:32,166 ♪ 80 00:03:32,200 --> 00:03:35,166 CASSIE: The doctor called me and he told me the news 81 00:03:35,200 --> 00:03:41,366 {\an1}that Zack had zero sperm in his semen analysis. 82 00:03:41,400 --> 00:03:45,566 And that was the first time... 83 00:03:48,666 --> 00:03:50,866 (voice breaking): we heard it. 84 00:03:50,900 --> 00:03:53,300 ♪ 85 00:03:53,333 --> 00:03:54,633 AARON MILBANK: Having no sperm 86 00:03:54,666 --> 00:03:56,400 {\an7}is not very uncommon. 87 00:03:56,433 --> 00:03:58,700 {\an7}But most of the time there's an obvious cause-- 88 00:03:58,733 --> 00:04:00,333 {\an1}a man who's had a vasectomy, 89 00:04:00,366 --> 00:04:02,933 {\an1}men who are taking testosterone. 90 00:04:02,966 --> 00:04:04,000 {\an1}So, in Zack's case, 91 00:04:04,033 --> 00:04:07,066 {\an1}unexplained no sperm with no blockage 92 00:04:07,100 --> 00:04:09,166 {\an1}is relatively uncommon. 93 00:04:09,200 --> 00:04:11,133 {\an1}Sometimes, we find genetic reasons. 94 00:04:11,166 --> 00:04:14,466 {\an1}That's not the case in Zack's case. 95 00:04:14,500 --> 00:04:16,200 {\an1}When you're told you don't have sperm, 96 00:04:16,233 --> 00:04:18,200 {\an1}you feel like you're less of a man. 97 00:04:18,233 --> 00:04:21,200 {\an1}You feel like, "Well, why am I different 98 00:04:21,233 --> 00:04:22,200 {\an1}"than all the other guys that are out there? 99 00:04:22,233 --> 00:04:24,100 {\an1}And how am I less qualified?" 100 00:04:25,666 --> 00:04:27,566 {\an4}Dr. Milbank, you're in good hands. I know. 101 00:04:27,600 --> 00:04:30,366 {\an1}I just have to have faith that everything is going to work out. 102 00:04:30,400 --> 00:04:33,700 (voiceover): I was diagnosed with non-obstructive azoospermia, 103 00:04:33,733 --> 00:04:37,066 {\an1}which by definition means that there are zero sperm. 104 00:04:37,100 --> 00:04:40,066 {\an1}The doctor proposed that we go in surgically 105 00:04:40,100 --> 00:04:44,200 {\an1}and look in the testicle and see if there is sperm there. 106 00:04:44,233 --> 00:04:46,766 ♪ 107 00:04:46,800 --> 00:04:49,866 KARINE CHUNG: In a patient who has non-obstructive azoospermia, 108 00:04:49,900 --> 00:04:51,933 {\an1}what that means is that the sperm production 109 00:04:51,966 --> 00:04:53,933 {\an7}is likely very compromised. 110 00:04:53,966 --> 00:04:55,833 {\an7}And so, in order to get sperm, 111 00:04:55,866 --> 00:04:59,133 {\an1}the urologist is making an incision in the testes 112 00:04:59,166 --> 00:05:01,166 {\an1}and pulling out some of the little tubules 113 00:05:01,200 --> 00:05:04,133 {\an1}that will contain small amounts of sperm. 114 00:05:04,166 --> 00:05:05,800 NARRATOR: Contrary to popular belief, 115 00:05:05,833 --> 00:05:10,100 {\an1}male infertility is as common as female infertility, 116 00:05:10,133 --> 00:05:13,033 {\an1}and has many causes, including abnormal sperm production, 117 00:05:13,066 --> 00:05:16,333 {\an1}chronic illness, injury, 118 00:05:16,366 --> 00:05:18,100 {\an1}or lifestyle choices. 119 00:05:18,133 --> 00:05:19,566 {\an1}DR. AARON MILBANK: Very good. 120 00:05:19,600 --> 00:05:21,500 {\an1}All right, Jeff, find something good. 121 00:05:21,533 --> 00:05:23,933 {\an7}TECH: Okay. 122 00:05:23,966 --> 00:05:26,900 {\an7}So, we want sperm that has 123 00:05:26,933 --> 00:05:28,000 {\an7}a normal shape to it. 124 00:05:28,033 --> 00:05:30,333 {\an7}The sperm that has the most normal shape 125 00:05:30,366 --> 00:05:33,900 {\an7}is usually going to have a better chance for fertilization 126 00:05:33,933 --> 00:05:35,933 {\an7}than sperm that has abnormal shapes. 127 00:05:35,966 --> 00:05:37,100 {\an7}MILBANK: Found one? 128 00:05:37,133 --> 00:05:38,533 {\an8}TECH: Yeah, there's a few sperm in here. 129 00:05:38,566 --> 00:05:39,966 {\an7}MILBANK: Nice! 130 00:05:40,000 --> 00:05:44,300 {\an7}This is a sperm that really has a nice head, midpiece, and tail. 131 00:05:44,333 --> 00:05:46,533 {\an7}You can see it right kind of here at the center. 132 00:05:46,566 --> 00:05:48,500 {\an8}♪ 133 00:05:48,533 --> 00:05:50,000 {\an8}MILBANK: So, if you think in terms of what 134 00:05:50,033 --> 00:05:52,166 {\an7}Zack's chances are of having a child 135 00:05:52,200 --> 00:05:54,933 {\an1}without any intervention, it's zero. 136 00:05:54,966 --> 00:05:58,200 {\an1}We have moved him from zero percent success to, 137 00:05:58,233 --> 00:06:02,033 {\an1}at this point with sperm in the lab, 138 00:06:02,066 --> 00:06:03,133 {\an1}probably about a 50% chance 139 00:06:03,166 --> 00:06:06,066 {\an1}of having a child that is genetically his. 140 00:06:06,100 --> 00:06:07,400 {\an1}I love you. 141 00:06:07,433 --> 00:06:08,733 I love you, too. 142 00:06:08,766 --> 00:06:12,300 ZACK: I'm of course happy that they did find sperm. 143 00:06:12,333 --> 00:06:15,966 {\an1}But you still have all those questions about what is next. 144 00:06:16,000 --> 00:06:21,133 ♪ 145 00:06:21,166 --> 00:06:23,333 SHANNA SWAN: If we take an average man today, 146 00:06:23,366 --> 00:06:26,366 {\an7}and look at his sperm, his father's sperm, 147 00:06:26,400 --> 00:06:28,366 {\an7}his grandfather's sperm-- 148 00:06:28,400 --> 00:06:31,266 {\an7}we see that he has on average 149 00:06:31,300 --> 00:06:36,533 {\an1}about half the number of sperm as his grandfather. 150 00:06:36,566 --> 00:06:39,866 {\an1}So, what we found when we looked in Western countries-- 151 00:06:39,900 --> 00:06:43,433 that is men from the general population 152 00:06:43,466 --> 00:06:45,900 {\an1}who didn't know whether or not they were fertile-- 153 00:06:45,933 --> 00:06:51,766 {\an1}we found that their sperm counts had dropped 50% in 40 years. 154 00:06:51,800 --> 00:06:56,500 {\an1}Because it's not likely to be genetic. 155 00:06:56,533 --> 00:06:57,966 {\an1}Why? Because it's too fast. 156 00:06:58,000 --> 00:07:01,566 {\an1}It's too fast a decline for a genetic change. 157 00:07:01,600 --> 00:07:02,866 {\an1}So then it's environmental. 158 00:07:02,900 --> 00:07:03,966 (lighter clicks) 159 00:07:04,000 --> 00:07:07,600 {\an1}Lifestyle factors like smoking too much, 160 00:07:07,633 --> 00:07:09,600 {\an1}binge drinking, stress. 161 00:07:09,633 --> 00:07:12,500 {\an1}A man's body weight, his obesity 162 00:07:12,533 --> 00:07:16,400 {\an1}is directly related to his semen quality. 163 00:07:16,433 --> 00:07:20,833 {\an1}Another is the chemicals in our daily life 164 00:07:20,866 --> 00:07:23,433 {\an1}that have the ability to interfere 165 00:07:23,466 --> 00:07:27,500 {\an1}with the production, distribution, 166 00:07:27,533 --> 00:07:30,233 {\an1}and utilization of testosterone. 167 00:07:30,266 --> 00:07:31,633 {\an1}And they are part 168 00:07:31,666 --> 00:07:35,966 {\an1}of a category called endocrine disruptors. 169 00:07:36,000 --> 00:07:37,933 {\an1}Endocrine means hormone. 170 00:07:37,966 --> 00:07:39,400 {\an1}Testosterone is a hormone. 171 00:07:39,433 --> 00:07:43,633 {\an1}So, chemicals in plastic, 172 00:07:43,666 --> 00:07:45,833 {\an1}soft plastic in particular, 173 00:07:45,866 --> 00:07:49,366 {\an1}have the ability to decrease testosterone. 174 00:07:49,400 --> 00:07:52,533 {\an1}We know that the chemicals in personal care products 175 00:07:52,566 --> 00:07:56,866 {\an1}include many endocrine disruptors. 176 00:07:56,900 --> 00:08:01,033 {\an1}The chemicals come into the mother's body, 177 00:08:01,066 --> 00:08:02,300 {\an1}they get to the fetus, 178 00:08:02,333 --> 00:08:04,300 {\an1}there's no question that they get to the fetus. 179 00:08:04,333 --> 00:08:07,366 {\an1}So, this is a really critical link to the picture. 180 00:08:07,400 --> 00:08:09,233 ♪ 181 00:08:09,266 --> 00:08:11,366 NARRATOR: These chemicals can reduce testosterone 182 00:08:11,400 --> 00:08:13,100 {\an1}in the developing fetus-- 183 00:08:13,133 --> 00:08:15,133 {\an1}and that can affect males' sperm production 184 00:08:15,166 --> 00:08:18,500 {\an1}and health later in life. 185 00:08:18,533 --> 00:08:20,000 SWAN: The consequences, 186 00:08:20,033 --> 00:08:23,366 {\an1}one of which is lowered sperm count, 187 00:08:23,400 --> 00:08:26,366 {\an1}and we see a lot of that in... all over the United States. 188 00:08:26,400 --> 00:08:31,533 {\an1}It's not just the number of sperm that we care about. 189 00:08:31,566 --> 00:08:33,633 {\an1}We also care about the shape of the sperm, 190 00:08:33,666 --> 00:08:36,833 {\an1}which has gone downhill as well. 191 00:08:36,866 --> 00:08:39,133 {\an1}It's got to swim straight. 192 00:08:39,166 --> 00:08:41,033 {\an1}Circles won't do. 193 00:08:41,066 --> 00:08:43,066 {\an1}It's got to get to the target. 194 00:08:43,100 --> 00:08:44,366 {\an1}So, what we're seeing is 195 00:08:44,400 --> 00:08:47,066 {\an1}that the sperm are failing the test, 196 00:08:47,100 --> 00:08:49,966 in lots of ways. 197 00:08:50,000 --> 00:08:52,033 NARRATOR: But healthy sperm are just one piece 198 00:08:52,066 --> 00:08:56,633 {\an1}of the fertility puzzle when it comes to making a baby. 199 00:08:56,666 --> 00:08:58,600 {\an1}In order for natural conception to occur, 200 00:08:58,633 --> 00:09:01,000 {\an1}there are actually a lot of things that need to go right. 201 00:09:01,033 --> 00:09:03,500 {\an1}So, the very first thing that needs to happen 202 00:09:03,533 --> 00:09:05,500 {\an1}is there needs to be ovulation, 203 00:09:05,533 --> 00:09:07,466 {\an1}which means that one mature egg 204 00:09:07,500 --> 00:09:09,466 {\an1}is released from the ovary. 205 00:09:09,500 --> 00:09:12,433 {\an1}That egg then needs to be picked up by the Fallopian tube 206 00:09:12,466 --> 00:09:14,500 {\an1}and it lives there for about 24 hours. 207 00:09:14,533 --> 00:09:15,800 {\an1}If there's sperm around, 208 00:09:15,833 --> 00:09:18,933 {\an1}the sperm needs to find the egg in the Fallopian tube 209 00:09:18,966 --> 00:09:21,500 {\an1}and then they join together, which we call fertilization. 210 00:09:21,533 --> 00:09:24,233 {\an1}The egg now transforms and becomes an embryo. 211 00:09:24,266 --> 00:09:25,900 CINDY DUKE: Reproduction is really exciting 212 00:09:25,933 --> 00:09:29,833 {\an7}because it's the best example of multiplication you'll ever see. 213 00:09:29,866 --> 00:09:32,833 {\an1}So, the embryo goes from one cell 214 00:09:32,866 --> 00:09:34,833 to two to four 215 00:09:34,866 --> 00:09:36,233 {\an1}and it just keeps doubling. 216 00:09:36,266 --> 00:09:40,333 {\an1}So that by the time the embryo gets into the womb, 217 00:09:40,366 --> 00:09:43,100 {\an1}it's hundreds of cells. 218 00:09:43,133 --> 00:09:44,533 KARINE CHUNG: Once it's in the uterus, 219 00:09:44,566 --> 00:09:47,466 {\an1}that blastocyst needs to send signals to the uterus 220 00:09:47,500 --> 00:09:49,066 {\an1}and the uterus needs to send signals back 221 00:09:49,100 --> 00:09:53,066 {\an1}until there's a connection, which we call implantation. 222 00:09:53,100 --> 00:09:56,066 {\an1}Even when a couple has no fertility issues whatsoever, 223 00:09:56,100 --> 00:09:59,133 {\an1}the chances that all of that will go right in a given month 224 00:09:59,166 --> 00:10:00,566 {\an1}is only about 25% to 30%. 225 00:10:00,600 --> 00:10:02,800 Here we are. Yeah, here we are. 226 00:10:02,833 --> 00:10:03,966 My turn. 227 00:10:04,000 --> 00:10:05,233 ♪ 228 00:10:05,266 --> 00:10:07,066 CHUNG: Approximately one in eight couples 229 00:10:07,100 --> 00:10:09,266 {\an1}suffer from infertility in the United States. 230 00:10:09,300 --> 00:10:10,700 {\an1}I think it's a private issue 231 00:10:10,733 --> 00:10:13,600 {\an1}where a lot of people who are struggling with fertility issues 232 00:10:13,633 --> 00:10:15,566 {\an1}don't really talk about it. 233 00:10:15,600 --> 00:10:17,633 {\an1}But I think it's important that we all acknowledge, 234 00:10:17,666 --> 00:10:19,333 {\an1}one in eight is a lot of people. 235 00:10:19,366 --> 00:10:20,600 ♪ 236 00:10:20,633 --> 00:10:24,566 NARRATOR: Each year, about 160,000 Americans 237 00:10:24,600 --> 00:10:29,266 {\an1}turn to in vitro fertilization, or I.V.F. 238 00:10:29,300 --> 00:10:31,833 {\an1}In the coming weeks, Cassie will take drugs 239 00:10:31,866 --> 00:10:34,800 {\an1}to stimulate the development of multiple eggs 240 00:10:34,833 --> 00:10:36,866 {\an1}in hopes that they can be fertilized 241 00:10:36,900 --> 00:10:39,333 {\an1}with Zack's sperm in the lab. 242 00:10:39,366 --> 00:10:42,100 {\an1}This is what I.V.F. looks like. 243 00:10:42,133 --> 00:10:43,166 {\an1}These are all the meds 244 00:10:43,200 --> 00:10:46,533 {\an1}and they come in a package, a big box. 245 00:10:46,566 --> 00:10:50,133 {\an1}And you open it up and you're like, wow! 246 00:10:50,166 --> 00:10:53,200 {\an1}This is what the next 20 days of my life 247 00:10:53,233 --> 00:10:56,200 {\an1}is going to be consumed of. 248 00:10:56,233 --> 00:10:57,933 {\an1}All of these meds 249 00:10:57,966 --> 00:10:59,933 in 20 days. 250 00:10:59,966 --> 00:11:02,000 {\an1}Thousands of dollars. 251 00:11:02,033 --> 00:11:04,333 This is I.V.F. 252 00:11:04,366 --> 00:11:08,200 ♪ 253 00:11:08,233 --> 00:11:11,700 EDWARDS-DUNN: "It hurts to give yourself shots. 254 00:11:11,733 --> 00:11:15,766 {\an1}"It hurts when your spouse has male factor infertility. 255 00:11:15,800 --> 00:11:19,800 {\an1}"It hurts when you and your spouse don't see eye to eye. 256 00:11:19,833 --> 00:11:24,100 {\an1}"It hurts because no one knows the silent tears 257 00:11:24,133 --> 00:11:25,666 {\an1}"that you cry at night. 258 00:11:25,700 --> 00:11:29,633 {\an1}"It hurts because you don't have insurance or money 259 00:11:29,666 --> 00:11:32,866 {\an1}"to cover treatment or adoption services. 260 00:11:32,900 --> 00:11:33,933 "It hurts! 261 00:11:33,966 --> 00:11:36,966 {\an1}"Because it seems like God is silent. 262 00:11:37,000 --> 00:11:40,933 {\an1}"It hurts because of the crazy comments people say to you like, 263 00:11:40,966 --> 00:11:42,900 "'Just relax.' 264 00:11:42,933 --> 00:11:47,666 {\an1}"It hurts because the baby you've always dreamed of 265 00:11:47,700 --> 00:11:50,200 {\an1}"seems like a distant reality 266 00:11:50,233 --> 00:11:53,133 {\an1}that may not ever happen." 267 00:11:56,000 --> 00:12:00,200 ♪ 268 00:12:03,066 --> 00:12:06,533 {\an1}In the African-American community, what I would hear 269 00:12:06,566 --> 00:12:08,033 {\an1}is that we were fertile, 270 00:12:08,066 --> 00:12:10,966 {\an1}that we were hyper-fertile. 271 00:12:11,000 --> 00:12:14,500 {\an1}Much of this is steeped in a number of breeding myths, 272 00:12:14,533 --> 00:12:17,200 {\an1}particularly during slavery. 273 00:12:18,933 --> 00:12:21,233 {\an1}Black women in particular-- 274 00:12:21,266 --> 00:12:22,700 {\an1}we didn't struggle with infertility. 275 00:12:22,733 --> 00:12:25,266 {\an1}That's what we were told. 276 00:12:25,300 --> 00:12:27,533 ♪ 277 00:12:27,566 --> 00:12:28,733 {\an1}And for those women 278 00:12:28,766 --> 00:12:31,600 {\an7}that were experiencing fertility challenges, 279 00:12:31,633 --> 00:12:33,600 {\an7}it was a secret, you know? 280 00:12:33,633 --> 00:12:35,033 {\an7}No one was talking about it. 281 00:12:36,400 --> 00:12:38,833 NARRATOR: Reverend Stacey Edwards-Dunn was 37 years old 282 00:12:38,866 --> 00:12:41,600 {\an1}when she married her husband Earl. 283 00:12:41,633 --> 00:12:43,666 {\an1}They planned to have a child right away 284 00:12:43,700 --> 00:12:47,300 {\an1}but were unable to, and turned to I.V.F. 285 00:12:47,333 --> 00:12:48,700 EARL DUNN: I think one of the key issues 286 00:12:48,733 --> 00:12:50,100 {\an8}with a lot of couples, 287 00:12:50,133 --> 00:12:52,933 {\an7}especially minority couples, is financial. 288 00:12:52,966 --> 00:12:55,533 It's financial, it's expensive. 289 00:12:57,000 --> 00:13:00,466 WANDA BARFIELD: Assisted Reproductive Technologies, or A.R.T. 290 00:13:00,500 --> 00:13:04,766 {\an8}does relate to socioeconomic status 291 00:13:04,800 --> 00:13:08,566 {\an1}because fertility treatments are relatively expensive. 292 00:13:08,600 --> 00:13:13,166 DUKE: I.V.F. could cost anywhere between $10,000 293 00:13:13,200 --> 00:13:18,066 {\an1}and as high as $25,000, if using your own eggs. 294 00:13:18,100 --> 00:13:19,666 {\an1}In terms of who gets to have a baby, 295 00:13:19,700 --> 00:13:22,666 {\an1}it's whether you can afford it, whether you have access to it. 296 00:13:22,700 --> 00:13:25,633 {\an1}We know that, unfortunately, 297 00:13:25,666 --> 00:13:27,733 {\an1}just simply looking at geographics in terms of 298 00:13:27,766 --> 00:13:30,633 {\an1}locations of fertility clinics, 299 00:13:30,666 --> 00:13:34,766 {\an1}they tend to be located in the more affluent neighborhoods. 300 00:13:34,800 --> 00:13:38,300 {\an1}For many people, it's cost prohibitive. 301 00:13:38,333 --> 00:13:41,200 HANK GREELY: I.V.F. is usually not covered 302 00:13:41,233 --> 00:13:43,366 {\an7}by either private insurance 303 00:13:43,400 --> 00:13:45,666 {\an7}or by the state health care program for the poor, 304 00:13:45,700 --> 00:13:47,600 {\an7}the state federal program Medicaid. 305 00:13:47,633 --> 00:13:49,633 {\an1}We're one of the few rich countries 306 00:13:49,666 --> 00:13:53,000 {\an1}that doesn't think of it as part of basic health coverage. 307 00:13:53,033 --> 00:13:58,233 DUKE: The good news is more and more states in the United States 308 00:13:58,266 --> 00:14:00,433 {\an1}now provide what we call mandated coverage, 309 00:14:00,466 --> 00:14:04,300 {\an1}which is a strong requirement or recommendation 310 00:14:04,333 --> 00:14:08,066 {\an1}that employers and other insurers 311 00:14:08,100 --> 00:14:10,366 {\an1}provide fertility coverage. 312 00:14:10,400 --> 00:14:13,966 NARRATOR: For six years, Stacey and Earl poured their life savings 313 00:14:14,000 --> 00:14:16,066 {\an1}into multiple I.V.F. treatments. 314 00:14:16,100 --> 00:14:20,600 {\an1}Finally, a doctor alerted Stacey that she had a rare condition 315 00:14:20,633 --> 00:14:22,666 {\an1}that no one had ever told her about. 316 00:14:24,600 --> 00:14:25,900 {\an8}EDWARDS-DUNN: So, I went to go see the doctor. 317 00:14:25,933 --> 00:14:28,500 {\an7}She said, "Had anyone ever told you 318 00:14:28,533 --> 00:14:31,000 {\an8}that you had one Fallopian tube?" 319 00:14:31,033 --> 00:14:32,566 {\an1}I said, "Absolutely not." 320 00:14:32,600 --> 00:14:36,266 {\an1}"Has anyone ever told you that you have a unicornuate uterus? 321 00:14:36,300 --> 00:14:39,533 {\an1}That your uterus is much smaller than the average uterus?" 322 00:14:39,566 --> 00:14:40,833 {\an1}I said, "Absolutely not." 323 00:14:40,866 --> 00:14:42,166 {\an1}Now although I had been diagnosed 324 00:14:42,200 --> 00:14:44,266 {\an1}with unexplained infertility, 325 00:14:44,300 --> 00:14:48,300 {\an1}they still never told me that I had one Fallopian tube 326 00:14:48,333 --> 00:14:50,266 {\an1}or had a unicornuate uterus. 327 00:14:50,300 --> 00:14:52,466 {\an1}Which could have been a, you know, 328 00:14:52,500 --> 00:14:56,466 {\an1}a major game-changer for every doctor that had seen me. 329 00:14:58,200 --> 00:15:00,933 BARFIELD: For African American women, there has been 330 00:15:00,966 --> 00:15:05,966 {\an1}a long-standing history of reproductive coercion, 331 00:15:06,000 --> 00:15:08,600 {\an1}of sterilization that we know that's gone on 332 00:15:08,633 --> 00:15:11,533 {\an1}in the history of the United States, 333 00:15:11,566 --> 00:15:14,600 {\an1}and there is a concern about trust. 334 00:15:14,633 --> 00:15:17,000 CHUNG: Across the board, there are disparities. 335 00:15:17,033 --> 00:15:20,133 {\an1}Clearly disparities in the medical system for the treatment 336 00:15:20,166 --> 00:15:22,166 {\an1}of African American men and women. 337 00:15:22,200 --> 00:15:25,100 {\an1}And I think that's true in the world of infertility as well. 338 00:15:26,400 --> 00:15:28,766 EDWARDS-DUNN: In our community, I hear it all the time. 339 00:15:28,800 --> 00:15:30,733 {\an1}When we go to doctors, 340 00:15:30,766 --> 00:15:33,633 {\an1}many doctors do not take us seriously. 341 00:15:33,666 --> 00:15:36,633 {\an1}Many doctors have provided diagnosis 342 00:15:36,666 --> 00:15:38,633 {\an1}oftentimes that's incorrect. 343 00:15:38,666 --> 00:15:39,933 (lighter clicks) 344 00:15:39,966 --> 00:15:42,933 ♪ 345 00:15:42,966 --> 00:15:45,733 NARRATOR: Reverend Stacey came to see the first six years 346 00:15:45,766 --> 00:15:48,100 {\an1}of her private fight for fertility 347 00:15:48,133 --> 00:15:51,000 {\an1}as her season of delay. 348 00:15:51,033 --> 00:15:55,000 EDWARDS-DUNN: A lot of people struggle with this idea of delay. 349 00:15:55,033 --> 00:15:57,266 And you wonder when your time is coming. 350 00:15:57,300 --> 00:16:01,066 {\an1}And so I had to get to the point that, you know, 351 00:16:01,100 --> 00:16:04,066 {\an1}each time I got a negative pregnancy test 352 00:16:04,100 --> 00:16:07,066 {\an1}or that the I.V.F. wasn't successful, 353 00:16:07,100 --> 00:16:09,133 {\an1}I had to eventually arrive to the point 354 00:16:09,166 --> 00:16:11,566 {\an1}that delay didn't mean denial. 355 00:16:12,733 --> 00:16:15,366 NARRATOR: Believing she would become a mother, 356 00:16:15,400 --> 00:16:18,300 {\an1}Reverend Stacey decided to break her silence. 357 00:16:18,333 --> 00:16:21,400 EDWARDS-DUNN: The moment that I was willing to open up 358 00:16:21,433 --> 00:16:23,366 {\an1}and publicly share about my story, 359 00:16:23,400 --> 00:16:25,466 {\an1}what happened is that women and couples 360 00:16:25,500 --> 00:16:27,400 {\an1}began to come out the woodworks. 361 00:16:27,433 --> 00:16:28,366 {\an1}Because they were like, 362 00:16:28,400 --> 00:16:31,300 {\an1}"My God, she gets it. 363 00:16:31,333 --> 00:16:35,333 {\an1}She, she's going through what I... what I'm going through." 364 00:16:35,366 --> 00:16:38,533 {\an1}Or "She's now been through, you know, what I'm going through." 365 00:16:38,566 --> 00:16:40,500 ♪ 366 00:16:40,533 --> 00:16:42,533 {\an1}Black women are struggling with infertility 367 00:16:42,566 --> 00:16:43,933 {\an1}at almost two times the rate 368 00:16:43,966 --> 00:16:47,700 {\an1}as our Caucasian brothers and sisters. 369 00:16:47,733 --> 00:16:50,833 TIFFANY HARPER: I knew when I was about 25 years old 370 00:16:50,866 --> 00:16:53,800 {\an7}what they kept telling me-- "You have a uterus full of fibroids." 371 00:16:53,833 --> 00:16:54,800 {\an7}And so, I didn't know if 372 00:16:54,833 --> 00:16:56,366 {\an7}that was going to impact my fertility. 373 00:16:56,400 --> 00:16:58,700 {\an7}I had just graduated from law school. 374 00:16:58,733 --> 00:17:01,233 {\an1}I wasn't interested in having a baby at that point. 375 00:17:01,266 --> 00:17:03,133 {\an1}And so I kind of... I didn't have symptoms. 376 00:17:03,166 --> 00:17:05,033 {\an1}I kind of let it go on and go on and go on. 377 00:17:06,633 --> 00:17:10,433 NARRATOR: Fibroids are benign tumors of muscular and fibrous tissue 378 00:17:10,466 --> 00:17:13,333 {\an1}that typically develop in the walls of the uterus. 379 00:17:13,366 --> 00:17:16,400 EYVAZZADEH: Fibroids cause a disruption inside the uterus 380 00:17:16,433 --> 00:17:19,100 {\an1}such that it becomes not only hard to get pregnant, 381 00:17:19,133 --> 00:17:22,033 {\an7}it also becomes harder to stay pregnant. 382 00:17:22,066 --> 00:17:24,033 {\an7}Black women experience miscarriages 383 00:17:24,066 --> 00:17:25,233 {\an7}at a much higher rate. 384 00:17:25,266 --> 00:17:28,266 {\an1}And I think it's almost always due to fibroids. 385 00:17:28,300 --> 00:17:29,700 ♪ 386 00:17:29,733 --> 00:17:31,133 NARRATOR: When Tiffany married 387 00:17:31,166 --> 00:17:32,633 {\an1}and was ready to start a family, 388 00:17:32,666 --> 00:17:34,633 {\an1}she struggled to get pregnant, 389 00:17:34,666 --> 00:17:36,700 {\an1}but did not know where to turn for help. 390 00:17:36,733 --> 00:17:38,166 (mouse clicks) 391 00:17:38,200 --> 00:17:40,200 HARPER: I think every community has that taboo subject, 392 00:17:40,233 --> 00:17:42,300 {\an1}that thing they just don't talk about at the dinner table, 393 00:17:42,333 --> 00:17:44,233 {\an1}and fertility is ours. 394 00:17:44,266 --> 00:17:45,233 {\an1}I didn't have a voice. 395 00:17:45,266 --> 00:17:47,566 {\an1}I was just struggling. 396 00:17:47,600 --> 00:17:51,566 {\an1}I'm a lawyer by trade and so I'm used to advocating for people. 397 00:17:51,600 --> 00:17:53,666 {\an1}But in this, I couldn't advocate for myself. 398 00:17:53,700 --> 00:17:55,566 {\an1}I didn't know how and I had, 399 00:17:55,600 --> 00:17:57,533 {\an1}I had too much pain, too much shame, 400 00:17:57,566 --> 00:18:00,266 {\an1}and that's when I came across Fertility for Colored Girls. 401 00:18:00,300 --> 00:18:04,533 {\an4}It's so difficult... WOMAN: Yeah. 402 00:18:04,566 --> 00:18:08,133 {\an1}And it's very difficult to be, like, 403 00:18:08,166 --> 00:18:11,733 {\an1}told this basic lie your whole life, 404 00:18:11,766 --> 00:18:13,800 {\an1}that it's just... everything's going to work out 405 00:18:13,833 --> 00:18:15,200 {\an1}and it really isn't. 406 00:18:15,233 --> 00:18:16,700 EDWARDS-DUNN: I do believe that God called me 407 00:18:16,733 --> 00:18:18,866 {\an1}to start Fertility for Colored Girls, 408 00:18:18,900 --> 00:18:20,866 {\an1}to create this safe space for women, 409 00:18:20,900 --> 00:18:23,766 {\an1}particularly African American women who were struggling 410 00:18:23,800 --> 00:18:24,933 {\an1}at insurmountable rates 411 00:18:24,966 --> 00:18:26,833 {\an1}because there was no place for them to go. 412 00:18:26,866 --> 00:18:28,466 ♪ 413 00:18:28,500 --> 00:18:32,566 HARPER: I went to the meeting and I was shocked 414 00:18:32,600 --> 00:18:37,066 {\an1}because there were so many Black and brown women there, 415 00:18:37,100 --> 00:18:39,033 {\an1}like me, who were struggling. 416 00:18:39,066 --> 00:18:42,000 {\an1}And it was the first time that I didn't feel alone. 417 00:18:42,033 --> 00:18:44,966 {\an1}We're believing and we're cheering you on 418 00:18:45,000 --> 00:18:47,000 {\an1}till the end. Yes. 419 00:18:47,033 --> 00:18:49,133 {\an1}Black women in particular, 420 00:18:49,166 --> 00:18:52,133 {\an1}we have experienced generations of oppression. 421 00:18:52,166 --> 00:18:57,000 {\an1}We carry generations of stress. 422 00:18:57,033 --> 00:18:58,766 {\an1}Someone says that, 423 00:18:58,800 --> 00:19:01,833 {\an1}you know, this stress and this trauma is also cellular, 424 00:19:01,866 --> 00:19:06,133 {\an1}and it particularly impacts us on this infertility journey. 425 00:19:06,166 --> 00:19:08,033 ♪ 426 00:19:08,066 --> 00:19:12,033 BARFIELD: Women, particularly African American women, 427 00:19:12,066 --> 00:19:16,266 {\an1}have experienced long-standing 428 00:19:16,300 --> 00:19:20,866 {\an1}social, economic, and environmental stress 429 00:19:20,900 --> 00:19:25,833 {\an1}that has really placed a burden on their bodies 430 00:19:25,866 --> 00:19:28,066 {\an1}in a way that translates 431 00:19:28,100 --> 00:19:32,200 {\an1}into more adverse reproductive health outcomes. 432 00:19:32,233 --> 00:19:34,066 {\an1}And that term is called weathering, 433 00:19:34,100 --> 00:19:40,500 {\an1}that this weathering in a way prematurely ages Black women. 434 00:19:40,533 --> 00:19:44,466 {\an1}Your stress hormones, cortisol, your fight-or-flight hormones 435 00:19:44,500 --> 00:19:48,500 {\an1}known as catecholamines or epinephrine, norepinephrine, 436 00:19:48,533 --> 00:19:51,966 {\an1}those hormones actually should only be present 437 00:19:52,000 --> 00:19:55,733 {\an1}at low doses overall in your general day-to-day 438 00:19:55,766 --> 00:19:58,733 {\an1}and only spike when you truly have 439 00:19:58,766 --> 00:20:02,033 {\an1}a new, short-term scare or anxiety. 440 00:20:02,066 --> 00:20:06,000 {\an1}For people who find themselves in societies where there's maybe 441 00:20:06,033 --> 00:20:08,866 {\an1}institutional racism, structural racism, 442 00:20:08,900 --> 00:20:11,666 {\an1}their catecholamines and their cortisol levels 443 00:20:11,700 --> 00:20:13,466 {\an1}are way higher than they should be. 444 00:20:13,500 --> 00:20:16,533 {\an1}And so if someone is constantly under stress 445 00:20:16,566 --> 00:20:18,666 {\an1}where their body is weathering, 446 00:20:18,700 --> 00:20:22,466 {\an1}that has a lot of long-term impacts 447 00:20:22,500 --> 00:20:23,500 {\an1}on all your organ systems. 448 00:20:23,533 --> 00:20:26,433 {\an1}And over time, we see that manifesting 449 00:20:26,466 --> 00:20:29,433 {\an1}in earlier ages of diagnosis with disease, 450 00:20:29,466 --> 00:20:35,600 {\an1}earlier ages of diagnosis in terms of high blood pressure, 451 00:20:35,633 --> 00:20:37,566 {\an1}diabetes, stress-related tension, 452 00:20:37,600 --> 00:20:40,633 {\an1}and even birth outcomes in women. 453 00:20:40,666 --> 00:20:44,300 (gospel singing) 454 00:20:44,333 --> 00:20:46,466 HARPER: The Black community is often described as 455 00:20:46,500 --> 00:20:48,466 {\an1}the most religious community in America. 456 00:20:48,500 --> 00:20:51,700 {\an1}And there's a big push to just pray about it. 457 00:20:51,733 --> 00:20:54,366 Rev. Stacey, because she's a reverend, 458 00:20:54,400 --> 00:20:57,400 {\an1}really kind of demystified that and said, 459 00:20:57,433 --> 00:20:58,600 {\an1}"God made the science too." 460 00:20:58,633 --> 00:21:02,000 {\an1}I had gone through one round of I.V.F. 461 00:21:02,033 --> 00:21:04,000 {\an1}and when they went in to retrieve the eggs, 462 00:21:04,033 --> 00:21:07,000 {\an1}they could not really get to my ovaries 463 00:21:07,033 --> 00:21:10,266 {\an1}because they've got these fibroids all over the place. 464 00:21:10,300 --> 00:21:12,100 {\an1}And upwards of 80% of Black women 465 00:21:12,133 --> 00:21:13,766 {\an1}suffer from fibroids. 466 00:21:13,800 --> 00:21:17,033 {\an1}And we don't do anything about it unless it's life-threatening. 467 00:21:17,066 --> 00:21:22,000 {\an1}And Rev. Stacey just really gave me the push I needed and, 468 00:21:22,033 --> 00:21:24,400 {\an1}and the permission to, to remove the fibroids 469 00:21:24,433 --> 00:21:27,300 {\an1}and move forward on my path to, to motherhood. 470 00:21:27,333 --> 00:21:30,866 NARRATOR: After surgery to remove her fibroids, 471 00:21:30,900 --> 00:21:34,600 {\an1}Tiffany embarked on more rounds of I.V.F. 472 00:21:34,633 --> 00:21:36,633 GREELY: I.V.F. doesn't seem to be 473 00:21:36,666 --> 00:21:39,100 {\an1}any more efficient than nature. 474 00:21:39,133 --> 00:21:42,933 {\an1}Still, most I.V.F. embryos do not become babies, 475 00:21:42,966 --> 00:21:46,100 {\an1}just as most embryos that are produced the old-fashioned way 476 00:21:46,133 --> 00:21:48,233 {\an1}don't become babies. 477 00:21:48,266 --> 00:21:50,433 {\an1}But if you've got blocked Fallopian tubes, 478 00:21:50,466 --> 00:21:53,366 {\an1}or if your sperm for some reason won't fertilize an egg, 479 00:21:53,400 --> 00:21:55,300 {\an1}for a variety of other reasons 480 00:21:55,333 --> 00:21:56,666 {\an1}there are a lot of people out there for whom 481 00:21:56,700 --> 00:21:59,300 {\an1}the old-fashioned way just won't work. 482 00:21:59,333 --> 00:22:04,566 {\an7}And for them, I.V.F. amazingly outperforms nature. 483 00:22:09,300 --> 00:22:12,300 {\an8}NARRATOR: This is the second time Cassie and Zack have tried 484 00:22:12,333 --> 00:22:14,433 {\an7}to conceive a child through I.V.F. 485 00:22:14,466 --> 00:22:16,333 {\an7}using sperm extracted from Zack. 486 00:22:16,366 --> 00:22:19,066 {\an1}Their first attempt did not produce viable embryos. 487 00:22:19,100 --> 00:22:21,500 ♪ 488 00:22:21,533 --> 00:22:24,400 {\an1}Within 24 hours of Zack's procedure, 489 00:22:24,433 --> 00:22:26,700 {\an1}Dr. April Batcheller will attempt 490 00:22:26,733 --> 00:22:29,400 {\an1}to collect eggs from both of Cassie's ovaries. 491 00:22:29,433 --> 00:22:32,333 BATCHELLER: We give women like Cassie 492 00:22:32,366 --> 00:22:35,066 {\an1}extra follicle stimulating hormone. 493 00:22:35,100 --> 00:22:37,200 {\an7}So that instead of just growing one egg, 494 00:22:37,233 --> 00:22:41,066 {\an7}maybe we can get 15 or 20 eggs from the ovary. 495 00:22:41,100 --> 00:22:43,400 ♪ 496 00:22:43,433 --> 00:22:45,033 {\an1}The goal is going to be 497 00:22:45,066 --> 00:22:49,233 {\an1}to place a needle into each one of these follicles here 498 00:22:49,266 --> 00:22:52,966 {\an1}and aspirate all of these beautiful eggs 499 00:22:53,000 --> 00:22:55,733 {\an1}that Cassie spent the past two weeks growing. 500 00:22:55,766 --> 00:22:58,866 NARRATOR: Follicles are the tiny sacs inside the ovaries 501 00:22:58,900 --> 00:23:01,600 {\an1}that nurture and release a woman's eggs. 502 00:23:01,633 --> 00:23:02,833 EYVAZZADEH: During an egg retrieval, 503 00:23:02,866 --> 00:23:05,633 {\an1}a doctor will place a probe inside the vagina 504 00:23:05,666 --> 00:23:08,200 {\an1}and through a needle-guided procedure, 505 00:23:08,233 --> 00:23:12,533 {\an1}follicles are drained of follicular fluid. 506 00:23:12,566 --> 00:23:15,033 {\an1}24. 507 00:23:15,066 --> 00:23:17,033 NARRATOR: In the room next door, 508 00:23:17,066 --> 00:23:19,633 {\an1}the embryologist will isolate Cassie's eggs 509 00:23:19,666 --> 00:23:23,533 {\an1}and try to fertilize them with Zack's sperm. 510 00:23:23,566 --> 00:23:25,066 BATCHELLER: Fertilization is probably 511 00:23:25,100 --> 00:23:27,366 {\an1}our biggest hurdle that we have here 512 00:23:27,400 --> 00:23:29,866 {\an1}because of Zacks's sperm challenge. 513 00:23:29,900 --> 00:23:31,433 ♪ 514 00:23:31,466 --> 00:23:35,233 {\an1}In this case, because Zach's sperm were surgically extracted, 515 00:23:35,266 --> 00:23:38,166 {\an1}they lack the ability to swim. 516 00:23:38,200 --> 00:23:41,800 {\an1}And so, we have to give them a bit of a boost 517 00:23:41,833 --> 00:23:43,400 by injecting the non-swimming sperm 518 00:23:43,433 --> 00:23:47,400 {\an1}into the egg with a needle, called a ICSI needle-- 519 00:23:47,433 --> 00:23:50,700 {\an1}intracytoplasmic sperm injection. 520 00:23:50,733 --> 00:23:53,933 NARRATOR: This revolutionary technology was developed 521 00:23:53,966 --> 00:23:57,333 {\an1}to assist fertilization for men with weak or few sperm. 522 00:23:57,366 --> 00:24:01,600 {\an1}Today, it is widely used in I.V.F. laboratories. 523 00:24:02,633 --> 00:24:05,866 {\an1}Oh... All right. 524 00:24:05,900 --> 00:24:08,100 Okay, I know, right? 525 00:24:08,133 --> 00:24:11,733 NARRATOR: Within 18 hours, Zack's sperm and Cassie's eggs 526 00:24:11,766 --> 00:24:14,666 {\an1}create three embryos. 527 00:24:14,700 --> 00:24:16,700 {\an1}From there, it is an anxiety-provoking 528 00:24:16,733 --> 00:24:18,300 {\an1}five or six days while we wait for the embryos 529 00:24:18,333 --> 00:24:21,900 {\an1}to grow and divide. 530 00:24:21,933 --> 00:24:24,366 ♪ 531 00:24:24,400 --> 00:24:29,033 CASSIE: I think being faced with infertility 532 00:24:29,066 --> 00:24:30,433 {\an1}is extremely hard. 533 00:24:30,466 --> 00:24:31,766 It's emotional. 534 00:24:31,800 --> 00:24:33,666 {\an1}You have the steps of grieving. 535 00:24:33,700 --> 00:24:37,233 {\an1}You're trying to accept and you're trying to, you know, 536 00:24:37,266 --> 00:24:39,233 {\an1}predict what's going to happen. 537 00:24:39,266 --> 00:24:41,733 {\an8}Everybody has such a unique story. 538 00:24:41,766 --> 00:24:44,733 {\an8}And when you have a child of your own 539 00:24:44,766 --> 00:24:46,900 {\an8}and you say, "Why not adopt?" 540 00:24:46,933 --> 00:24:49,666 that's their opinion, you know. 541 00:24:49,700 --> 00:24:51,133 They decided to be parents themselves, 542 00:24:51,166 --> 00:24:52,333 they have biological children. 543 00:24:52,366 --> 00:24:56,633 {\an1}And it's really hard to hear that. 544 00:24:56,666 --> 00:24:58,200 {\an1}You look into your future. 545 00:24:58,233 --> 00:25:00,166 {\an1}What does that look like for us? 546 00:25:00,200 --> 00:25:03,733 {\an1}Who's going to be with us for our family Christmases? 547 00:25:03,766 --> 00:25:04,866 (chuckles) 548 00:25:08,666 --> 00:25:11,633 Like, who's going to be with us, 549 00:25:11,666 --> 00:25:15,733 like, when we're saying our last words? 550 00:25:15,766 --> 00:25:18,633 I think, like... 551 00:25:18,666 --> 00:25:20,866 we want to have the joys of children. 552 00:25:26,233 --> 00:25:29,300 DUKE: There are a lot of causes for infertility. 553 00:25:29,333 --> 00:25:31,100 {\an1}So big items are male factor, 554 00:25:31,133 --> 00:25:33,400 {\an1}where there's something going on with the sperm. 555 00:25:33,433 --> 00:25:36,133 {\an7}Tubal factor, where there's something going on 556 00:25:36,166 --> 00:25:37,433 {\an7}with the Fallopian tube, 557 00:25:37,466 --> 00:25:41,233 {\an7}and anovulation where there's an issue relating to... 558 00:25:41,266 --> 00:25:43,666 {\an1}ability to release an egg from the ovary. 559 00:25:43,700 --> 00:25:46,700 NARRATOR: One condition that affects a woman's ability 560 00:25:46,733 --> 00:25:47,766 {\an1}to ovulate regularly 561 00:25:47,800 --> 00:25:52,766 {\an1}is polycystic ovary syndrome, or PCOS, 562 00:25:52,800 --> 00:25:55,233 {\an1}a hormonal disorder that if left untreated, 563 00:25:55,266 --> 00:25:57,000 {\an1}can have long-term consequences. 564 00:25:57,033 --> 00:25:58,600 DUKE: We know that people 565 00:25:58,633 --> 00:26:01,266 with P.C.O.S., because of insulin resistance, 566 00:26:01,300 --> 00:26:03,800 {\an1}also struggle with their weight. 567 00:26:03,833 --> 00:26:05,133 {\an1}And so, in the United States, 568 00:26:05,166 --> 00:26:07,633 {\an1}where we're facing an obesity epidemic, 569 00:26:07,666 --> 00:26:11,200 {\an1}and thus a diabetes crisis as well, 570 00:26:11,233 --> 00:26:14,666 {\an1}it's really important to diagnose PCOS even in teenagers. 571 00:26:14,700 --> 00:26:16,666 NARRATOR: An even more common illness 572 00:26:16,700 --> 00:26:21,100 {\an1}affecting a woman's fertility is endometriosis, 573 00:26:21,133 --> 00:26:23,900 {\an1}an inflammatory disease of the reproductive system, 574 00:26:23,933 --> 00:26:25,966 {\an1}that can begin in puberty. 575 00:26:26,000 --> 00:26:27,900 {\an1}It afflicts at least ten percent of women 576 00:26:27,933 --> 00:26:32,233 {\an1}and takes an average of six to eight years to diagnose. 577 00:26:32,266 --> 00:26:33,833 {\an1}One of the biggest downsides 578 00:26:33,866 --> 00:26:38,300 {\an1}to endometriosis progressing without diagnosis or treatment 579 00:26:38,333 --> 00:26:42,700 {\an1}is that it can cause really bad scarring of the Fallopian tubes. 580 00:26:42,733 --> 00:26:45,233 {\an1}But it also can cause the eggs to die. 581 00:26:45,266 --> 00:26:48,666 {\an1}Some women may stop ovulating regularly. 582 00:26:48,700 --> 00:26:52,300 {\an1}And some may even go into menopause prematurely 583 00:26:52,333 --> 00:26:53,433 as a result. 584 00:26:53,466 --> 00:26:54,833 ♪ 585 00:26:54,866 --> 00:26:56,300 NARRATOR: But one of the major challenges for women 586 00:26:56,333 --> 00:26:59,366 {\an1}who are struggling to conceive is the age of their eggs. 587 00:26:59,400 --> 00:27:00,900 GRIFO: We as a society 588 00:27:00,933 --> 00:27:04,533 {\an7}all need to know that there are issues with having babies 589 00:27:04,566 --> 00:27:05,900 {\an8}when we're older 590 00:27:05,933 --> 00:27:08,800 {\an7}and we need to be thoughtful about planning our fertility. 591 00:27:08,833 --> 00:27:10,733 {\an1}It's not a popular message, 592 00:27:10,766 --> 00:27:13,766 {\an1}and it does create anxiety, which no one wants to do. 593 00:27:13,800 --> 00:27:15,600 {\an1}But, on the other hand, you know, 594 00:27:15,633 --> 00:27:17,233 {\an1}I can't tell you the number of women who have said, 595 00:27:17,266 --> 00:27:19,333 {\an1}"No one told me this stuff, I can't believe I'm 44 596 00:27:19,366 --> 00:27:21,566 {\an1}"and thinking it's easy to get pregnant. 597 00:27:21,600 --> 00:27:23,200 {\an1}And now you're telling me I almost have no chance." 598 00:27:23,233 --> 00:27:26,500 NARRATOR: As a woman ages, not only does the quantity 599 00:27:26,533 --> 00:27:28,066 {\an1}of her eggs decline, 600 00:27:28,100 --> 00:27:31,366 {\an1}but so does the health of her eggs. 601 00:27:31,400 --> 00:27:33,700 {\an7}There's a crucial moment during fertilization, 602 00:27:33,733 --> 00:27:35,333 {\an7}when the egg needs to eject 603 00:27:35,366 --> 00:27:37,733 {\an7}exactly half of its chromosomes-- 604 00:27:37,766 --> 00:27:39,366 {\an7}with perfect precision. 605 00:27:39,400 --> 00:27:41,266 {\an8}GRIFO: Eggs are aging as you get older. 606 00:27:41,300 --> 00:27:43,366 {\an1}And they don't release the chromosomes 607 00:27:43,400 --> 00:27:45,000 {\an1}until they're ovulated and fertilized. 608 00:27:45,033 --> 00:27:48,000 {\an1}And that's, you know, this graphic here-- 609 00:27:48,033 --> 00:27:51,033 {\an7}which shows a sperm and an egg. 610 00:27:51,066 --> 00:27:53,300 {\an7}This is the egg kicking out half the chromosomes. 611 00:27:53,333 --> 00:27:56,600 {\an7}When this egg is 25, it's moving the chromosomes around 612 00:27:56,633 --> 00:27:59,000 {\an7}with 25-year-old machinery 613 00:27:59,033 --> 00:28:00,633 {\an7}versus 40-year-old machinery, 614 00:28:00,666 --> 00:28:01,900 {\an1}you're going to see more mistakes 615 00:28:01,933 --> 00:28:02,966 {\an1}where a chromosome goes where it shouldn't. 616 00:28:03,000 --> 00:28:05,600 {\an1}And, for instance, Chromosome 21, 617 00:28:05,633 --> 00:28:08,633 {\an1}there should be one copy here and one copy there. 618 00:28:08,666 --> 00:28:12,300 {\an8}NARRATOR: But sometimes an egg, especially an older egg, 619 00:28:12,333 --> 00:28:14,833 {\an7}fails to eject its extra copy. 620 00:28:14,866 --> 00:28:16,200 GRIFO: Now all of a sudden, you've got an embryo 621 00:28:16,233 --> 00:28:17,933 {\an1}that has three copies of Chromosome 21, 622 00:28:17,966 --> 00:28:20,600 {\an1}trisomy 21, that's Down Syndrome. 623 00:28:20,633 --> 00:28:25,600 NARRATOR: In the last decade, egg freezing has become increasingly popular 624 00:28:25,633 --> 00:28:27,500 {\an1}for women interested in delaying childbirth 625 00:28:27,533 --> 00:28:31,166 {\an1}or who are going to undergo chemotherapy. 626 00:28:31,200 --> 00:28:32,433 CHUNG: I'm asked all the time 627 00:28:32,466 --> 00:28:34,733 {\an7}what is the ideal age to freeze eggs. 628 00:28:34,766 --> 00:28:37,900 {\an7}And I think that somewhere between 28 and 34. 629 00:28:37,933 --> 00:28:41,433 {\an1}That's because in that window, 630 00:28:41,466 --> 00:28:43,466 {\an1}the quality of the eggs and the quantity of the eggs 631 00:28:43,500 --> 00:28:45,366 {\an1}is still optimal. 632 00:28:45,400 --> 00:28:47,733 {\an1}After 35, it is possible to freeze eggs 633 00:28:47,766 --> 00:28:50,366 {\an1}but the outcomes are not quite as successful. 634 00:28:50,400 --> 00:28:53,533 EYVAZZADEH: Egg freezing is one of the greatest discoveries 635 00:28:53,566 --> 00:28:56,733 in modern times. 636 00:28:56,766 --> 00:28:58,700 {\an7}It is a huge game-changer. 637 00:28:58,733 --> 00:29:02,700 {\an7}It allows women to donate eggs to themselves 638 00:29:02,733 --> 00:29:05,600 {\an7}at a time when they may not have as many options. 639 00:29:05,633 --> 00:29:07,866 {\an1}It allows women to choose partners 640 00:29:07,900 --> 00:29:10,633 {\an1}based on things that are not related 641 00:29:10,666 --> 00:29:13,566 {\an1}to their biological clock. 642 00:29:13,600 --> 00:29:16,066 ♪ 643 00:29:16,100 --> 00:29:18,866 TRYSTAN REESE: When I first saw him in the hospital 644 00:29:18,900 --> 00:29:20,833 {\an1}and everyone's screaming at me to push, 645 00:29:20,866 --> 00:29:22,866 {\an1}and they're screaming at me to slow down. 646 00:29:22,900 --> 00:29:27,066 {\an1}And then everything goes completely silent. 647 00:29:29,266 --> 00:29:32,166 {\an7}And I hear him come out 648 00:29:32,200 --> 00:29:33,966 {\an7}and then they lift him up in the light 649 00:29:34,000 --> 00:29:35,166 {\an7}and I get to see him for the first time. 650 00:29:35,200 --> 00:29:36,500 ♪ 651 00:29:36,533 --> 00:29:40,766 {\an1}And he opens his mouth, and he just starts to cry, 652 00:29:40,800 --> 00:29:44,900 {\an1}which was the most amazing sound I've ever heard. 653 00:29:44,933 --> 00:29:49,333 ♪ 654 00:29:49,366 --> 00:29:52,866 NARRATOR: Creating a baby was the last thing on Trystan's mind 655 00:29:52,900 --> 00:29:55,333 {\an1}as he searched for his identity. 656 00:29:55,366 --> 00:29:58,866 {\an1}I, like many people, always did feel 657 00:29:58,900 --> 00:30:00,966 {\an1}there was something different about me. 658 00:30:01,000 --> 00:30:03,266 {\an1}And I think, tragically, 659 00:30:03,300 --> 00:30:04,933 {\an1}I actually felt that there was something wrong with me, 660 00:30:04,966 --> 00:30:06,933 {\an1}that I was broken. 661 00:30:06,966 --> 00:30:10,233 {\an1}For me it was just excruciating and it came to the point 662 00:30:10,266 --> 00:30:11,866 {\an1}where I didn't believe that I could continue 663 00:30:11,900 --> 00:30:14,300 {\an1}to live a kind of life that I was living. 664 00:30:14,333 --> 00:30:18,233 {\an1}And it really wasn't until I was 18 or 19 665 00:30:18,266 --> 00:30:20,300 {\an1}when I realized, "Oh, my God, I'm not broken at all, 666 00:30:20,333 --> 00:30:21,833 {\an1}I'm just transgender." 667 00:30:21,866 --> 00:30:25,433 {\an1}When I finally did tell my mom specifically, 668 00:30:25,466 --> 00:30:27,966 {\an1}you know, "I'm transgender. I'm going to be transitioning," 669 00:30:28,000 --> 00:30:30,633 {\an1}you know, I just watched her face fall. 670 00:30:30,666 --> 00:30:32,600 {\an1}And it's not that she's transphobic, 671 00:30:32,633 --> 00:30:34,666 {\an1}she just truly believed that it meant choosing 672 00:30:34,700 --> 00:30:37,333 {\an1}an unhappy life for myself. 673 00:30:37,366 --> 00:30:39,500 CHUNG: For people who have gender dysphoria, 674 00:30:39,533 --> 00:30:40,766 {\an1}what that means is that 675 00:30:40,800 --> 00:30:43,800 {\an1}they have a really distressing discomfort 676 00:30:43,833 --> 00:30:47,200 {\an1}because there's a discrepancy in their gender identity 677 00:30:47,233 --> 00:30:49,766 {\an1}and how they appear on the outside 678 00:30:49,800 --> 00:30:52,233 {\an1}or the sex they were assigned at birth. 679 00:30:52,266 --> 00:30:54,566 {\an1}So, by matching their physical appearance 680 00:30:54,600 --> 00:30:55,800 {\an1}to their gender identity, 681 00:30:55,833 --> 00:30:57,800 {\an1}that allows the world to perceive them 682 00:30:57,833 --> 00:31:00,233 {\an1}as they already perceive themselves. 683 00:31:00,266 --> 00:31:04,466 NARRATOR: Trying to match his appearance to his identity, 684 00:31:04,500 --> 00:31:06,900 {\an1}Trystan turned to testosterone. 685 00:31:06,933 --> 00:31:08,433 TRYSTAN: Looking back on it now, 686 00:31:08,466 --> 00:31:11,500 {\an1}I'm like, "Oh, I took testosterone 687 00:31:11,533 --> 00:31:13,433 {\an1}from the black market." 688 00:31:13,466 --> 00:31:17,366 {\an1}And that is a really, really, really dumb idea. 689 00:31:17,400 --> 00:31:19,500 {\an1}Because your whole endocrine system 690 00:31:19,533 --> 00:31:21,566 {\an1}is a very delicate constellation. 691 00:31:21,600 --> 00:31:23,166 {\an1}It's like a spiderweb. 692 00:31:23,200 --> 00:31:25,200 {\an1}You know, you pull on one piece and everything else goes. 693 00:31:25,233 --> 00:31:27,133 {\an1}There's a complex signaling 694 00:31:27,166 --> 00:31:29,166 {\an1}that occurs naturally in men and women, 695 00:31:29,200 --> 00:31:33,033 {\an1}where there's hormone signals that come from your brain 696 00:31:33,066 --> 00:31:35,033 {\an1}that speak to the ovaries and speak to the testes. 697 00:31:35,066 --> 00:31:39,033 {\an1}When you take testosterone or you take estrogen, 698 00:31:39,066 --> 00:31:42,600 {\an1}those hormones then take over the signaling 699 00:31:42,633 --> 00:31:45,200 {\an1}that would normally be driven by the brain. 700 00:31:45,233 --> 00:31:47,833 {\an1}And that can have implications for reproductive health. 701 00:31:47,866 --> 00:31:49,666 {\an1}For example, testosterone therapy 702 00:31:49,700 --> 00:31:52,166 {\an1}can lead to increased risks of stroke, 703 00:31:52,200 --> 00:31:54,100 {\an1}heart attacks, blood clots. 704 00:31:54,133 --> 00:31:56,266 {\an1}You should really be under doctor supervision, 705 00:31:56,300 --> 00:32:00,200 {\an1}or if not a doctor but a nurse or a naturopathic doctor, 706 00:32:00,233 --> 00:32:03,100 {\an1}but someone who has advanced training in hormone management. 707 00:32:03,133 --> 00:32:06,266 {\an1}But a lot of L.G.B.T.Q. people take risks with their health 708 00:32:06,300 --> 00:32:07,700 {\an1}because they're scared. 709 00:32:07,733 --> 00:32:09,900 (birds singing) 710 00:32:09,933 --> 00:32:11,933 (bee buzzing) 711 00:32:15,400 --> 00:32:18,700 NARRATOR: Discrimination towards the L.G.B.T.Q.+ community 712 00:32:18,733 --> 00:32:20,766 {\an1}has hindered access to healthcare 713 00:32:20,800 --> 00:32:23,633 {\an1}and led to misperceptions. 714 00:32:23,666 --> 00:32:25,766 BIFF CHAPLOW: The message has always been that, like, 715 00:32:25,800 --> 00:32:28,633 {\an1}gay people are dangerous to children, 716 00:32:28,666 --> 00:32:30,566 {\an7}that gay people shouldn't raise children. 717 00:32:30,600 --> 00:32:32,466 {\an7}That, like, we are the opposite of family. 718 00:32:32,500 --> 00:32:33,533 {\an7}We destroy family. 719 00:32:33,566 --> 00:32:35,500 ♪ 720 00:32:35,533 --> 00:32:38,766 {\an1}When it became clear that Lucas and Haley, 721 00:32:38,800 --> 00:32:41,433 {\an1}my biological niece and nephew, were going to need a home, 722 00:32:41,466 --> 00:32:42,700 {\an1}it was pretty clear that we were 723 00:32:42,733 --> 00:32:45,766 {\an1}going to be the only people that could take them. 724 00:32:45,800 --> 00:32:48,066 {\an1}Or they would need to go into foster care. 725 00:32:48,100 --> 00:32:49,766 And so, 726 00:32:49,800 --> 00:32:51,366 you know we had a discussion 727 00:32:51,400 --> 00:32:53,333 and Trystan was, like, very supportive. 728 00:32:53,366 --> 00:32:55,366 {\an1}Was like yes, let's do this, let's take them. 729 00:32:55,400 --> 00:32:56,966 Did you concentrate? 730 00:32:57,000 --> 00:32:58,633 {\an1}Concentrate means you work very hard... 731 00:32:58,666 --> 00:33:00,500 TRYSTAN: It never occurred to me until I met Biff, 732 00:33:00,533 --> 00:33:01,733 {\an1}I started thinking, 733 00:33:01,766 --> 00:33:03,666 {\an1}you know, I would love to have a family with him. 734 00:33:03,700 --> 00:33:06,766 {\an1}And seeing him with kids I was just like, 735 00:33:06,800 --> 00:33:08,800 {\an1}that door could open for us. 736 00:33:08,833 --> 00:33:12,600 {\an1}We could have a physical manifestation of this, you know, 737 00:33:12,633 --> 00:33:16,733 {\an1}profound and true experience of love we have for each other. 738 00:33:16,766 --> 00:33:17,833 BIFF: Many people like me 739 00:33:17,866 --> 00:33:19,766 {\an1}don't ever have the opportunity 740 00:33:19,800 --> 00:33:23,833 {\an1}to have a kid that is biologically connected to them, 741 00:33:23,866 --> 00:33:27,666 {\an1}either because the reproductive systems don't match up 742 00:33:27,700 --> 00:33:29,733 {\an1}or they don't have the resources. 743 00:33:29,766 --> 00:33:30,766 {\an1}And in many cases I think people 744 00:33:30,800 --> 00:33:32,733 {\an1}don't even imagine. 745 00:33:32,766 --> 00:33:34,066 {\an1}That was one thing that people would always say, 746 00:33:34,100 --> 00:33:36,266 {\an1}is, like, two men can't make a baby. 747 00:33:36,300 --> 00:33:37,766 {\an1}And so, I'm sort of like, 748 00:33:37,800 --> 00:33:40,266 {\an1}"Watch us." (laughs) 749 00:33:40,300 --> 00:33:41,466 ♪ 750 00:33:41,500 --> 00:33:44,166 NARRATOR: How do two men make a baby? 751 00:33:44,200 --> 00:33:47,300 CHUNG: Hormone treatment can suppress the reproductive system. 752 00:33:47,333 --> 00:33:52,200 {\an1}So, for example, a transgender man who is taking testosterone 753 00:33:52,233 --> 00:33:54,200 {\an1}will experience a cessation of menses. 754 00:33:54,233 --> 00:33:56,166 {\an1}So, periods will stop coming. 755 00:33:56,200 --> 00:33:59,166 {\an1}And that's actually an intended consequence of the treatment. 756 00:33:59,200 --> 00:34:02,233 {\an1}But in addition, it will suppress the ovaries 757 00:34:02,266 --> 00:34:04,366 {\an1}so that he is no longer ovulating. 758 00:34:04,400 --> 00:34:06,366 {\an1}When they come off of testosterone, 759 00:34:06,400 --> 00:34:08,966 {\an1}there are reports that the menses will return. 760 00:34:09,000 --> 00:34:12,966 {\an1}Testosterone really acts to the ovulatory system 761 00:34:13,000 --> 00:34:15,033 {\an1}the same way that any hormonal birth control 762 00:34:15,066 --> 00:34:18,666 {\an1}that stops ovulation and menstruation impacts the system. 763 00:34:18,700 --> 00:34:19,700 {\an1}It just hits pause 764 00:34:19,733 --> 00:34:22,600 on the sort of egg maturing factory. 765 00:34:22,633 --> 00:34:25,733 {\an1}And when you go off testosterone, as I did 766 00:34:25,766 --> 00:34:27,700 {\an1}it takes a few months, 767 00:34:27,733 --> 00:34:29,700 {\an1}and then the egg maturing factory 768 00:34:29,733 --> 00:34:32,866 {\an1}kicks back into gear and you ovulate and menstruate 769 00:34:32,900 --> 00:34:34,966 {\an1}just as you had before. 770 00:34:35,000 --> 00:34:36,966 CHUNG: There have been reports of pregnancies. 771 00:34:37,000 --> 00:34:39,966 {\an1}But what we don't know is if a person has been 772 00:34:40,000 --> 00:34:43,000 {\an1}on testosterone for a long period of time, 773 00:34:43,033 --> 00:34:44,800 {\an1}is that return of ovarian function 774 00:34:44,833 --> 00:34:46,300 {\an1}going to actually occur. 775 00:34:46,333 --> 00:34:49,233 {\an7}If you want to see the belly, I'm actually wearing a whole... 776 00:34:49,266 --> 00:34:52,233 {\an8}NARRATOR: Trystan had been taking testosterone for 12 years 777 00:34:52,266 --> 00:34:54,366 {\an7}before trying to get pregnant. 778 00:34:54,400 --> 00:34:56,533 {\an7}After experiencing a miscarriage, 779 00:34:56,566 --> 00:34:58,333 {\an7}he soon became pregnant with Leo. 780 00:34:58,366 --> 00:35:00,566 {\an7}... gigantic giant. (laughter) 781 00:35:00,600 --> 00:35:02,733 {\an1}Leo looks so much like you that people just assume 782 00:35:02,766 --> 00:35:04,766 {\an1}that I wasn't involved at all. 783 00:35:04,800 --> 00:35:06,366 {\an1}(laughs) 784 00:35:06,400 --> 00:35:08,366 They do assume that we had a surrogate 785 00:35:08,400 --> 00:35:11,366 and just used my sperm for that. 786 00:35:11,400 --> 00:35:12,366 We did have a surrogate 787 00:35:12,400 --> 00:35:13,666 and we did use my sperm. 788 00:35:13,700 --> 00:35:15,033 {\an1}It was me, I was my own surrogate. 789 00:35:15,066 --> 00:35:16,266 Trystan was the surrogate. 790 00:35:17,833 --> 00:35:19,200 TRYSTAN: How do you navigate pregnancy 791 00:35:19,233 --> 00:35:21,033 {\an1}as a transgender man? 792 00:35:21,066 --> 00:35:23,233 {\an1}Maybe you feel conflicted about 793 00:35:23,266 --> 00:35:25,233 {\an1}or even negative about having breasts. 794 00:35:25,266 --> 00:35:29,366 {\an1}But now, that's being used to nourish a human. 795 00:35:29,400 --> 00:35:32,100 {\an1}Maybe you felt conflicted about having a uterus to begin with, 796 00:35:32,133 --> 00:35:33,533 {\an1}now it's being used to grow a person-- 797 00:35:33,566 --> 00:35:34,733 {\an1}you're building a family. 798 00:35:36,033 --> 00:35:37,400 NARRATOR: Trystan felt grateful that he was able 799 00:35:37,433 --> 00:35:39,600 {\an1}to become pregnant and give birth. 800 00:35:39,633 --> 00:35:42,566 {\an1}But for patients about to transition, 801 00:35:42,600 --> 00:35:45,966 {\an1}there are steps they can take to preserve their fertility. 802 00:35:46,000 --> 00:35:49,000 {\an1}In patients who are undergoing gender-affirming therapy, 803 00:35:49,033 --> 00:35:52,033 {\an1}I think it's important that they are presented with the option 804 00:35:52,066 --> 00:35:55,266 {\an1}to either freeze eggs or freeze sperm 805 00:35:55,300 --> 00:35:57,200 {\an1}before they start those treatments. 806 00:35:57,233 --> 00:35:59,400 TRYSTAN: Fertility preservation is invasive. 807 00:35:59,433 --> 00:36:00,466 {\an1}It is very expensive. 808 00:36:00,500 --> 00:36:02,400 {\an1}And it takes a long time. 809 00:36:02,433 --> 00:36:03,766 {\an1}It can take weeks or even months, 810 00:36:03,800 --> 00:36:06,800 {\an1}depending on how successful the first retrieval is. 811 00:36:06,833 --> 00:36:09,400 {\an1}And a majority of trans adults 812 00:36:09,433 --> 00:36:10,966 {\an1}who say they wish they'd preserved their fertility, 813 00:36:11,000 --> 00:36:12,133 {\an1}they said that they were not counseled, 814 00:36:12,166 --> 00:36:13,366 {\an1}they didn't think about it. 815 00:36:13,400 --> 00:36:16,000 CHUNG: Counseling the younger group 816 00:36:16,033 --> 00:36:17,400 {\an1}about fertility preservation 817 00:36:17,433 --> 00:36:21,133 {\an1}before gender-affirming therapy is particularly challenging 818 00:36:21,166 --> 00:36:23,333 {\an1}because these are teenagers. 819 00:36:23,366 --> 00:36:25,166 And many times, they're so distraught 820 00:36:25,200 --> 00:36:26,866 {\an1}by their gender dysphoria, 821 00:36:26,900 --> 00:36:29,666 {\an1}that they're really eager to start 822 00:36:29,700 --> 00:36:32,666 {\an1}their gender-affirming treatments. 823 00:36:32,700 --> 00:36:35,133 {\an1}Honestly if you had told me at age 22, 824 00:36:35,166 --> 00:36:37,133 {\an1}you know, you have to choose between transitioning 825 00:36:37,166 --> 00:36:39,133 {\an1}and ever having a biological child, 826 00:36:39,166 --> 00:36:43,233 {\an1}it would not have taken me one second to make that decision. 827 00:36:43,266 --> 00:36:44,166 {\an1}I would have chosen transition. 828 00:36:44,200 --> 00:36:46,200 {\an1}I thought I was choosing transition 829 00:36:46,233 --> 00:36:48,000 {\an1}over ever having a family, 830 00:36:48,033 --> 00:36:50,866 {\an1}ever falling in love, ever having community support, 831 00:36:50,900 --> 00:36:53,133 {\an1}ever getting married. 832 00:36:53,166 --> 00:36:55,200 CHUNG: What the research has shown is that 833 00:36:55,233 --> 00:36:58,833 {\an1}at least 50% of transgender men and women 834 00:36:58,866 --> 00:37:02,000 {\an1}do wish to have children or have a family in the future. 835 00:37:02,033 --> 00:37:04,533 Okay, Leo... 836 00:37:04,566 --> 00:37:08,666 TRYSTAN: Change comes from moving into the place that's hard 837 00:37:08,700 --> 00:37:10,633 {\an1}and looking for the light. 838 00:37:10,666 --> 00:37:15,633 {\an1}Often when you say like, "Well, why don't you just adopt?" 839 00:37:15,666 --> 00:37:18,333 {\an1}It's rooted in this belief that we shouldn't have access 840 00:37:18,366 --> 00:37:21,600 {\an1}to the same things as everyone else. 841 00:37:21,633 --> 00:37:24,666 {\an1}I don't want to be like men who are not transgender. 842 00:37:24,700 --> 00:37:26,600 {\an1}I feel like what I am is unique. 843 00:37:26,633 --> 00:37:27,933 {\an1}It's powerful, it's a gift. 844 00:37:27,966 --> 00:37:29,333 (Leo chattering) 845 00:37:29,366 --> 00:37:30,733 {\an1}If I had been assigned male at birth, 846 00:37:30,766 --> 00:37:32,933 {\an1}I never would have had Leo. 847 00:37:32,966 --> 00:37:34,666 ♪ 848 00:37:34,700 --> 00:37:36,600 {\an1}So when I look at me pregnant, 849 00:37:36,633 --> 00:37:39,266 {\an1}you know, I'm just one of the many men 850 00:37:39,300 --> 00:37:42,400 {\an1}who happen to be unique in that we can create life. 851 00:37:42,433 --> 00:37:44,366 {\an1}And I think that's pretty cool. 852 00:37:44,400 --> 00:37:46,400 ♪ 853 00:37:49,600 --> 00:37:52,266 ♪ 854 00:37:52,300 --> 00:37:54,333 {\an1}BATCHELLER (on phone): Hi Cassie, it's Dr. Batcheller calling, 855 00:37:54,366 --> 00:37:58,366 {\an1}I was just calling you with some excellent news this morning. 856 00:37:58,400 --> 00:37:59,433 {\an1}I wanted to call and let you know 857 00:37:59,466 --> 00:38:01,466 {\an1}that we have your CCS results back 858 00:38:01,500 --> 00:38:04,366 {\an1}and that both of these embryos are normal 859 00:38:04,400 --> 00:38:06,500 {\an1}and available for transfer, which is pretty exciting. 860 00:38:06,533 --> 00:38:08,366 CASSIE: We got that call 861 00:38:08,400 --> 00:38:11,400 {\an1}and it was two embryos 862 00:38:11,433 --> 00:38:13,533 {\an1}and they're both normal, 863 00:38:13,566 --> 00:38:15,266 {\an7}and they're both baby girls. 864 00:38:15,300 --> 00:38:18,700 {\an7}So, we're super excited, at least I am 865 00:38:18,733 --> 00:38:19,900 about the girl part. 866 00:38:19,933 --> 00:38:22,533 NARRATOR: Both of Cassie and Zack's embryos 867 00:38:22,566 --> 00:38:24,800 {\an1}were frozen and one has been thawed out 868 00:38:24,833 --> 00:38:27,300 {\an1}to be transferred today. 869 00:38:27,333 --> 00:38:30,533 {\an7}Our embryo today is a 5BB, that's the grade of it, 870 00:38:30,566 --> 00:38:34,533 {\an7}and frozen embryo transfer and it's a baby girl. 871 00:38:34,566 --> 00:38:37,566 {\an7}And then Jos... baby Joseph, January 2020. 872 00:38:37,600 --> 00:38:39,566 {\an7}So today's the day, 873 00:38:39,600 --> 00:38:42,533 {\an7}we waited four years for this, so we're over the moon excited. 874 00:38:42,566 --> 00:38:44,266 {\an1}Are you guys ready? 875 00:38:44,300 --> 00:38:45,533 {\an1}Yes. Yes. 876 00:38:45,566 --> 00:38:47,333 {\an1}All right, I'm ready too. 877 00:38:47,366 --> 00:38:49,700 {\an1}So, we're here today doing Cassie and Zack's transfer 878 00:38:49,733 --> 00:38:51,700 {\an1}after a long road of going through 879 00:38:51,733 --> 00:38:53,733 {\an1}several I.V.F. cycles to get here. 880 00:38:53,766 --> 00:38:55,966 {\an1}So, we warmed up their embryo a few hours ago 881 00:38:56,000 --> 00:38:57,966 {\an7}and then transferred it successfully. 882 00:38:58,000 --> 00:38:59,433 {\an7}Everything went very smoothly today. 883 00:38:59,466 --> 00:39:02,400 {\an1}So now we are just in the nine-day waiting period. 884 00:39:02,433 --> 00:39:06,100 ♪ 885 00:39:09,333 --> 00:39:13,333 {\an7}It's been five years, four embryos, 886 00:39:13,366 --> 00:39:18,300 {\an8}three transfers, zero pregnancies, for me. 887 00:39:18,333 --> 00:39:25,066 {\an7}And then one mosaic embryo, one surrogate, and our baby. 888 00:39:25,100 --> 00:39:27,166 {\an8}♪ 889 00:39:27,200 --> 00:39:29,200 {\an7}Infertility just feels like 890 00:39:29,233 --> 00:39:35,133 {\an7}a special little corner of hell that just goes on and on and on. 891 00:39:35,166 --> 00:39:37,066 {\an7}And you can keep throwing money into it 892 00:39:37,100 --> 00:39:40,133 {\an7}and time and sadness and blood and sweat and tears, 893 00:39:40,166 --> 00:39:41,833 {\an7}and you may end up with nothing. 894 00:39:41,866 --> 00:39:45,800 {\an7}(bird singing, water trickling, Erin shushing) 895 00:39:45,833 --> 00:39:47,433 {\an7}I don't like to say that it's a miracle 896 00:39:47,466 --> 00:39:50,766 {\an7}because that doesn't have the smack of truth to it. 897 00:39:50,800 --> 00:39:53,666 {\an7}She is the spoils of war. 898 00:39:53,700 --> 00:39:55,766 (chuckles) She is the result 899 00:39:55,800 --> 00:39:58,000 {\an1}of many years of battle. 900 00:39:58,033 --> 00:39:59,833 {\an1}And she is our victory. 901 00:39:59,866 --> 00:40:04,300 NARRATOR: After four years and three failed cycles of I.V.F., 902 00:40:04,333 --> 00:40:08,966 {\an1}Erin was diagnosed with recurrent implantation failure-- 903 00:40:09,000 --> 00:40:11,333 {\an1}meaning her embryos were unable to embed themselves 904 00:40:11,366 --> 00:40:12,966 {\an1}into the wall of her uterus. 905 00:40:13,000 --> 00:40:14,333 EYVAZZADEH: Erin came to me. 906 00:40:14,366 --> 00:40:16,233 {\an7}She was frustrated, she wanted answers, 907 00:40:16,266 --> 00:40:17,866 {\an7}she didn't have a diagnosis. 908 00:40:17,900 --> 00:40:22,300 NARRATOR: Testing pointed to an issue with Erin's immune system-- 909 00:40:22,333 --> 00:40:25,666 {\an1}it was identifying her embryos as foreign. 910 00:40:25,700 --> 00:40:27,133 EYVAZZADEH: That's why 911 00:40:27,166 --> 00:40:31,466 {\an1}we decided as a team to consider using a gestational carrier. 912 00:40:31,500 --> 00:40:35,100 NARRATOR: Before transferring any of Erin's embryos 913 00:40:35,133 --> 00:40:37,466 {\an1}to the gestational carrier, or surrogate, 914 00:40:37,500 --> 00:40:39,433 {\an1}Dr. Aimee Evyazzadeh used 915 00:40:39,466 --> 00:40:43,400 {\an1}pre-implantation genetic testing, or P.G.T., 916 00:40:43,433 --> 00:40:46,500 {\an1}to make sure they had the correct number of chromosomes. 917 00:40:46,533 --> 00:40:49,300 {\an1}Offered at most I.V.F. clinics, 918 00:40:49,333 --> 00:40:53,233 {\an1}the test is used by about 35% of patients 919 00:40:53,266 --> 00:40:57,300 {\an1}and can cost between $1,500 to $5,500. 920 00:40:57,333 --> 00:41:02,300 {\an1}This test is typically done when an embryo is about five days old 921 00:41:02,333 --> 00:41:05,300 {\an1}and has divided to roughly 300 cells. 922 00:41:05,333 --> 00:41:09,300 {\an1}The inner cell mass is what could develop into a fetus. 923 00:41:09,333 --> 00:41:12,300 {\an1}The outer layer of cells-- called the trophectoderm-- 924 00:41:12,333 --> 00:41:15,200 {\an1}is what could develop into the placenta. 925 00:41:15,233 --> 00:41:19,166 {\an1}An embryologist plucks just a few cells from this outer layer 926 00:41:19,200 --> 00:41:21,166 {\an1}and a lab performs a genetic test on them 927 00:41:21,200 --> 00:41:25,233 {\an1}to count how many chromosomes each cell contains. 928 00:41:25,266 --> 00:41:28,633 {\an1}Based on this test, the embryos are generally classified 929 00:41:28,666 --> 00:41:31,166 {\an1}as "abnormal" or "normal." 930 00:41:31,200 --> 00:41:33,200 {\an1}But if the sample contains a mixture 931 00:41:33,233 --> 00:41:36,166 {\an1}of genetically normal and abnormal cells, 932 00:41:36,200 --> 00:41:39,166 {\an1}then the embryo is considered "mosaic." 933 00:41:39,200 --> 00:41:41,233 ERIN: We had four embryos left. 934 00:41:41,266 --> 00:41:42,566 {\an1}One of them was abnormal, 935 00:41:42,600 --> 00:41:44,533 {\an1}two of them were normal, 936 00:41:44,566 --> 00:41:46,500 {\an1}and one of them was mosaic. 937 00:41:46,533 --> 00:41:48,700 {\an1}So, you think, I want to get my best chance. 938 00:41:48,733 --> 00:41:50,600 {\an1}And so I want to use the embryo that looks the best, 939 00:41:50,633 --> 00:41:51,766 {\an1}that has the highest grade, 940 00:41:51,800 --> 00:41:54,700 {\an1}and that has really good genetic testing results. 941 00:41:54,733 --> 00:41:56,733 {\an1}And I don't want to use these garbage embryos 942 00:41:56,766 --> 00:41:58,100 {\an1}that have tested abnormal 943 00:41:58,133 --> 00:41:59,666 {\an1}or partially abnormal like a mosaic. 944 00:41:59,700 --> 00:42:04,133 NARRATOR: One of the normal embryos did, not survive the thaw 945 00:42:04,166 --> 00:42:07,066 {\an1}so Erin and her husband Gary considered transferring 946 00:42:07,100 --> 00:42:09,833 {\an1}the mosaic embryo with the remaining normal one. 947 00:42:09,866 --> 00:42:11,200 GARY LEVIN: We knew we would transfer 948 00:42:11,233 --> 00:42:13,000 {\an7}this one healthy one that we had left 949 00:42:13,033 --> 00:42:14,000 {\an7}but then the question was, 950 00:42:14,033 --> 00:42:15,000 {\an7}what do we do 951 00:42:15,033 --> 00:42:16,933 {\an7}with the mosaic embryo that's left? 952 00:42:16,966 --> 00:42:19,933 {\an7}We also didn't want to discard it. Right. 953 00:42:19,966 --> 00:42:21,933 {\an1}Because there was a certain percentage chance 954 00:42:21,966 --> 00:42:23,800 {\an1}that it could result in a healthy pregnancy. 955 00:42:23,833 --> 00:42:28,866 NARRATOR: In the end, one normal embryo and one mosaic embryo 956 00:42:28,900 --> 00:42:32,000 {\an1}were transferred into the surrogate. 957 00:42:32,033 --> 00:42:34,933 {\an1}Soon after, Erin and Gary got good news. 958 00:42:34,966 --> 00:42:39,500 ERIN: Fortunately, we got positive pregnancy results. 959 00:42:39,533 --> 00:42:41,033 {\an1}So, we knew our surrogate was pregnant. 960 00:42:41,066 --> 00:42:44,033 {\an1}The two embryos were different sexes. 961 00:42:44,066 --> 00:42:46,000 {\an1}So, the healthy one was a male embryo 962 00:42:46,033 --> 00:42:49,733 {\an1}and the mosaic embryo was a female. 963 00:42:49,766 --> 00:42:52,733 {\an1}When we were told there was just one 964 00:42:52,766 --> 00:42:54,500 {\an1}and that it had implanted, 965 00:42:54,533 --> 00:42:56,266 {\an1}we assumed that we were having a boy. 966 00:42:56,300 --> 00:42:58,433 (baby heartbeat) 967 00:42:58,466 --> 00:43:00,600 NARRATOR: A blood test revealed a girl. 968 00:43:00,633 --> 00:43:03,466 {\an1}The mosaic embryo had implanted. 969 00:43:03,500 --> 00:43:05,566 CHUNG: In discussing the risks associated 970 00:43:05,600 --> 00:43:08,500 {\an1}with transferring a potentially abnormal embryo, 971 00:43:08,533 --> 00:43:12,500 we talk about three possible scenarios. 972 00:43:12,533 --> 00:43:15,566 {\an1}One is that the embryo just wouldn't implant. 973 00:43:15,600 --> 00:43:18,566 {\an7}The second scenario is that that embryo would implant 974 00:43:18,600 --> 00:43:19,900 {\an7}and it would result in a miscarriage. 975 00:43:19,933 --> 00:43:23,266 {\an1}The third possible scenario though is that 976 00:43:23,300 --> 00:43:27,233 {\an1}if the embryo truly is abnormal and implants, 977 00:43:27,266 --> 00:43:31,233 {\an1}it could result in a baby with genetic abnormalities 978 00:43:31,266 --> 00:43:34,266 {\an1}due to abnormal cells being present. 979 00:43:34,300 --> 00:43:38,233 {\an1}Before we will transfer a mosaic embryo in any patient, 980 00:43:38,266 --> 00:43:40,466 {\an1}they need to have genetic counseling. 981 00:43:40,500 --> 00:43:43,200 That throws you into a whole other world 982 00:43:43,233 --> 00:43:45,133 that you have to get expertise in 983 00:43:45,166 --> 00:43:48,166 {\an1}to decide if that's going be a viable pregnancy 984 00:43:48,200 --> 00:43:49,833 and how do you find out if it is 985 00:43:49,866 --> 00:43:51,866 {\an1}and will we need to look at early termination 986 00:43:51,900 --> 00:43:53,900 or what are the odds that this 987 00:43:53,933 --> 00:43:55,866 is a miscarriage. 988 00:43:55,900 --> 00:43:57,866 And if it's not, what are the odds 989 00:43:57,900 --> 00:43:59,766 {\an1}that this is a baby who will be born with special needs. 990 00:43:59,800 --> 00:44:04,400 CHUNG: There have been several case reports of patients 991 00:44:04,433 --> 00:44:08,433 {\an1}who have had pregnancies from transfer of mosaic embryos. 992 00:44:08,466 --> 00:44:13,200 {\an1}And I think it's too early to say whether any of these embryos 993 00:44:13,233 --> 00:44:15,233 {\an1}actually translate into birth defects for the baby. 994 00:44:15,266 --> 00:44:21,066 {\an1}Maybe later in life as we follow these babies as they grow older, 995 00:44:21,100 --> 00:44:23,100 {\an7}there might be something that's identified 996 00:44:23,133 --> 00:44:24,633 {\an7}that's related to the mosaicism. 997 00:44:24,666 --> 00:44:27,333 {\an8}♪ 998 00:44:27,366 --> 00:44:29,000 {\an8}GARY: We're in this world of testing everything 999 00:44:29,033 --> 00:44:30,333 {\an7}and going through I.V.F., 1000 00:44:30,366 --> 00:44:32,400 {\an1}we're getting all this information that most couples 1001 00:44:32,433 --> 00:44:35,433 {\an1}that have natural pregnancies 1002 00:44:35,466 --> 00:44:37,900 {\an1}never even have to face. 1003 00:44:37,933 --> 00:44:39,800 ♪ 1004 00:44:39,833 --> 00:44:41,833 CHUNG: What we really care about is whether the baby 1005 00:44:41,866 --> 00:44:45,866 {\an1}is going to have the proper amount of genetic material. 1006 00:44:45,900 --> 00:44:46,966 {\an1}But what we're testing 1007 00:44:47,000 --> 00:44:48,933 {\an1}is a small portion of the trophectoderm, 1008 00:44:48,966 --> 00:44:50,900 {\an1}which we know is the portion of the embryo 1009 00:44:50,933 --> 00:44:53,900 {\an1}that's destined to become the placenta. 1010 00:44:53,933 --> 00:44:57,933 {\an1}So, there is some controversy over how accurate this test is 1011 00:44:57,966 --> 00:45:00,000 {\an1}and whether we are at the point where we should be doing it 1012 00:45:00,033 --> 00:45:01,333 {\an1}for all of our patients. 1013 00:45:01,366 --> 00:45:04,600 Yes, go, go! 1014 00:45:04,633 --> 00:45:06,866 GRIFO: Mother Nature's all about spectrum, all about continuum. 1015 00:45:06,900 --> 00:45:10,800 {\an7}So, there's no embryo that has all normal cells. 1016 00:45:10,833 --> 00:45:13,833 {\an1}If 70% of the cells are abnormal, 1017 00:45:13,866 --> 00:45:15,866 those are called high-level mosaic. 1018 00:45:15,900 --> 00:45:17,833 ♪ 1019 00:45:17,866 --> 00:45:20,500 {\an1}If only 30% of the cells are abnormal, 1020 00:45:20,533 --> 00:45:22,366 {\an1}those are low-level mosaics. 1021 00:45:22,400 --> 00:45:25,433 NARRATOR: When fewer abnormal cells are present, 1022 00:45:25,466 --> 00:45:28,333 {\an1}miscarriage rates are predicted to go down 1023 00:45:28,366 --> 00:45:31,366 {\an1}and the chances for a live birth increase. 1024 00:45:31,400 --> 00:45:33,400 {\an1}There seems to be a better outcome 1025 00:45:33,433 --> 00:45:35,333 {\an1}with the lower level mosaics over the high-level mosaics, 1026 00:45:35,366 --> 00:45:36,600 {\an1}but we're still learning that. 1027 00:45:38,000 --> 00:45:40,633 CHUNG: There is actually a lot of research that suggests that 1028 00:45:40,666 --> 00:45:42,700 {\an1}the embryo may be capable of correcting itself 1029 00:45:42,733 --> 00:45:44,266 {\an1}once it's inside. 1030 00:45:45,133 --> 00:45:48,100 NARRATOR: But how? 1031 00:45:48,133 --> 00:45:51,100 {\an1}Researchers-- including Dr. Shawn Chavez-- 1032 00:45:51,133 --> 00:45:54,033 {\an1}have found evidence that suggests that on day four, 1033 00:45:54,066 --> 00:45:57,233 {\an1}the embryo performs a self-inspection. 1034 00:45:57,266 --> 00:45:59,866 {\an7}I like to liken it to a card game. 1035 00:45:59,900 --> 00:46:04,433 {\an7}So that you can actually share information with your neighbor. 1036 00:46:04,466 --> 00:46:07,400 {\an1}And so you can start to decide, based on your card game, 1037 00:46:07,433 --> 00:46:11,366 {\an1}who looks good to become a placental cell, 1038 00:46:11,400 --> 00:46:13,366 {\an1}part of the placenta, and who looks good 1039 00:46:13,400 --> 00:46:15,400 {\an1}to become part of the inner cell mass, 1040 00:46:15,433 --> 00:46:18,300 {\an1}which is going to become an embryo. 1041 00:46:18,333 --> 00:46:20,400 ♪ 1042 00:46:20,433 --> 00:46:22,433 NARRATOR: At this developmental stage, 1043 00:46:22,466 --> 00:46:25,400 {\an1}Dr. Chavez has noticed embryos discarding cells 1044 00:46:25,433 --> 00:46:29,366 {\an1}or fragments of cells that are chromosomally damaged. 1045 00:46:29,400 --> 00:46:32,766 CHAVEZ: They have a significant amount of DNA damage. 1046 00:46:32,800 --> 00:46:35,733 {\an1}And we think that the embryo actually knows that it's there 1047 00:46:35,766 --> 00:46:37,600 {\an1}and basically has a signal to it that says, 1048 00:46:37,633 --> 00:46:39,000 {\an1}"You are not going to divide 1049 00:46:39,033 --> 00:46:41,066 {\an1}"because you're chromosomally abnormal 1050 00:46:41,100 --> 00:46:43,966 {\an1}and your DNA is highly damaged." 1051 00:46:44,000 --> 00:46:46,233 {\an1}I really like to point out your attention 1052 00:46:46,266 --> 00:46:49,800 {\an1}is this large excluded cell. 1053 00:46:49,833 --> 00:46:52,200 {\an1}So, you can see based on its size, 1054 00:46:52,233 --> 00:46:55,266 {\an1}it probably came from very, very early in development. 1055 00:46:55,300 --> 00:46:57,166 {\an1}Besides being excluded, 1056 00:46:57,200 --> 00:46:59,700 {\an1}it is never allowed to divide again. 1057 00:46:59,733 --> 00:47:02,900 NARRATOR: More needs to be understood about mosaic embryos, 1058 00:47:02,933 --> 00:47:04,900 {\an1}but some couples-- 1059 00:47:04,933 --> 00:47:06,833 {\an1}especially those who are running out of options-- 1060 00:47:06,866 --> 00:47:10,733 {\an1}are deciding that the prospect of having a healthy child 1061 00:47:10,766 --> 00:47:12,733 {\an1}is worth the risks. 1062 00:47:12,766 --> 00:47:15,733 {\an1}If a woman only produces mosaic embryos, 1063 00:47:15,766 --> 00:47:18,733 {\an1}most clinics don't want that liability. 1064 00:47:18,766 --> 00:47:20,266 {\an1}I think the tide is turning. 1065 00:47:20,300 --> 00:47:23,300 {\an1}I think they're finally starting to realize 1066 00:47:23,333 --> 00:47:26,933 {\an1}if that's the only thing a woman has is a mosaic embryo, 1067 00:47:26,966 --> 00:47:28,866 {\an1}that they should give it a shot. 1068 00:47:28,900 --> 00:47:31,900 {\an1}And so, I'm hoping that more clinics 1069 00:47:31,933 --> 00:47:35,000 {\an1}are going to accept that responsibility. 1070 00:47:35,033 --> 00:47:36,533 ♪ 1071 00:47:36,566 --> 00:47:38,366 EYVAZZADEH: Finally, in August of 2020, 1072 00:47:38,400 --> 00:47:40,400 {\an1}American Society for Reproduction Medicine 1073 00:47:40,433 --> 00:47:42,466 came out with a committee opinion 1074 00:47:42,500 --> 00:47:44,400 {\an1}saying that every single clinic 1075 00:47:44,433 --> 00:47:47,366 {\an1}needs to have a policy in place for mosaic embryos 1076 00:47:47,400 --> 00:47:49,833 {\an1}and patients need to be told about it as well. 1077 00:47:49,866 --> 00:47:51,200 ♪ 1078 00:47:51,233 --> 00:47:53,300 ERIN: Don't let a clinic or a testing lab 1079 00:47:53,333 --> 00:47:55,300 {\an1}tell you you shouldn't use these embryos. 1080 00:47:55,333 --> 00:47:59,366 {\an1}Keep them and maybe if you are more comfortable, 1081 00:47:59,400 --> 00:48:01,400 {\an1}use them as a lower priority. 1082 00:48:01,433 --> 00:48:04,133 {\an1}But they really could be a real baby. 1083 00:48:04,166 --> 00:48:07,300 (baby fussing) 1084 00:48:10,166 --> 00:48:13,100 ♪ 1085 00:48:13,133 --> 00:48:16,833 CASSIE: We transferred baby girl a few weeks ago. 1086 00:48:16,866 --> 00:48:19,833 {\an1}We got a positive pregnancy test, 1087 00:48:19,866 --> 00:48:21,833 {\an1}which we were over the moon about. 1088 00:48:21,866 --> 00:48:22,866 {\an1}And a few days later, 1089 00:48:22,900 --> 00:48:25,866 {\an8}my HCG level, 1090 00:48:25,900 --> 00:48:29,600 {\an7}which is the indicator of your pregnancy, went down. 1091 00:48:29,633 --> 00:48:31,866 And then it was confirmed that I... 1092 00:48:31,900 --> 00:48:33,866 we had a miscarriage. 1093 00:48:33,900 --> 00:48:35,500 ♪ 1094 00:48:35,533 --> 00:48:39,533 {\an7}One in four women of reproductive age will experience 1095 00:48:39,566 --> 00:48:41,133 {\an8}a pregnancy loss 1096 00:48:41,166 --> 00:48:43,500 at some point in her reproductive lifetime. 1097 00:48:43,533 --> 00:48:46,633 {\an1}That means 25% of women. 1098 00:48:46,666 --> 00:48:49,933 {\an1}It is quite natural and very common 1099 00:48:49,966 --> 00:48:51,866 {\an1}for women to blame themselves. 1100 00:48:51,900 --> 00:48:53,933 {\an1}And the first way to help someone understand 1101 00:48:53,966 --> 00:48:56,366 {\an1}it's not their fault 1102 00:48:56,400 --> 00:48:59,400 {\an1}is to let them know how common this is. 1103 00:48:59,433 --> 00:49:02,433 {\an7}Through this journey we've come closer and closer and closer 1104 00:49:02,466 --> 00:49:04,433 {\an7}to being able to actually have a child. 1105 00:49:04,466 --> 00:49:07,366 {\an7}And it feels like it's within reach. 1106 00:49:07,400 --> 00:49:09,966 {\an1}It's just, just barely out of reach. 1107 00:49:10,000 --> 00:49:11,533 {\an1}Are you sleeping... 1108 00:49:11,566 --> 00:49:15,766 NARRATOR: Cassie and Zack have one remaining embryo to transfer. 1109 00:49:15,800 --> 00:49:19,133 CASSIE: For the next frozen embryo transfer, I'm nervous. 1110 00:49:19,166 --> 00:49:21,066 {\an1}I have one more embryo left. 1111 00:49:21,100 --> 00:49:23,133 ZACK: This needs to work. 1112 00:49:23,166 --> 00:49:26,133 {\an1}And if this doesn't work, what's next? 1113 00:49:26,166 --> 00:49:28,066 {\an1}We haven't talked about what's next, 1114 00:49:28,100 --> 00:49:29,133 {\an1}if this doesn't work, 1115 00:49:29,166 --> 00:49:32,733 {\an1}because we're just praying that it does. 1116 00:49:32,766 --> 00:49:37,766 NARRATOR: I.V.F. succeeds only about half the time for couples. 1117 00:49:37,800 --> 00:49:40,533 ♪ 1118 00:49:40,566 --> 00:49:44,800 {\an1}Cassie and Zack's last embryo resulted in another miscarriage. 1119 00:49:44,833 --> 00:49:47,500 {\an1}They plan to try again with I.V.F., 1120 00:49:47,533 --> 00:49:50,566 {\an1}starting with another surgery for Zack. 1121 00:49:50,600 --> 00:49:53,766 ♪ 1122 00:49:53,800 --> 00:49:57,500 EDWARDS-DUNN: To hold onto hope means to look beyond 1123 00:49:57,533 --> 00:50:01,500 {\an1}what might be negative or what might not be working out 1124 00:50:01,533 --> 00:50:04,633 {\an1}in a way that you desire to happen in that time 1125 00:50:04,666 --> 00:50:07,400 {\an1}and know that something better is going to come. 1126 00:50:07,433 --> 00:50:10,533 ♪ 1127 00:50:10,566 --> 00:50:16,066 HARPER: I went through my third round of I.V.F. in May of 2018. 1128 00:50:16,100 --> 00:50:21,100 {\an1}They retrieved two eggs, they fertilized. 1129 00:50:21,133 --> 00:50:23,100 {\an7}My doctor came into the room and I'll never forget she said, 1130 00:50:23,133 --> 00:50:27,033 {\an7}"Tiffany, they look great!" 1131 00:50:27,066 --> 00:50:32,000 {\an7}(voice breaking): And I remember thinking, you know... 1132 00:50:32,033 --> 00:50:33,033 {\an1}no one's ever said that to me. 1133 00:50:33,066 --> 00:50:34,433 {\an1}No one's ever said they look great. 1134 00:50:34,466 --> 00:50:36,900 {\an1}Like this is... I have a shot. 1135 00:50:36,933 --> 00:50:40,366 {\an1}And so, we put them both back in and the rest is history. 1136 00:50:40,400 --> 00:50:42,800 {\an1}I gave birth to my son nine months later. 1137 00:50:42,833 --> 00:50:46,800 {\an1}And he is everything that I prayed for, 1138 00:50:46,833 --> 00:50:48,833 {\an1}everything that I've been waiting for, 1139 00:50:48,866 --> 00:50:51,000 {\an1}everything that, like, I didn't know I needed. 1140 00:50:51,033 --> 00:50:54,133 ♪ 1141 00:50:54,166 --> 00:50:56,533 NARRATOR: Reverend Stacey Edwards-Dunn and her husband Earl 1142 00:50:56,566 --> 00:50:59,833 {\an1}decided to try one last time. 1143 00:50:59,866 --> 00:51:01,200 EARL DUNN: After seven years, I just told her, 1144 00:51:01,233 --> 00:51:04,333 {\an1}I said, "Let's try one more time," 1145 00:51:04,366 --> 00:51:05,666 {\an1}because I think I had a good feeling. 1146 00:51:05,700 --> 00:51:08,633 {\an7}Our bonding together, our faiths together, 1147 00:51:08,666 --> 00:51:11,433 {\an7}that, that whole collectiveness. 1148 00:51:11,466 --> 00:51:13,300 ♪ 1149 00:51:13,333 --> 00:51:15,933 EDWARDS-DUNN: On January 2, we received the call 1150 00:51:15,966 --> 00:51:18,900 {\an1}from the doctor around 2:30. 1151 00:51:18,933 --> 00:51:20,966 {\an1}Everything, like the world seemed to stop. 1152 00:51:21,000 --> 00:51:24,000 {\an7}The doctor, the nurses, everybody was on the phone, 1153 00:51:24,033 --> 00:51:25,933 {\an7}saying, "We call with good news. 1154 00:51:25,966 --> 00:51:27,633 {\an7}We want you to know that you are pregnant." 1155 00:51:27,666 --> 00:51:30,600 {\an1}(laughter and giggling) 1156 00:51:30,633 --> 00:51:33,566 ♪ 1157 00:51:33,600 --> 00:51:34,566 Our daughter that... Shiloh, 1158 00:51:34,600 --> 00:51:37,333 that was born on September 11-- 1159 00:51:37,366 --> 00:51:40,333 she is she's a gift to so many. 1160 00:51:40,366 --> 00:51:43,366 {\an1}Whether your path is becoming pregnant naturally 1161 00:51:43,400 --> 00:51:46,533 {\an1}or becoming a parent through I.V.F., 1162 00:51:46,566 --> 00:51:48,433 {\an1}donor eggs, donor sperm, 1163 00:51:48,466 --> 00:51:52,100 {\an1}surrogacy, embryo adoption, or adoption-- 1164 00:51:52,133 --> 00:51:56,066 {\an1}there is a plan or a path for you. 1165 00:51:56,100 --> 00:52:01,166 {\an1}That's what you hold onto and know at the end of the path, 1166 00:52:01,200 --> 00:52:03,166 {\an1}there is a miracle waiting for you. 1167 00:52:03,200 --> 00:52:07,866 {\an1}And whatever path that is, the path isn't deficient, 1168 00:52:07,900 --> 00:52:10,066 {\an1}it's just different. 1169 00:52:10,100 --> 00:52:13,333 ♪ 1170 00:52:32,500 --> 00:52:38,433 ♪ 1171 00:52:43,600 --> 00:52:47,733 {\an8}ANNOUNCER: To order this program on DVD, visit ShopPBS 1172 00:52:47,766 --> 00:52:50,800 {\an7}or call 1-800-PLAY-PBS. 1173 00:52:50,833 --> 00:52:53,833 {\an7}Episodes of "NOVA" are available with Passport. 1174 00:52:53,866 --> 00:52:57,366 {\an7}"NOVA" is also available on Amazon Prime Video. 1175 00:52:57,400 --> 00:53:02,400 {\an8}♪