Shaarei Tikvah Pesach 5780

the

Today By: Idy Berkowitz Mid-track SHAAREI TIKVAH/ PESACH 5780
Walking down the street And freeze?
The most heavenly sight I meet I remember Thursday What
Cuddled sweetly Long after night hit Makes me flop
Tucked in neatly A candle we both lit Step back
Pudgy little hands He turned around to say With unease?
Identical pink bands “Now is a time to pray When
Gently closed eyes Ask and plead Will I strip off
Their chests in unison rise For all you need” That mask
The scene so silky and warm I dared to test And pray?
Simply not the norm “What did you request?” When
I can’t remove my gaze He sadly smiled Will I cry
My heart is set ablaze “I asked for a child” And ask
I finally look away His face was so sincere And sway?
Continue on my way I could see a tear Why
“Hashem…” I scream silently I shut my eyes closed Am I scared
But then Trying to stay composed To say
I stop short “Hashem…” I gave a soundless sigh To scream?
My emotions taut Then
I faulted Why
My feelings bolted
… Can’t I dare
What
Makes me stop To pray

For my dream? •

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SHAAREI TIKVAH/ PESACH 5780Our services include:

• Medical Referrals
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• Private Consultations
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• Educational Events
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52

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718-686-8912 • Atime.org

53

Chizuk From Within SHAAREI TIKVAH/ PESACH 5780

OATNIHMOELRDS Infertility Beyond Cycling

“For most people, infertility equals meds and blood tests and shots and procedures. It conjures up images of
long waits in doctors’ offices and early morning appointments. It means annoying insurance companies and
frantic runs to the pharmacy.

I know about it all because sometimes, I’m one of those people. But not always.
I don’t have kids. I’m also not cycling. And nope, I’m not on birth control, either.
I know there are so many others out there like me: the ones who can’t have kids and also can’t do anything
about it. Or, sometimes, there are things to do about it, but they aren’t typical. They’re none of the things that
come to mind when you think of infertility.
Actually, there are lots of things that are the same. Like the emptiness, weariness, loneliness and longing.
Feeling the stares and wishing you could just disappear... We who don’t cycle also pass the baby stores and wish
we could buy adorable, cozy things. We have the same hopes and crashing disappointments, the twists of our
hearts and the challenges of acceptance. Those parts of infertility are the same.
But for me, and lots of others like me, infertility doesn’t always (and will perhaps never) include so many things
that it does for you, which has its upsides, too. But honestly, I wish I could cycle right now. I wish I could feel like
I’m doing something tangible. When I talk to my IF friends, I want support and understanding. But there is so
much I can’t say... It's simply too personal. And then they suppose I’m doing the same things as they are.
And I wonder. Would they ever be able to accept me and relate to me and support me if they knew what it
was like to live in my ‘Never-Never Land’?”
- Tehilla

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And so we turned to you, dear ATIMERs-on-hold, and asked you to let us into your
individual worlds. What follows are simply tidbits of so many voices out there. As your
stories came in, we were deeply touched, and overtly amazed. Your collective strength
of spirit is something to be proud of. May Hashem bentsh our efforts, and send us all
yeshuos — b’karov!

Necessary Respite Suri shares, “We had to break for three years due to SHAAREI TIKVAH/ PESACH 5780
our diagnosis. That break was probably the hardest part
While there are many who have never experienced of our infertility!” Like Suri, Tzipora and her husband
the ups and downs of a medical cycle, for others, a “non- also took a break due to complications they faced. “My
cycling” status was attained through a necessary albeit husband had a varicocele repair, which put us on hold.
voluntary break, on the heels of previous taxing tries. It wasn’t for long but it was a real struggle. We resumed
cycling afterward, but now we are on hold again for
Meira recalls, “We put a tremendous amount of effort other MF-related reasons.”
into cycling. For a full month, we were out of town.
We traveled to the city for two-plus hours back and Both Suri and Tzipora expressed newfound
forth, numerous times, for appointments of just a few appreciation for the gift of cycling. “When we were
minutes.” able to start cycling again, I had a completely different
outlook,” Suri relates, “I realized that fertility treatments
When Meira received a positive, her joy knew bounds. are a true gift that so many people daven for!” And
Unfortunately, it wasn’t meant to last. “A few days after although neither Suri or Tzipora’s experience proved to
we heard a heartbeat and all the numbers were stable, be smooth, both felt that the bumpy road of cycling,
we lost our precious fetus,” Meira relates. “We were with all its failures and painful losses, was still easier
broken and burnt out. The stress was too much to bear.” to endure than the years during which they put their
cycling on hold.
At that point Meira and her husband took an
extended break. While many people in Meira’s inner Esther, whose treatment is also on hold due to a male-
circle couldn't understand, she and her husband knew factor diagnosis, shares her take;
that the long break was needed in order for them to
adequately recharge and start living again. “We acted “Baruch Hashem, we are candidates for TESE.
like we were in shana rishona,” says Meira, “and it was However, we were advised to first wait and see if any
absolutely blissful. I don’t think we could've handled of the up-and-coming medical advances can work for
returning to cycling if not for that break.” us. We wait, and wait, occasionally running some tests
here and there, but mostly we just wait to hear about
Medical Gridlock tentative progress.”

Still others break for medical reasons. While there are The frustrating part, Esther relates, is that she and
certainly female-factor diagnoses that render a couple her husband are unsure if what they’re waiting for will
unable to cycle, those who shared their experiences with come to fruition, or even be helpful for them in the long
us were predominantly male-factor based. run. “We're not sure if we're waiting for nothing, or for
something,” Esther explains, “Time is passing, and we
don’t know if we’ll be successful with surgery, if that’s

55

SHAAREI TIKVAH/ PESACH 5780 what it comes to; there are no guarantees. Being in particulars of her case.
limbo is hard, especially when you’re not sure what
you’re waiting for or for how long to wait.” While Gitty’s team of genetic counselors and
doctors conducted research, her hopes for building
Like Esther, Shiffy too is waiting for new advances. a family were effectively put on hold. “We were
Although Shiffy’s husband is a candidate for TESE, offered segulahs and unsolicited advice about various
recent developments have given Shiffy and her naturopathic doctors,” Gitty says with a smile, “It was
husband renewed hope and the possibility of seeing absurd, because we weren't even trying to conceive at
success without surgical measures. The catch? The that point!”
advances they are waiting for are not ready just yet.
Eventually, Gitty and her husband met up with the
Still, Shiffy remains optimistic, despite the hardship right shaliach, who was able to reassure them that
of her undefined status. “The way I see it,” Shiffy their specific mutation was a mild one, and not a
explains, “is true, we can go ahead and do surgery cause for concern. Still, Gitty’s experiences on pause
today. But what’s the point if there will be a bigger entirely changed her outlook.
chance of success tomorrow? The medical scene is
developing so fast that if TESE will restrict our ability "During that time, I learned that hope is a luxury,”
to take advantage of further developments down the Gitty says, “at that point, when I was on birth control,
line, it isn’t worth the risk.” I couldn't even hope. In addition, I used that time to
work immensely on my emunah, and that was, and is,
While Shiffy remains upbeat, she doesn’t overlook a very powerful tool for which I am truly grateful.”
the hardships either. “It is really difficult,” she admits.
“Especially if you feel like you just want to get on with Tali realized that genetics would play a role in
it already, but your hands are tied. It’s not an easy her fertility after failing multiple FETs. Her doctor
place to be.” recommended conducting genetic testing on her
few remaining embryos. At that point, Tali and her
Genetic husband lacked both the wherewithal and funding
Complications for the expensive process. “The whole thing was
unexpected, since I was healthy and young,” Tali says.
In recent years, various breakthroughs in the field of Their time “on hold” was especially hard, since Tali
genetics have vastly altered the prospects for carriers and her husband were unsure how long it would
of genetic disease. Despite those advances, for many stretch. In the end, it took them over a year to put the
couples genetics present a serious minefield that requisite resources together and begin trying again.
requires careful and deliberate navigation — and
often, waiting as well. Performance
Challenges, a
Gitty explains, “At some point in our journey, we Personal Struggle
were told that we were both carriers of a mutation of
the same gene. We were advised to use birth control For many couples, medical solutions are a remote,
and try to meet with some genetic counselors to and at times, irrelevant, part of their treatment plans.
identify our specific area of concern.” However, due to For some, performance struggles may be the entire
the rare prevalence of her specific genetic mutation issue, while for others, performance challenges are
within the Ashkenazic community, the advisors merely indicative of medical complexities to follow.
whom Gitty consulted with weren’t familiar with the

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Although Chava* and her husband haven't yet with our special connection and the beautiful and SHAAREI TIKVAH/ PESACH 5780
received a formal medical diagnosis, for them and happy relationship we share,” she says. “Nonetheless,
many others, proper performance has morphed into there’s always a lurking void — the lack of completion,
a serious challenge that needs to be resolved before the lack of fulfillment, the lack of children. We’ve been
moving forward. to doctors, and they have some ideas, but it’s very
difficult to do any standard procedures when there’s
Chava shares, “It’s hard to express my feelings on nothing to work with.”
this topic. Since our struggles are emotion-based,
there is so much unknown and frustration. There are Hindy’s husband relates:
a lot of ups and downs and better times and worse
times, and many times you get the feeling that you are “As Pesach approaches, and again we’ll say the
just going in circles. On top of the original stress that Mah Nishtanah ourselves, the thought lingers in my
affected our intimacy, the stress of infertility makes mind – maybe next year will be different. Maybe next
the struggle so much harder.” year our home won’t be so quiet. It’s been hard for us
all these years as the waiting carries on. We believe
The key in Chava’s struggle is patience. “Baruch we’re almost there, yet each month we fail again. The
Hashem, as I’ve said, we’ve had better times, which doctors, rabbanim, and therapists who we speak to tell
is definitely encouraging. Right now we need to be us that we’ll be okay. But as ovulation kicks in, intimacy
patient, and keep at it, continuing to do what needs dysfunction follows right along. Our natural, inborn
to be done,” she says. And yet, at the same time, desire for children clearly doesn’t help us – it just adds
Chava realizes that in her specific case, these issues to the societal pressure we already live with.
may only be a gateway to a greater medical challenge.
“We don't have an immediate goal to look forward The doctors tell us to go to therapists, where we
to,” she explains. “We don't even know if spending all spend lots of money we don’t have until we realize that
this time and money working on performance will they don’t have any experience with our specific issue.
cure our infertility. This is just the beginning. There is
no knowing how long it will take.” Each month we try to come up with something new
that might work, but most of our therapists
Like Chava, Hindy’s experience with infertility is also
performance-based. Unlike Chava, Hindy’s husband’s are out of ideas. We’re just guessing, because there are
struggles are the result of an early childhood trauma no clear steps to take. Working to overcome my anxiety
— having been abused by an adult figure while still a from childhood abuse is essential to our hishtadlus. I try
child. not to blame

Hindy shares, ”My husband suffers from a myself for our situation. I tell myself, “although my
disorder, which affects us deeply. The doctors say it’s challenge comes in a unique form, I am still
psychological, which makes perfect sense, considering
his experiences. At this point, we’ve been part of the part of the A TIME world until this is over, may it
infertility world for a few years. I wish, as horrible as happen b’karov!”
this sounds, that our treatment plan would call for
cycling. But obviously, that’s not an option for us.” While couples like Hindy and her husband often
feel alone even among the IF crowd, the reality is
Despite the hardships that Hindy and her husband that there are countless others like them, unseen
face, Hindy chooses to focus on the positive — and unheard. Whereas the unnecessary shame of
her strong bond with her husband and the happy undergoing fertility treatments has been all but
marriage they’ve built together. “The many rabbanim eradicated amongst IFers, the personal nature of
and therapists we’ve been to are all very impressed intimacy dysfunction and the painful stigma of abuse
remain largely undiscussed.

57

Mimi, a courageous survivor of severe abuse, shares, The Takeaway
“Wherever I go, whoever I talk to, I have to pretend
everything is fine and answer people’s innocent “Couples who struggle with issues that preclude
questions. I nod and listen to random advice and them from cycling often feel alone, even among fellow
segulos and comments — when that is the furthest IF friends,” Rochie shares, a thought that is echoed by
thing from my mind!” so many in her shoes.

Mimi’s experiences have rendered a most painful “The loneliness is greatly exacerbated by the fact
dichotomy. “The last thing I can face is having a baby,” that what we’re dealing with is so personal, it’s not
she says, “even though I want one so badly at the something that can be discussed with others,” Shira
very same time. My abuser made my relationships so adds, “even within the IF world.”
complicated. The damage broke me so deeply, I don’t
even have the confidence within me to mother a This means that even though there are countless
child. And yet, more than anyone, I need a baby that is people experiencing the same hardships, women like
mine to look after, to love, and to try to protect from Shira and Rochie don’t always have the chance to
this sometimes scary and dangerous world. I carry this reach out and receive the support they so desperately
deep, dark secret with me wherever I go.” need.

Like Hindy, Mimi wishes she too could be part of “I feel like I’m living a double — or perhaps triple —
the conversations about early-morning monitoring life,” Debbie says. In addition to the strength of spirit
and shots. And yet for Mimi, and countless others, Debbie shows to friends and family, and the seeming
their story is different. It involves grueling work with openness she displays to her IF counterparts, there’s
therapists and counselors who are equipped to a third world hidden away from even the infertility
provide guidance for their specific journey. Mimi asks friends Debbie is close to — her world of personal
of the IF community, “Realize how much you don’t struggle and a treatment plan (or lack thereof) that
know about the person sitting next to you, even at an doesn’t entail shots or ultrasounds.
A TIME event. Please, tread carefully.”

In closing, Debbie asks of fellow ATIMERs-on-hold, “Know that you’re not alone. Know that there are so many
like you, and just because no one is talking about it, it doesn’t mean that there aren’t others experiencing the
same pain, the same loneliness, and the same hardships. We are in this together.”
And to the rest of ATIMERs, the message is clear: Don’t ask. Don’t assume. Simple awareness goes a long way.

Most of all, “We hope to be out of this dark tunnel really, really soon,” says Hindy’s husband, “and we hope that
anyone dealing with issues like these — and all ATIMERs — see the light at the end of their tunnel bekarov, b’ezras
Hashem!”

SHAAREI TIKVAH/ PESACH 5780 WE MUST LET GO OF THE LIFE WE HAVE PLANNED SO AS TO ACCEPT
THE ONE THAT IS WAITING FOR US. - JOSEPH CAMPBELL

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PLEAHSOELD

By: Rivky Frankel

Today In fact And I know
I called the bank I was feeling My call
And was pleasantly told: Terribly Is very important
Please hold. Impatient. To Him.
And very soon And was wondering And I know
A representative Why Hashem
Will handle She even thought Is rewarding me
My request. I was being patient. For holding.
So listening But I guess And I am sure
Not so patiently If I was holding the line Up there
To jazzy music Not slamming down He is thanking me
I held. I was being patient. For my patience.
Every now and then So you see Even if today
The anonymous voice I am still I am not at all
Thanked me Very painfully In the mood
For holding. Waiting. Of being patient.
And kept telling me And it seems like Because
How very important Hashem Even if I feel
My call Keeps telling me: Terribly
Was to them. Please wait. Impatient.
And then But even if I fail I guess
She went on Lose grip If am still holding on
And thanked me Not so patiently Not giving up.
For my patience. I still hold on. I am being patient. •
Well Because I know
I was not at all That Hashem SHAAREI TIKVAH/ PESACH 5780
In the mood Will handle
Of being patient. My request.

PATIENCE IS NOT THE ABILITY TO WAIT,
BUT THE ABILITY TO KEEP A GOOD ATTITUDE WHILE WAITING

59

SHAAREI TIKVAH/ PESACH 5780Adoption

all in the
family

as told to
shterna karp

In the frum community, where we measure
our relevance by checking off milestones such
as marriage and children, childlessness can be
devastating , and unless you’ve been there, it’s
impossible to understand how deep the pain
reaches.
“Im yirtzeh Hashem by you” — these words
are possibly the most well-meaning but heart-
wrenching ones a childless couple has to hear. All
too often, I’ve had to endure this well-intentioned
wish at brissim as my peers, and soon younger men,
passed me by and became fathers.
When I was a newlywed in kollel, I taught a teenager
how to drive. Years later, when he was a father
himself, he wished me, “Soon by you” at a bris. His
well-meaning comment hit a raw nerve. I had once
been his teacher, and now he had passed me by as
well.
Guests at the local Shacharis minyan would attempt
some friendly banter after davening as they zipped
their tallis bags. The small talk would inevitably turn
awkward when they asked me, “So, where do your
kids go to school?”
With no other way to answer, I’d force a polite
chuckle and say, “Ask me another question.” Our

60

61 SHAAREI TIKVAH/ PESACH 5780

lives Adoption didn’t seem to
be an option for us, because
weren’t we had heard that the costs
involved were prohibitive. Our
always this bank accounts had been emptied
after years of fertility treatments.
way. My wife, Sarah There seemed to be no way we’d ever
have children.
Leah,* and I stood under
Yet Sarah Leah had bitachon that it would
the chuppah with the hope of a happen. She peppered conversations with
“When we have kids...” and “Our kids will...”
large family, certain that our path would be like While she continued to expect the impossible, I
considered myself realistic; children just weren’t a
that of any other couple. Instead, it veered into a desolate part of our future.

maze of twists, turns and abrupt stops, leaving us with So we celebrated our tenth, eleventh and twelfth
wedding anniversaries, and our dream of building
the searing, hollow ache that can only be felt by those a family remained just that — a wistful dream.But
Hashem’s salvation comes in the blink of an eye.
longing for children.
It was a quiet evening when the phone rang with the
When Sarah Leah first started to worry about our empty news that would forever change our lives. My wife’s first
home, I dismissed her concern. “We just need time,” I cousin was on the line with a question. A family with four
assured her. It was my own form of denial. I foolishly kids — non-frum relatives of my wife who lived in Illinois
hoped that without an official diagnosis, we could — was about to be split up, and the kids would be placed
postpone facing the truth of an underlying medical issue. in non-Jewish foster homes. Would we be willing to take
in the two boys and two
That is why we started treatment years later than most
others in our situation. girls?Before the phone call, we had been a childless
couple facing the prospect of another quiet evening.
We underwent treatment, which was financially, When we hung up, we were the potential parents of
emotionally, and physically draining...and worst of all, four Jewish souls. We’ve spent years begging Hashem for
unsuccessful. children. Perhaps this is how He is sending them to us, I
thought. Besides, if we didn’t take the children, no one
“We’ve tried everything that modern medicine has to else would — and there was no way of knowing what
offer you,” the doctor said after another failed attempt. would happen to them next.

SHAAREI TIKVAH/ PESACH 5780 I crumbled inside when I heard that we had reached the Suddenly, we found ourselves facing the possibility of
end of every dream we had once had. We went home in a going rapidly from a lonely household of two to a home
daze, letting it all sink in and wondering what our future filled with four young children, but after years of waiting,
would hold. we were ready. We jumped right in and trusted that
Hashem would guide us.

When we saw the first photo of the children, ages three
to 13, Sarah Leah and I fell in love. We could easily

62

envision them playing in our backyard, reading books I remember speaking to our case worker at A TIME about SHAAREI TIKVAH/ PESACH 5780
on our living room couch, and sleeping soundly in our the difficulty of all the details and legal technicalities.
empty bedrooms . But that day was still a long way off. “The hardest part of adoption is finding a child,” she told
We would watch three more seasons come and go — us. “And you found four
more than nine months — before our children would
come home. of them already!” Whenever the going got tough after
that, we would picture the kids and remember what
The red tape was often overwhelming. The children we were fighting for. One of the brachos of this waiting
needed to cross states lines to live with us, which meant period was that we had time to research different
two social service agencies to deal with and a never- subsidies and adoption grants. Baruch Hashem, our
ending pile of paperwork. The Illinois social services family was eligible for Title IV-E, which pays the children’s
informed us that because the children were going to medical insurance and provides them with a small
another state, stipend until age eighteen.

they would no longer be eligible for state funding. Raising We went to each foster care training session and hoped
four kids with no financial backing was a scary idea, but for the best, all the while trying to ignore the voices inside
a teaching from the Lubavitcher Rebbe — that every our heads warning us that it could all fall through at any
child comes into a family with the blessings necessary moment. But then, when we heard the good news that
to care for him or her — echoed in our minds. “We’ll do Illinois would finally give in to all of New York’s
it anyway,” we told the case worker. The next hurdle was
when Illinois sent the ICPC (Interstate Compact on the demands, the relief was even greater.Baruch Hashem, we
Placement of Children) packet with a request for “relative were one step closer to bringing the children home!
placement, no benefits” to New York, but New York
rejected the adoption request unless it was switched to We finished our training, passed our home study,
“kinship foster care, benefits required.” They refused to and went for an FBI background check. With all the
accept the welfare of four more children if their home paperwork in order, we were able to speak with the kids
state would not take financial responsibility. for the first time. During our first Skype call, I remember
thinking that this is what it must feel like for a heart
Just like that, the momentum of the initial phone call to melt. I am so grateful to Hashem that our children
ground to a halt, and instead of moving forward, we were connected with us right away. We flew out to visit them
in limbo. The children were in Illinois, we were in New for a few days, and then, on August 6, 2014, more than
York, and it seemed that there was no way to bridge the thirteen years after my wife and I began building our
gap. We spent hours calling anyone we knew with either home together, the social workers flew our children to
experience or connections, but each conversation ended New York.
in a roadblock.
Our precious kinderlach were a gift from Shamayim,
The states continued to argue about placing the kids literally delivered to our doorstep. All we had to do was
with us, and we could do nothing but sit idly and watch open the door and welcome them into our lives.
the time tick past. The hardest part was that we weren’t
allowed to contact the children while the paperwork was What still amazes me most is just how quickly things
still being processed. Whenever I look back to this time, I became normal. Our children melded right into our lives,
am filled with regret that we missed nine months of our the community welcomed them with open arms, our
children’s lives while we waited for the bureaucracy to extended A TIME family cele-
sort itself out.
brated with us, and immediately we felt like a unit. Yet
there are challenges.

63

For starters, our kids went through Gehinnom before we ‘fore-closed’ children,” Sarah Leah once said.
found them. Their first home wasn’t a happy one, and
that trauma carries over. Our older daughter was only “We’re happy, but someone else is mourning them.”
eleven when she had to start feeding and taking care of
her younger siblings. It reminded me of the halacha for when a loved one
passes away and leaves a large yerusha. In such a situation,
Their mother, who battles mental illness and addictions, the person is halachically obligated to say both “Baruch
often left them out in the cold at Dayan Ha’emes” and “Hatov V’hameitiv.” Sarah Leah and I
are thrilled to have our children, but we have sorrow for
night or used them as pawns when she fought with their their pain and the pain of their former family.
father or grandparents. Sarah Leah and I tried to make
peace with our children’s grandmother, who has several Taking kids out of a secular home and raising them in a
mental disorders herself, but our efforts were rebuffed. frum one was another struggle. The younger two, ages
three and four, were too young to miss another life. But
Sadly, they are very dysfunctional. our oldest son and daughter were resistant at first to
leading a frum life.
Our children’s birth family is still in the
picture, which means the saga is ongoing. Before they came to us, they had been eating treif and
We are there to pick up the pieces after going to church. I taught the oldest two to read the alef-
yet another broken promise and to hold beis; today, my son reads faster than I can. Our oldest son
our children tight when they cry about was nearly enrolled in public high school; today, he is a
feeling abandoned by their mother or yeshivah graduate.
mistreated by their grandmother.
We spent two decades using our worn- out wedding
My wife compares adopting children to bentchers, but now we have -a fresh batch from our son’s
buying a house in foreclosure. It is bitter- bar mitzvah.
sweet. You get a great deal, but it comes at
the expense of someone who is crying over We sent the younger ones to cheder for the best Yiddishe
their lost home. “We chinuch, and today they are knowledgeable
got four enough to teach my wife and me Torah.
At first they didn’t understand what
SHAAREI TIKVAH/ PESACH 5780 being Jewish meant, but today they
are all shomer Shabbos.

Adopting them was a modern-
day pidyon shvuyim. We gave
four Yiddishe neshamos a new
chance at life. I don’t want to
paint rainbows and make it
seem easy, but it was worth
every struggle. There’s a certain
amount of blind faith involved
in adoption. You can’t know
everything

you are getting into beforehand, and
if we had, we might have been scared
off. As with other mitzvos, you have to do
your part and trust that Hashem has your
back. One of our biggest hurdles was dealing with

64

the complex halachos related to adoption. Because the We didn’t want to send our oldest away so soon SHAAREI TIKVAH/ PESACH 5780
children are related to Sarah Leah, we knew they were after she arrived, so we got a high
Jewish, but we didn’t have enough proof for a beis din to
go on. We either needed further proof of their lineage, or school off the ground. A few kids from nearby towns
they would have enrolled as well — one of whom introduced us to her
brother, our daughter’s future husband. And b’ezras
to undergo geirus. The latter wasn’t ideal. The oldest two Hashem, our family will soon grow even more with the
were not in a place to go along willingly, and there was arrival of einiklach. I often tell our oldest daughter that
always the chance that the younger ones would reject she is where she is meant to be; it just so happens that
Yiddishkeit when they reached bar or bas mitzvah. We her line was a little less straight than most.
began a lengthy investigation with many dead ends.
Recently my younger daughter and I were sorting
We traced their great-great-grandmother’s grave and through some papers from a decade ago. In the mix
brought proof that she was buried in a cemetery for Jews were the medical bills and records of our failed fertility
only. That wasn’t enough on its own, but we also found a treatments, all of them reminders of our grim certainty
1929 census that listed their family’s language as Yiddish. that we would never have children. I handed the papers
With both pieces of evidence and Sarah Leah’s testimony to her — my very own daughter — and helped her throw
about the family tree, the dayan had sufficient reason to them into the fireplace. Together, we watched them
declare our children Jewish from birth. catch fire and travel through the chimney as nothing but
smoke.
When we walked our daughter to the chuppah, we were
filled with the pride that comes after a lengthy journey. Dovid Hamelech’s words from Tehillim (113:9) ran
The battle to find her and her siblings, to raise them and through my mind: “He makes the barren woman dwell
teach them about Hashem’s wondrous ways, were all in her house, a joyful mother of children.” If you had
worth it. asked us on our wedding day where we would want to be
in thirty years, we would have painted an image similar
I often tell our children that even if we had hand-picked to the one we are living. We took many detours along
them from the Most Awesome Kids in the Universe Store, the way, but we landed in the right place — with our
we couldn’t have gotten as lucky as we are. beautiful children.

Hashem wiped away our many years of pain. l Postscript: Sara Leah and I have one goal in sharing
Unfortunately, the insensitive remarks haven’t stopped; this story — to raise awareness about and encourage
they’ve merely changed. Instead of comments like “Soon adoption in all forms. After hearing our story, two
by you,” we get questions like “Who are the real parents?” couples have already been inspired to adopt, baruch
and “So your kids aren’t actually yours?” Baruch Hashem, Hashem, and there are countless more children and
couples out there waiting to find each other. Even
though, our kids look very much like my wife, and fostering children who are not eligible for adoption is an
we get comments less often than might be expected. incredible mitzvah and pure pidyon shvuyim. In the years
Most people don’t even realize that there’s very little since we adopted our beautiful children, the
blood connecting us. It’s a blessing, but we would have
adopted them no matter what. They’re our children. advocacy and resources for adoption have expanded,
I’ve learned that not everything in life has to be perfect which makes it easier — although you shouldn’t expect
to be amazing.It’s hard to understand Hashem’s ways, it to come without chal lenges. Anything good is worth
but sometimes His plan for us is made clear. If we’d had fighting for. If you would like to hear more, my wife and I
kids years earlier, we probably wouldn’t have considered can be contacted through A TIME.____________ *The
adopting a family of four. When the children first came, names in this story were changed to respect the privacy
our out-of-town community only had an elementary of the family. •
school.

65

Support

SHAAREI TIKVAH/ PESACH 5780 I’ve come to realize that infer- ing for pregnancy test results, waiting that everything else seems to have
tility treatments — particularly for your first ultrasound, waiting to melted away into oblivion without
IVF — are nothing more than giant, hear the heartbeat, waiting, waiting, you even noticing. Nothing matters
expensive and often painful games waiting. It’s enough to drive anyone much anymore, except making it
of watch and wait (although “game” mad. to the next appointment, the next
would imply there’s fun to be had, phone call, the next milestone. Your
and I can assure you that there is Without even noticing, a life in previously multifaceted, interesting,
none of that). Waiting for hormones waiting quickly becomes a life in lovely life becomes an excruciat-
to kick in, waiting for follicles to limbo — a time when you feel stuck, ing slog through a never-ending
grow, waiting for retrieval day, constantly counting down the days checklist where nothing else matters
waiting for Day 3 numbers, Day 5 until the current wait ends and the anymore except ticking off the next
numbers, waiting for genetic testing next one begins. Minutes blend into item. Time slows down to an aching
results, waiting for your next men- hours, which blend into days and crawl, with nothing meaningful with
strual cycle, waiting for your lining to into weeks, and before you know which to fill the molasses-thick drip
thicken, waiting for transfer day, wait- it, you’ve waited away months of of each passing minute.
your life with such singular focus

66

If the waiting doesn’t kill you, the LIFE MAYabout all the ways things
watching certainly will. I am a doer BE A GIANTcan go wrong, or Googling
by nature. If there’s something I
want to see or experience or accom- every symptom you feel and
plish, I figure out the necessary steps every statistic under the sun,
and then do. I love an actionable
plan. I thrive on getting things done. QUESTIONbut in the end, where does
When I say I'm going to do, I do.
But infertility and IVF don’t work all of that worry and infor-
like that. Yes, you have a protocol mation overload get you?
to follow and steps to take, but the
results of those actions are com- MARK RIGHTIn the past, I’ve found it
pletely out of your hands. And that
helplessness, that loss of power, our shockingly easy to descend
best laid plans going up in smoke —
well, it’s disorienting and crazy-mak- NO?W, BUT ITintoablackholeofdwelling
ing at best.
on every possible terrible
But the hardest part about the outcome in any given
watching is that because there’s
nothing you can do to affect the HASN’T STOPPED.situation. I’ve imagined it
outcome, it feels like everything and all. But in the last few years,
anything can affect the outcome.
You worry about how every little I’ve made a concerted effort I’ve had to employ this method
thing you do, say, or even think can to change that tendency. more times than I can count the last
change the course of your treat- What I’ve found that works for me several months, but it has been a
ment. You Google everything and, (both with worry and with handling lifesaver. Even with the best inten-
unsurprisingly, fall down rabbit negative or upsetting emotions in tions, I still find it so easy to lose
holes of misinformation that only general) is to: myself in the watching and waiting
cause more anxiety. You lose focus (and worrying). But by recognizing
easily, and find yourself distracted by 1. Recognize and acknowledge how what is happening to me (step #1!),
everything and nothing all at once. I’m feeling and why (the why is the I’m able to address it and then get
You fall prey to silly superstitions key, so don’t skip that part!).
in a desperate, grasping attempt
to feel some semblance of control 2. Allow myself a set amount of time back to living. I have been enjoying
over a situation that is 100 percent (say, 15 minutes) to divulge and a social life again, made time to
uncontrollable. fully immerse myself in that feel- get out of the house for museum
ing. Denying or ignoring emotions trips or amazing meals, gone for
This is no way to live. doesn’t work. I know I’m feeling long hikes, and have torn through
that emotion for a valid reason, a huge chunk of my ever-growing
I’ve learned that despite the and it shouldn’t be neglected — reading list. Life may be a giant
all-encompassing nature of this but it also shouldn’t consume me. question mark right now, but it
process, you cannot forget to keep hasn’t stopped. There is no pause
living. Life is still happening, and
each day wasted worrying about an 3. When time is up, so is the worry button on living. Worry does not SHAAREI TIKVAH/ PESACH 5780
uncontrollable outcome is another (or the anxiety/anger/sadness/ alter outcomes (and neither does
24 hours you’ll never get back. Yes, self-pity/fear/what have you). obsessively watching and waiting).
you can easily fill your days worrying That’s it. I’ve felt the feelings, and Life keeps on keeping on whether
now the feelings have no more we’re ready for it or not, and if this
control over me. Time to move process has taught me anything, it’s
on. Which brings me to the last to never miss a minute of it, because
step... you never know what life has in
store for you. •
4. Divert. Shift gears to a neutral or,
better yet, positive thought, feel- By: Melissa Andersen/ thencomesmaybe.com

ing or action and be on your way.

67

SHAAREI TIKVAH/ PESACH 5780Support

Hope!MGoornodin,g,

68

By: Malka S. SHAAREI TIKVAH/ PESACH 5780

Finally,
I’ll do a test.
Here goes…
I’m scared to look,
Can hardly breathe.
I don’t see another line.
Wait, maybe I do…
Nah, it’s the shadow of the control line.

Wait, maybe there is a drop of a pinkish tinge…
It’s probably the lighting...
Is there something there?
Let me look in the sunlight –
I don’t see anything…
Wait, maybe, maybe I do?
Am I crazy? Am I imagining something there?
DH, what do you think?
Inside, outside…
Fluorescent, maybe just regular lighting?
Let me take a break and look again soon,
I don’t trust myself to see accurately,
Still nothing.

Oh, Hashem, please make another line appear!
Because with the positive or negative result,
The fate of my heart will also be determined…
Maybe I should draw another red line,
To just allow myself to imagine…

69

SHAAREI TIKVAH/ PESACH 5780 Where’s the beautiful embryo that was inside my womb?
I promised to take care of you!
Where are you now?
I know this was test #2, but maybe it was a faulty test?
I think I should try a new strip…
No – this is obsessive already!
I’ll stop looking,
Throw it out!

Five minutes later…
I’m digging through the trash,
Maybe the line just took time to show up,
I need to just check again…
This is so not normal!
But I can’t help it…

Oh, Hashem,
It’s so easy for You to create,
So very hard for me to accept this…

Five years ago,
I got a positive!!
A real one! (versus imagined)
For three months, I kept that strip,
It sat on my dresser,
Filled me with intense joy,
Every time I saw it.
But then I threw it out,
After the D & C….
Cause it hurt too much to look at it.
Maybe these little strips,
Bring out a bit of PTSD in me,
Is that even possible??

Oy, Hashem… help me!
The tears are coming,
Hot and thick drops of wet,
Can I still hope??
I want to.
I’m scared to.
Please catch me when I fall.
I thought I was prepared for a negative,
But how do I prepare for this overwhelming feeling??
I just want to taste joy… •

70

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71

SHAAREI TIKVAH/ PESACH 5780Support

10WORDS

ItnilfietyrTDHAETSCRIBE
By: Steve Wiens

72

WHAT IS INFERTILITY? The Oxford Dictionary defines it as: “The inability to

conceive children or young.” But anyone going through infertility knows that al-
though this may define the medical part of infertility, it affects our emotions and
feelings way deeper than just being unable to achieve a pregnancy.

HERE ARE TEN WORDS I WOULD USE TO DESCRIBE HOW INFERTILIT Y FEELS:

1. LONELY. We saw couple after couple get preg- you're terribly embarrassed about, because it's good SHAAREI TIKVAH/ PESACH 5780
nant before us, our best friends included. When they for you. But in the right places, and with people who
told us, we high-fived them, then we went home and can handle it.
hardly knew what to say to each other. We felt lost,
sad and even lonelier than before. We were excited 7. STRESSED. Even though it seems like a
for them; we were just very sad for us. stressed-out couple is less likely to get pregnant, the
American Society for Reproductive Medicine finds
2. EXPOSED. Everybody wants to give you that there is no proof that stress causes infertility.
advice, and some people say incredibly stupid things. Besides, trying hard to "not be so stressed about it"
My favorite: "You just need to stop trying so hard!" never worked for us. It also didn't help to "just stop
Some people want to know every excruciating detail trying." Everybody has a friend who was infertile for
of what you're doing to get pregnant. Suddenly, your 73 years, and the day they stopped trying, they got
most private details are the subject of casual con- pregnant. That never happened with us. It's okay to
versation. It's okay to avoid the question, smile and be stressed. Don't stress about your stress. Trying
change the subject. hard not to be stressed is silly.

3. ON HOLD. We were always checking the 8. DESPAIR. The cycle of hope and despair with
calendar, wondering if we should plan that vacation, infertility can take you out. I remember getting so
or that work trip, because what if we're pregnant? excited when my wife was two days late, and just
Then we stopped doing that, because we would have knowing that this time, it's going to happen! Then, a
never lived if we would have scheduled everything few days or hours later, when she told me she got "it,"
around a "what if." It's okay to miss a month or two; I would plunge into despair. The alternative is to tem-
you have to live your life. This is hard, but over the per your hope so that your despair doesn't get so low.
long haul, it will create more stress if you feel so After about a hundred months of experiencing this
trapped that you can't plan anything. cycle, we found that the best route is to keep hoping,
and if it doesn't happen, keep crying. It's too hard to
4. INVADED. For women, there are so many pretend that you're not excited and that you're not
things entering your body (probes, needles, drugs) depressed. Be excited. Be depressed. It's okay to hope,
and so many people measuring your progress. The and it's okay to cry. Keep hoping and keep crying.
loss of control can almost merge into a loss of self.
But, it feels like once you've started down this road, 9. LOSS. This was not how it was supposed to
there's no stopping until you get pregnant. It's okay be. This was not what you dreamed it would be. And
to say what you need, and it's okay to shore up your you don't know how it will end. It's okay if you don't
boundaries in whatever ways you can. know how to wrap your mind around your emo-
tions. Be gentle with yourself for not totally having
5. AWKWARD. During one of the first visits, I control of how you feel from moment to moment.
actually ran into some people from my community…
They asked, "What are you doing here?" I mean, what 10. AMBIVALENCE. Every time you have to go
do you say? It's okay to laugh at yourself sometimes. through another kind of treatment, you ask yourself:
Is it worth it? Do I really want it that bad? And then
6. ANGRY. Unfair is the password that gets you in the very next breath, you are taken out by the
into the infertility club. Many thoughts and feelings sheer magnitude of how much you want a baby. It's
may be irrational, but it’s also good to be honest in okay to want and not want. That's normal. •
safe places. You actually may be angry, and you may
need to find some safe places to be honest about Huffingtonpost.com
that. It's okay to express the darkness, even the stuff

73

SupportSHAAREI TIKVAH/ PESACH 5780 BIG

74 BOYS

DON'T

CRY?
WPerlolb,aTblhyeyShould
By: Amanda Lipschik

I’ve spent much time talking about the medical
aspect as well as the emotional side of what wom-
en endure when struggling with miscarriage and
infertility. But what about our husbands in all of
this? How come they are often just tagging along
while we do “all” the work? Aren’t we supposed to
be a team? I mean, we signed up for this together.
We had very real conversations about when to
start trying and then what doctor to see, what the
next steps should be, when we were ready to take
the leap, etc. And yet, oftentimes, we forget we
have a partner in this equation.

It’s not that we purposely place nails it perfectly when he says that WHEREAS IT’S SHAAREI TIKVAH/ PESACH 5780
our husbands to the side. After our culture frames pregnancy as ACCEPTABLE
all, we can’t have babies without ”something that women go through FOR WOMEN TO
their help, but most of the physi- and men just support.” As a result, GRIEVE, CRY
cal and emotional toll falls on the he had no idea how to deal with AND FALL APART,
woman. We are the ones suffering his own emotions after his wife’s SOCIETY EXPECTS
the physical pains of losing a baby, miscarriage. Because whereas it’s OUR MALE
giving ourselves injections, expe- acceptable for women to grieve, cry COUNTERPARTS
riencing the side effects of fertility and fall apart, society expects our TO BE RESILIENT,
treatment, and so on. We become male counterparts to be resilient, POSITIVE AND
so self-involved and overwhelmed positive and hopeful. That doesn’t HOPEFUL.
that we may sometimes forget there seem fair. Despite what society tells
is someone else experiencing this us, a man’s heart breaks just like a your own pain. Don’t forget your
with us. To be honest, I’m guilty of female's. They are without a doubt wife, but don’t feel the need to
occasionally doing this. There were struggling in this journey too and define your grief solely through her
a few times where I caught myself experiencing similar feelings. They pain.” Take the time to “check-in”
so wrapped up in my appointments, are also most likely feeling helpless with each other and assess where
treatment and own feelings and in their inability to protect us or you’re at, emotionally, mentally,
disappointment, that I didn’t always “fix” the problem. And yet, they and physically. Hold each other
“check-in” with my husband to see aren’t given the time, or more im- up and give each other the time
how he was doing. Part of this is portantly, the permission, to process and space to be vulnerable. And
human nature, I believe. We’re so their own reactions and feelings. let’s remember that while we, the
focused and so entrenched in what’s women, may experience the burden
going on in our own lives that we Wouldn’t the journey be so much of physical symptoms, this affects
don’t have the strength — or time easier if it was two people doing more than just ourselves. Let’s give
—to ask our husbands how they are this all together, side by side, as the same weight and concern to
feeling. opposed to one holding the other our husbands' feelings as we do our
one up? Try it! Challenge the men in own. Their sadness, anxiety and fear
​But more than that, there’s a your life to stop playing the “strong may be different from ours but they
culture in which we generally expect one” and be honest and real with aren’t any less valid. The feelings are
the men in our lives to “be strong” himself — and with you! To join you there and they’re very real. •
— to just be there for us and hold on the journey as equals, connect by
our hands without breaking. Men sharing how they’re coping, and to
don’t cry, right? They are supposed stop feeling the pressure to always
to sit by our side and deal with the be in control and have the answers.
same pain, but in silence, without As Jeremy Littau says about men,
any emotion. A male author, Jeremy “Grieve as hard as you need to, in
Littau, who wrote on the subject a way that’s true to yourself and

75

Support

thJeuFsotuMr eWaanldlBy:TsovaBr?ody

Loneliness. and then comes the Motivation those friends. Okay, I’ve got some
Monster. IF friends, too. But a bunch of them
It’s such a harmless-sounding work exactly the hours when I don’t.
word. So you’re lonely? Go out I want to exercise. I want to Or they deal with their loneliness
and find a friend, they say. Go on a cook a yummy supper. I want to some other way, I don’t know how,
walk. Get out of the house and see do errands. I want to make all but they’re not picking up the
the world. Or stay inside and bake those phone calls I keep pushing phone either way. So there goes
cookies. Distract yourself. What’s off. I want to do the laundry and that.
the issue? the ironing. I want to do a lot of
things… just… it’s so quiet here. Infertility equals loneliness. It’s
The thing about loneliness is that So lonely. So never mind, I’ll just just part of the package.
it’s my biggest motivation monster. eat chocolate and call a friend to
It kills all my willpower. Why, exactly, schmooze instead. Ironically, I was always the type
do I need the presence of another who needed my “alone time.” Sure,
human being in order to fold my And then my monster gets even I’m friendly, but crowds, or even
laundry? Good question. No good bigger — because I don’t even have too much one-on-ones, get me
answer, though. anybody to call! It’s 5:30 p.m. and I exhausted. Only now I’ve got way
just got home from work, but most too much alone time. It’s hard.
I don’t really need anyone else of my friends are in the middle
there. To be honest, I usually of crazy hour with their kids. So But you know what they say... “If
don’t even want anyone else scratch all
there. Working on my own is cozy,
efficient, and I can do
it all how I want to,
without interruptions.

But… in order to do
any of the things on
my to-do list, I need
motivation,

SHAAREI TIKVAH/ PESACH 5780 Loneliness is
my biggest
motivation
monster.

76

you can’t beat them, join them!” ridiculous it sounds. 8. C an’t get up at all? That means
So I guess it’s about time I learn to you really need to just let it out.
“celebrate” my loneliness. Or, better 4. Give in, and distract yourself. At Punch your pillow, cry, write,
put, learn to live with it as happily least you won’t be sad. Forget scream, sing, jump up and down
as I can. about the dishes or laundry on your bed, bury yourself in
or anything else on the to-do your quilt, stamp as hard as you
So for all of you out there who list. Just sit and read a novel, can, talk to your teddy bear —
find themselves in the same spot, take a bubble bath, strum your whatever it takes. Letting it out
here are some ideas: guitar, redo your make-up, go and acknowledging the feelings
for some retail therapy, put on — even just to yourself (or teddy
1. Turn the music on blaring. I your favorite hand cream, or ) actually go a long way in making
mean super-duper loud, like at do whatever it is for you at the you feel better.
a chasunah. Your favorite song, moment that makes you feel
even if it’s the sad, slow kind. good. Tough luck on supper. 9. D o something totally silly. Like set
up a real pity party for yourself,
2. Break down what you have to 5. Take a nap. Really. It’s not complete with the fancy pitcher
do into teensy, tinsy pieces. Ask always so bad to just go to sleep and chips in a bowl. Or grab
yourself, “Can I handle just that?” and forget about the world. something as a microphone and
If it’s tiny enough, the answer will Everything always seems brighter let your whole silent house know,
probably be yes. Then tell yourself, anyway once you’ve got some in vivid detail, just how horrible
“Okay, all I have to do is just that.” sleep in your system. Don’t you feel. Make funny faces and
worry so much about getting off stick out your tongue at yourself
3. Give yourself a tiny random schedule. Right now, this is what in the mirror. Put on your hugest
goal. Something like: Get off the you need, and you’ll worry about fake smile and say “Gosh, this
couch, walk across the room and later… later. is crazy.” You can’t really help
back. Turn it into a game and see yourself from laughing.
what you can dare yourself to do. 6. I f you can, get outside. Best if you
You can add a points system… have a porch, and you can swing 10. Think of something you’re
whatever gets you moving. on the hammock. Sunshine is a looking forward to and plan it
Forget how great cure for lots of things. out in your mind.
(Not always, but sometimes.)
Once you get moving, it’s easier
7. C hoose only one thing to keep the momentum going.
you Learn how to be funny enough that
want you won’t feel as lonely, even when
to do. you’re alone. •
Like
sweep
the
floor.
That’s
it.

WE SOMETIMES THINK WE WANT TO DISAPPEAR, SHAAREI TIKVAH/ PESACH 5780
BUT ALL WE REALLY WANT IS TO BE FOUND.

77

SHAAREI TIKVAH/ PESACH 5780Support

HOW TO
HANDLE
RECEIVING

TOO
MUCH

ADVICE

78

If you are going through infertility treat- 3. BE PROACTIVE. "DON'T THINK REACHING OUT IS A SIGN OF WEAKNESS," EVERYONE REASSURES YOU.
ment, you have probably been encouraged You know that fertility treatments are SHAAREI TIKVAH/ PESACH 5780
to reach out for emotional support from mentally and physically taxing and may test
your friends and family. "Don't be shy," you your stamina and psychological reserves.
are told. "Don't think reaching out is a sign Rather than wait for issues to arise and find
of weakness," everyone reassures you. "Don't yourself being emotional with the wrong
think you have to take this journey alone," people or at the wrong time, set yourself
say the advice givers. And they are right. up with the right people for you during the
Talking with supportive friends and family two-week wait or when you expect other
can give you an opportunity to hear yourself results. It’s easier to cancel than to reach out
and listen to yourself as another would, an at the last minute.
opportunity to change or fine-tune your
feelings, and a chance to know and accept 4. D ON’T PRETEND IT’S
your emotions. ALL FINE IF IT ISN’T.

But suppose you do ask for emotional sup- Expecting too much of yourself is add-
port, and then get too much! Suppose, with ing insult to injury. You are already coping
the best of intentions, your people are asking with infertility; don’t add to your struggles
too many questions, giving you too much by putting up with too much advice or too
advice, telling you about too many of their many questions. Just say something like,
own experiences, and trying to fix things by “I’m on advice overload, but thanks,” or if it’s
taking over. Your worst nightmare? Don’t use someone who is close to you, “I just need
this possibility as an excuse to avoid asking some comforting today.”
for support if you do want it and need it. In-
stead, use these four strategies to make sure Now suppose you use these strategies and
this doesn’t happen. still find that talking about your fertility jour-
ney with more than your doctor, partner and
1. C HOOSE YOUR SUPPORT best friend is not for you. That's fine. Even
GROUP THOUGHTFULLY. though the popular notion is that expressing
feelings helps you sort them out, research
Choose listeners who will respect your pri- says “not so much.” Actually, a study of more
vacy and let you take the lead in the conver- than 2,000 people in the Journal of Consulting
sation. And don’t make dates with downers. and Clinical Psychology found that many of
those who did not express their multitude
2. D ON’T FEEL PRESSURE of emotions after September 11th showed
TO SHARE. fewer signs of distress later on than many of
those who did. For some, it seems, talking is
If you are not ready to talk about your mis- cathartic, but for others it’s a rehearsal and a
carriage, let your support system know that reminder of negative feelings and anxieties,
you would prefer not to talk right now, but and can hold you back. Know yourself before
just want their company. They will probably you reach out for advice and know who will
feel relieved that they don’t have to come up give you what you need. •
with answers to your problems, and flattered
that you feel good just being around them. rmany.com

DON'T BASE YOUR DECISIONS ON THE ADVICE OF THOSE
THAT DON'T HAVE TO DEAL WITH THE RESULTS.

79

Medical

10 YEARS
OF FERTILITY
ADVANCES

HOW A DECADE OF MAJOR DISCOVERIES
HAS DRAMATICALLY CHANGED HOW
WE THINK ABOUT CONCEPTION.

By: Julia Calderone

SHAAREI TIKVAH/ PESACH 5780 Since the first IVF baby was born in 1978, the seemingly past. Here are some of the biggest breakthroughs in
supernatural ability to unite sperm and eggs outside the fertility since 2010.
body and implant them directly into the womb has been
heralded as the most remarkable achievement in fertility 1. Egg freezing is no longer considered experimental
to date. “It’s allowed millions of babies to be born that
otherwise would not have been born; I think it’s been Scientists have been able to easily freeze embryos
revolutionary,” said Dr. Mindy Christianson, M.D., medical and sperm for decades, but it wasn’t until 2012 that
director of the Johns Hopkins Fertility Center. egg freezing went from an experimental procedure to
a promising insurance policy for thousands of women
Now, as we start a new decade, what kinds of major in the United States, including cancer patients, single
advancements in fertility science have we seen since women, and those who want or need to delay having
2010? While we’re still a far cry from a future in which children. “The ability to successfully freeze eggs over
a woman can analyze her egg reserve with the tap of a the last ten years has been one of the bigger, if not the
smartphone, or in which a man can get a running tally of biggest, achievement,” Dr. Christianson said.
his sperm count with the flick of a smartwatch, the past
ten years have been no less remarkable than decades This is largely because of the development of a flash-

80

freezing technique called vitrification. Previously, human Dr. Christianson said, “it was cost-prohibitive for most SHAAREI TIKVAH/ PESACH 5780
eggs — which are the largest cells in the human body and patients to do genetic testing of their embryos.” Today,
hold a lot of water — were challenging to freeze because she said, companies charge per embryo, making it much
ice crystals would develop and damage the cell. But with more affordable.
vitrification, experts can freeze the cells so quickly that
ice crystals don’t have a chance to form. Another advancement that has allowed providers to
select the most robust embryos to implant: the ability
2. We can more reliably select the best embryos for IVF to grow them in the lab until they reach what is called
the blastocyst stage (which occurs five or six days after
IVF is expensive, not to mention emotionally and fertilization). If an embryo is healthy enough to survive
physically taxing. It’s important, then, that providers until this stage outside the body, the thinking goes, it has
select the best and most competent embryos from the a higher chance of sticking around after implantation.
petri dish in the lab to implant into the womb. While Such advances in selecting the best embryos have also
experts have for more than ten years been able to scan allowed providers to transfer just one, rather than
the genetic material of these rudimentary cells for signs multiple, embryos into the womb at a time, reducing the
that they might fail to implant or result in miscarriage risk of twins or more — and thereby reducing risk in the
or birth defects, genetic testing of embryos has become pregnancy.
more mainstream, affordable and reliable in the past
decade. “With the right embryo, most women will have a very
high chance of live birth, and we’re able to decrease that
“When I was still in training seven or eight years ago,” risk of multiples,” Dr. Christianson said. “So I think that’s

81

SHAAREI TIKVAH/ PESACH 5780 one of the revolutionary breakthroughs.” sperm for use with assisted reproductive technologies
like IVF.
3. Uterus transplants have become less like science
fiction “A lot of those men are now considered treatable,” Dr.
Schlegel said, “whereas before, our understanding of how
Before the 2010s, the only parenting options for and whether you could treat them was pretty limited.”
women who didn’t have a uterus or who couldn’t
carry a pregnancy were adoption or surrogacy. But in 5. We’re better at freezing ovarian tissue for later
2013, doctors in Sweden made history after a 35-year- use
old patient, who had had a uterus from a 61-year-old
woman transplanted, gave birth to a healthy boy. In For women who can’t freeze their eggs, like
2016, doctors in Brazil advanced the technique even prepubescent girls or women who suddenly need cancer
further, announcing that a 32-year-old woman had given treatment, ovarian tissue freezing has offered a chance
birth with a uterus that had been transplanted from a for them to preserve their ovaries for later reimplantation
deceased donor. and use. The procedure has been available for about
twenty years, Dr. Christianson said, but within the
While these breakthroughs are huge for reproductive past ten years, there have been several advances in the
science, Dr. Christianson said, uterine transplants are also technique and more live births as a result.
expensive. “It’s the only transplant we know of that is for
a one-time use to make a baby and then you don’t need Because most people who have frozen ovarian tissue
the transplant anymore,” she said. So while this procedure haven’t needed to use it yet, the procedure is still
is revolutionary for the right type of patient, it most likely considered experimental. “Hopefully at some point the
won’t become mainstream. experimental label will be lifted,” Dr. Christianson said.

4. Men who were previously considered “infertile” 6. We’re getting a better understanding of how
have more options lifestyle affects fertility

One of the biggest achievements for male infertility, It’s perhaps not surprising that diet, sleep and exercise
said Dr. Peter Schlegel, M.D., urologist in chief at New play a role in fertility. And while scientists are still in the
York-Presbyterian Hospital/Weill Cornell Medical early stages of sussing out how the food we eat and the
Center and former president of the American Society sleep and exercise we get translate to prolificacy, recent
for Reproductive Medicine, has been in the treatment — albeit limited — evidence is offering more clues.
of those with severe infertility. Particularly in men who
produce little to no sperm, he said, or who had previously A 2018 review from scientists from Harvard University,
been rendered “sterile” because of treatments like for instance, found that folic acid, vitamin B-12, omega-3
chemotherapy. fatty acids and a Mediterranean diet were linked with
better fertility in women, while “unhealthy” diets, like
A technique called micro-TESE — which was those high in trans fats, red and processed meats, added
developed in the late 1990s, improved in the 2000s and sugars and sugar-sweetened beverages, were associated
more popularized in the past decade, Dr. Schlegel said — with worse fertility. In men, similarly, researchers have
involves identifying areas of the testicle that have the best found that those who follow healthy diets tend to have
sperm production and microsurgically removing those better fertility, while those with diets high in saturated
and trans fats are worse off.

82

There is also budding evidence about how exercise and condition but who don’t have only the classic signs, like SHAAREI TIKVAH/ PESACH 5780
sleep affect virility in men, Dr. Schlegel said — and some high blood pressure and protein in their urine. Now, for
of the results seem counterintuitive. Moderate exercise, instance, it is well understood that some women may
for instance, seems to be beneficial, but when those have only organ problems, such as with their liver or
men exercise more vigorously — such as by cycling for kidneys, before high blood pressure and protein in the
more than five hours per week, he said — their sperm urine set in.
counts can be reduced by nearly half. Men who get six to
eight hours of sleep per night tend to have better sperm New research has also offered clues on how women
production and fertility than those who get more or less, who are high risk might thwart the condition completely.
Dr. Schlegel said. A double-blind, placebo-controlled trial published in
2017, for example, found that taking 150 milligrams of
While many of these studies are promising, most are aspirin daily from 11 to 14 weeks of pregnancy through
based on observational data, Dr. Schlegel said, so it’s not the 36th week could reduce the chances of developing
yet clear why researchers are seeing such associations, preeclampsia. Though because high doses of aspirin can
or whether changes to diet, sleep and exercise can really also be associated with certain risks to a pregnancy, like
alter your fertility in the first place. pregnancy loss or certain birth defects, you should never
start taking it without consulting your doctor.
7. We’re getting a better grasp on preeclampsia
8. We have better fertility-preserving surgeries for
While the textbook signs and symptoms of cancer patients
preeclampsia have been well understood — high blood
pressure, protein in the urine, swelling, headache, trouble In the past, a cervical cancer diagnosis might have
breathing and more — scientists still don’t understand meant the end of your ability to conceive, because
what causes the condition, and diagnosing it and standard treatment was to remove all or part of the
predicting those who will develop it are challenging. uterus. But recent advances in fertility-conserving
Similarly, the most effective treatment for preeclampsia is surgeries have given cancer patients more options. A
also the least satisfying one — delivery. procedure called a trachelectomy, for instance, which
has been around for decades but has become more
But research in recent years has helped improve our commonly used in recent years, allows doctors to remove
understanding of how the condition progresses in the only the cervix in patients who have cervical cancer. “And
body, said Dr. Ananth Karumanchi, M.D., a professor of as a result, she’s able to preserve her uterus for future
medicine at Cedars-Sinai Medical Center in Los Angeles. pregnancy,” Dr. Christianson said.
And that research has led to development of the first
blood test — which has been widely used abroad — Similarly, there has been a push in recent years to treat
that can accurately diagnose the condition in women endometrial cancer more conservatively, Dr. Christianson
who have preeclampsia. While the test has not yet been said, by trying hormonal therapies before removing the
approved in the United States, Dr. Karumanchi said that uterus.
its development was a big deal because it might lead to
new therapies for preeclampsia within the next decade. Julia Calderone is a senior staff editor for NYT
Parenting. Follow her @juliacalderone. •
The definition of preeclampsia was revised in 2014,
based on new evidence, to capture women who have the nytimes.com

83

Medical

NEW YORK STATE
IVF COVERAGE

What You Need to Know About the 2020 Fertility Mandate

By: Lisa Rosenthal, RMA of Connecticut

SHAAREI TIKVAH/ PESACH 5780 2020 started off with great news states that cover some sort of fertili- other forms of fertility treatment.
(think fireworks!) for the one in ty coverage, but not IVF.)
eight New York couples who need There was an update to the origi-
fertility treatment to build a family. Curious about the history, IVF nal bill in 2002, but even with newer
This celebration is specifically for facts, what’s new, and what to research and information on the
those who need in-vitro fertiliza- expect from this bill? Everything you efficacy of IVF, it was still excluded.
tion (IVF) and fertility preservation need to know about the new 2020
coverage. Thanks to a bill passed mandate is below. Given that IVF is now the “gold”
last year in New York that has taken standard of fertility treatment,
effect on January 1, 2020, qualifying History of yielding much higher pregnancy
residents of the state went from no Fertility Treatment rates, denial of insurance coverage
IVF coverage to three cycles covered Coverage in NY has meant that people in New York
by insurance! State have either endured financial
In the early 1990s, the first fertility hardship or been unable to afford
We celebrate as New York State insurance law in New York was writ- successfully building their families,
becomes the tenth state in the Unit- ten, specifically excluding IVF. This due to lack of insurance coverage.
ed States to specifically cover IVF was considered a win at the time;
and the sixth state to cover fertility it was helpful to those who needed Regardless of financial burden and
preservation. (There are sixteen and could be successful with intra- insurance neglect, IVF has continued
uterine inseminations (IUIs) and to boast impressive statistics.

84

Recent IVF Statistics  F reezing and storing of gam- Thanks to a bill SHAAREI TIKVAH/ PESACH 5780
etes are also included when passed last year
 Statistics in 2016 report that the coverage applies. in New York,
there were 263,577 IVF cycles qualifying residents
done in the United States. It’s  F ertility preservation is a big of the state went
safe to assume it’s a higher num- win on this bill. It will cover from no IVF
ber now, 4 years later. persons whose fertility might coverage to three
or will be impacted by medical cycles covered by
 I n that same year, there were intervention, giving them an insurance.
81,022 pregnancies and 65,996 opportunity to freeze gam-
deliveries derived from IVF. etes or whatever is medically try IVF. Simply put, if IVF is needed,
necessary. This will be true for IVF is now able to be used.
 T otal infants born from IVF in all commercial markets, as well
2016 were 76,930 (55,244 single as fully insured Small and Large Thank You
babies, 21,686 multiple birth Group markets. The New York
babies). State frequently asked questions Thank you Governor Cuomo,
sections answers, “Q-7. What RESOLVE: The National Infertility
 There are 42 fertility practices in fertility preservation services Association, American Society for
New York State that report to are required to be covered? Reproductive Medicine, the Alliance
the Centers for Disease Control Standard fertility preservation for Fertility Preservation , EMD Sero-
(CDC). IVF success rates vary services include the collecting, no, Ferring Pharmaceuticals, and so
widely, depending on fertility preserving and storage of ova or many more who worked on getting
diagnosis, age of intended par- sperm.” this bill passed.
ents, and experience of fertility
practice.  New York Infertility Demonstra- Special thanks to Risa Levine, Esq.
tion Program will be left intact
So it’s clear that IVF helps people and may provide assistance to And thank you to Governor Cuo-
build their families. those not covered by the new bill. mo and his staff for putting together
a list of frequently asked questions,
Finally, the new and improved When Does It answered in an understandable way!
New York State Mandate acknowl- Take Effect?
edges those numbers and changed IVF Coverage in
the policy to include IVF coverage. Immediately! This bill went into New York State
This is life changing for many New effect January 1, 2020. Is Finally Here
York state residents.
How Much Coverage 2020 is the launch of a new
What Is New With is Offered? decade. And for New York state
the New York residents, it means IVF coverage,
State Mandate? In addition to the fertility cov- for those who have Large Group
erage that has previously been coverage (over 100 people). It will
Here, we break it down for you offered in New York State, three mean more affordable family build-
point-by-point: rounds of IVF treatment will now ing, less financial hardship and the
be available, when determined knowledge that appropriate medical
 3 IVF cycles (lifetime) to policy- to be medically necessary by the treatment is available for those with
holders of fully insured em- fertility doctor. And unlike some of infertility. •
ployers who are a Large Group the other sixteen states that offer
market (over 100 employees). fertility treatment coverage, there is rmact.com
no clause in this bill that determines
 Fertility medications are a prerequisite of other fertility treat-
included! This is a piece of this ment cycles offered first. Meaning, it
legislation that is not being doesn’t make you try other methods
talked about but can mean the of fertility treatment before you can
difference between affordable
care and unaffordable care.

85

Medical

EGG QUALITY
VS. EGG QUANTITY

By: Dr. Lucky Sekhon, RMA of NY

Egg number and egg quality decrease over the course of a woman's
lifetime, impacting natural fertility. However, because these terms are
often mistakenly used interchangeably, it is important to define and

differentiate egg quantity from egg quality.

SHAAREI TIKVAH/ PESACH 5780 What is the female ovaries. Women are born with a misconceptions about the biological
biological clock? finite number of eggs, which cannot clock, with the terms “egg quantity”
be regenerated or modified. As a and “egg quality” often being used
Of all the factors involved in result, the number and quality of interchangeably. We’re here to set
establishing a healthy pregnancy eggs decrease over the course of a the record straight, dispel common
(sperm, the reproductive tract woman’s lifetime, impacting natural myths, and provide you with
and eggs), the only time-sensitive fertility and the odds of successful everything you need to know about
aspect are the eggs in a woman’s fertility treatment. There are many egg quantity and quality.

86

EGG QUANTITY and cannot be recycled to be used an effort to stimulate the ovaries SHAAREI TIKVAH/ PESACH 5780
again in a future cycle. The size of to produce estrogen. When the
What is egg quantity the recruited pool of eggs is always FSH level is high, it indicates a low
and how does it change in proportion to how many total egg count, as the brain is pumping
over time? eggs are stored away in the ovary. out more of this hormone to try
In addition, fertility treatments/ and stimulate the ovaries. FSH
Egg quantity refers to the amount medications can only impact the should only be tested on day 2 to
of eggs left in a woman’s ovaries, recruited eggs and cannot reach 4 of menstruation, as the level can
at a given point in time. At birth, the eggs stashed in the ovary, to fluctuate throughout the course of
there are 1 to 2 million eggs, with be used in future cycles. When the cycle. In addition, FSH level will
this number gradually decreasing doctors perform an ultrasound be falsely lowered in anyone taking
throughout early reproductive and count the number of eggs estrogen-containing birth control.
life. Over time, the rate of decline seen on the screen, it provides a
in egg quantity speeds up, usually ballpark estimate of how many What does egg
becoming more accelerated at potential eggs can be stimulated quantity tell me about
age 35 and beyond. Once the egg and retrieved during an IVF cycle. my fertility?
count approaches less than 1,000, A total count of at least eight
menstrual cycles start to become follicles (follicles are fluid-filled A common misconception is that
irregular and eventually stop, spaces that each contain a single all women with high egg counts
resulting in menopause. For reasons egg) is considered synonymous are very fertile. However, studies
that are not always clear, some with having “normal” ovarian have definitively shown that egg
women may be born with an overall reserve. quantity does not predict that
lower egg quantity to start with, chance of naturally conceiving a
whereas others may experience an Blood tests pregnancy. In an unmedicated,
earlier than expected acceleration in natural menstrual cycle, a single
the rate of loss of eggs. • P erforming bloodwork to assess egg is typically ovulated. Therefore,
certain hormone levels can provide the odds of becoming pregnant is
How is it tested? a relative indicator of egg quantity. not a “numbers game” but more
AMH (Anti-mullerian hormone) a function of the quality of that
Ultrasound is produced by the cells that line single egg that is ovulated. The
the follicles. The higher the egg number of eggs overall correlates
• Every month a subset of the quantity, the higher the AMH level. to the number of eggs recruited
eggs stored inside the ovaries are In general, levels less than 1ng/ in a given cycle, and available for
recruited “out of hiding” to the ml indicate reduced egg quantity. treatment purposes. Therefore, egg
surface of the ovary, becoming AMH levels can be tested at any quantity may provide doctors with
visible on ultrasound. In a natural time in a woman’s menstrual cycle information on whether a patient
cycle where ovulation takes place, and regardless of whether they is an ideal candidate for treatments
one of these eggs will be randomly are using hormonal forms of birth such as IVF, which rely on being able
selected to be the lucky one that control. to access and utilize an adequate
gets released and has a shot at Follicle stimulation hormone (FSH), number of eggs.
being fertilized by sperm. The rest is another hormone level that
of the recruited eggs are discarded can be measured to indicate egg
quantity. It is produced by a gland
in the brain, called the pituitary, in

87

SHAAREI TIKVAH/ PESACH 5780 OF ALL THE Sometimes an abnormal embryo regenerate new sperm cells over
FACTORS will start to implant and only then time. Nowadays, many patients who
INVOLVED IN stop growing — this is the most undergo IVF treatment opt to have
ESTABLISHING prevalent cause of miscarriage. their embryos genetically tested
A HEALTHY Some of these genetic errors can via preimplantation genetic testing
PREGNANCY, result in live birth of a child with (PGT). These embryo quality tests
THE ONLY significant health problems (i.e. may provide an indirect assessment
TIME-SENSITIVE Down syndrome). of egg quality.
ASPECT ARE
THE EGGS IN A How does egg quality How do you turn back
WOMAN’S change over time? or slow the biological
OVARIES. clock?
No one is immune to egg-quality
EGG QUALITY issues. Even in a woman’s 20s to There is no known way to “turn
early 30s, approximately 25–30% of back the clock” and regenerate
What is egg quality? the embryos that form from their the number of eggs or reduce the
eggs are anticipated to have genetic proportion of eggs that will give rise
Just like owning anything (i.e. errors. This proportion rises to ~50% to abnormal, unhealthy embryos.
cars, appliances, etc.) for decades, by age 37–38, and to over 70% at However, healthy lifestyle choices,
without the ability to change age 40 and beyond. This is the main such as avoiding cigarette smoking
or replace parts, would lead to reason why it is increasingly rare to — which is known to accelerate
breakdowns over time, the quality hear of women over the age of 45 decline in egg quantity and increase
of eggs diminishes as women years old conceiving children using the risk of premature menopause,
age. Eggs become more prone to their own eggs (unless using eggs/ can help to slow the biological clock.
accumulating imbalances in the embryos that they froze when they In addition, exposure to radiation
amount of DNA and the odds of were younger). or chemotherapy can accelerate
ovulating a genetically abnormal egg decline in egg quantity. Women
increase with aging. An egg with the How can it be tested? have the option to preserve their
wrong number of chromosomes, fertility, in general, and in advance
if fertilized, will give rise to an There is no way to directly of these types of treatments, by
embryo with the incorrect amount test a woman’s egg quality or freezing eggs and/or embryos, to
of DNA. This most often leads to understand what proportion of a halt the biological clock.
the embryo not having the proper woman’s eggs would give rise to
programs to guide normal growth genetically abnormal embryos. The bottom line is, egg quantity
and development — with most Unlike egg quantity, no blood test does not equal egg quality.
genetically abnormal embryos or ultrasound can allow us to assess Quantity can be tested directly
not implanting at all, leading to a egg quality on an individual basis. with hormonal blood work and
negative pregnancy test that month. We know that most genetic errors ultrasound; quality cannot. The
found in embryos are derived from best indicator of egg quality is your
egg quality. The genetic content age — which is the most important
of the embryo is less tied to the predictor of one’s natural fertility. •
age of sperm, as men are able to

88

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89

Medical

What to eat
if you have

PCOSor
Endo

Finding the right diet can be difficult, but when you have a
hormonal disorder or a disease, it can be even more complicated.
Then add trying to conceive on top of it, and it’s a recipe for
struggle. So how do you make sure you’re living a healthy lifestyle?
We’ve broken down what foods to avoid and what to eat if you
have endometriosis and PCOS.

SHAAREI TIKVAH/ PESACH 5780 What Is condition’s name comes from. disease with symptoms that are
Endometriosis? Symptoms include extreme pelvic triggered by hormonal imbalance
pain, cramping, bloating, pain in and excess estrogen.
Endometriosis is a condition other parts of your body that can
where the tissue that’s typically include back pain, leg pain and What is PCOS?
found inside the uterus grows pain during intercourse. While pain
on the outside of it. The tissue during menstruation is normal, Polycystic Ovary Syndrome
that lines the uterus is called the endometriosis pain is chronic, severe (PCOS) is a hormonal disorder
endometrium, which is where the and consistent. Endometriosis is causing enlarged ovaries with small
foundationally an inflammatory cysts on the outer edges. Women

90

with PCOS are usually found to have Foods to avoid if you endometriosis (as well as any SHAAREI TIKVAH/ PESACH 5780
excess androgen hormones and too estrogen-dominant hormonal
much insulin. PCOS is also known have endometriosis: health issue).
to be a metabolic disorder. In fact,
there have been some doctors, • G luten. Gluten is an inflammatory Foods to avoid if you
researchers and women’s health care agent that causes an overall
advocates who have proposed that inflammatory response in the have PCOS:
PCOS be renamed to “Metabolic body. Gluten is also often laden
Reproductive Syndrome” to give a with pesticides and research shows • Soy. Soy milk is often substituted
more complete picture of what this that 75% of endometriosis sufferers for dairy milk when looking for
syndrome involves. Because PCOS will see improvement after 12 an alternative. Soy isn’t your
involves insulin and metabolism, it is months on a gluten-free diet. friend if you have PCOS because
one reason why something like the it contains “phyto,” or plant,
keto diet can be helpful in treating • D airy. Research shows dairy is estrogen that acts like estrogen in
PCOS since it can help lower insulin known to trigger the symptoms of the body, and eating too much of
levels and regulate blood sugar endometriosis via an inflammatory it confuses your body into thinking
(more on this later). response. One thing to note is it has enough of the real deal in
that dairy containing A1 Casein supply. This sends a signal to your
Although PCOS and has been found to cause higher endocrine system to slow down
endometriosis are very different, levels of inflammation than dairy estrogen production, subsequently
they are similar in that they both that contains A2 Casein. A2 Casein slowing the production of
involve hormone imbalance and is found in the milk of goats and luteinizing hormone (LH), and
inflammation. They are also both sheep, and some women may be possibly shutting down ovulation.
known to contribute to infertility. able to tolerate these products.
• S eed oils. Seed oils are used
Foods to avoid for both: • Alcohol. Alcohol can raise in processed foods and by
your estrogen levels which can restaurants because they are
• Sugar, since sugar disrupts both worsen symptoms of PCOS and cheap and don’t have a unique
hormone balance and triggers
an inflammatory response in the
body.

• H ighly processed carbs. Things
like white bread, pastries and
other baked goods (in wrappers)
should be avoided. Since these are
processed much the same as sugar
in the body the same applies as
above.

91

Examples include beets, lemon,
lime, cabbage and carrots.

• O rganic whenever possible.
Eating organic is healthy all around
and can alleviate symptoms of
both endometriosis and PCOS.

SHAAREI TIKVAH/ PESACH 5780 flavor, which makes them easy to indigestion, heartburn, and Bonus:
use in any food product. Seed oils imbalances in the gut microbiome.
include vegetable oil, soybean oil, Caffeine can also disrupt sleep and While not food-related, it’s good to
canola oil, rapeseed oil, sunflower promote anxiety. eliminate all toxic household and
oil and safflower oil, among others. personal care products from your
They are unhealthy because So, what should I eat? life when dealing with any sort of
they are composed primarily hormone imbalance. There are so
of omega-6 fats, which cause • L eafy greens. Greens such as kale many “non-toxic/green” brands to
inflammation. Inflammation is one and spinach are rich in Vitamin choose from now – check out EWG.
of the primary causes of insulin B and minerals like calcium. They org for recommendations.
problems, hormone imbalance can play a key role in regulating
and PCOS. Avoid them by avoiding sugar, hormones, thyroid function All of this said it’s important
processed foods, and by cooking and fat metabolism. to note “bio-individuality,” or the
with coconut oil, olive oil or ghee idea that each person is unique in
(clarified butter) at home. • H ealthy fats. Fatty acids can how they can or cannot tolerate
help balance hormones and can certain foods. The best suggestions
• C offee. The caffeine in coffee encourage fertility. These include for your specific case can be
increases your stress hormones, avocado, nut butters, chia seeds, obtained from your reproductive
which in turn, increases your extra-virgin olive oil and fatty fish endocrinologist or physician. Also,
insulin levels. Becoming like salmon (wild when possible). be sure to celebrate the “little
accustomed to coffee decreases victories” instead of being too hard
your insulin sensitivity, making • I mmune system boosters. Ginger on yourself if you aren’t 100% on
it more difficult to regulate your and garlic are known to promote any diet advice. Almost no one can
blood sugar levels. The acidity of good immunity. be, so give yourself credit when you
coffee causes digestive discomfort, have one less sugary treat one day
• F oods that support liver health. and cut yourself some slack when
you don’t. •

92

Bulletin Board Volunteer

Great News! Need to be near your Become a part of the ATIME Family
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A Time Support Groups Breaking Misc
News!
Join our phone support groups from the Collection Kits
comfort and privacy of your home! New insurance law in New York are available
State requires large group at the
Phone Support Groups on the following topics: health insurance plans gemachim
 Primary Infertility statewide to cover 3 cycles in Monsey
 Secondary Infertility of IVF. It also requires all and Boro Park
 Unsuccessful IVF commercial insurance plans
 Pregnancy Loss Support to cover all pre-cancer
 Male Factor Infertility
 Men's Support Group treatment fertility preservation.
 Mothers of Couples Experiencing Infertility
Contact the A TIME helpline
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Meals Inspiration! Car Rides SHAAREI TIKVAH/ PESACH 5780

Be welcomed home after an Information! Chizuk! Rides to and from your center from Williamsburg
exhausting day of procedures Find it all 24 hours and back call Chesed 718-218-9000
with a gourmet meal to warm a day whenever you
need it by calling Rides to and from your Manhattan center from
your body and heart. Boro Park and back call Chesed 718-431-0111
You will be registered for this service Kol Chaya:
718-298-2646 Rides to and from your Manhattan center Lakewood and
when ordering hashgacha. back call Lakewood Bikur Cholim 732-905-3020 Ext. 117
Available in many areas. (Yiddish or English)
Darchei Chesed of Monsey 845-425-4070
‫לע״נ ר׳ ישעי׳ בן ר׳ משה זי״ע מקערעסטיר‬

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Humor

By: Shevy Levine

SHAAREI TIKVAH/ PESACH 5780 It’s a game we play Was a couple’s way to fight, But let us not be ungrateful,
from time to time, Now we know it’s more than that To all you folks, it’s true,
Pre-writing what we’ll say, I‘m I-ing U with delight Your advice simply moved us to tears,
When DH will get up to speak, (…Sorry no news there…). Let’s give credit where it is due!
On that long-awaited day. And PGD sounded like This we kept on hearing,
In any case, A real fancy degree, Now do you let me ask,
Long or short, Little did we know it was “Has anyone cured anything,
It’ll go something like this, Post Grad Diploma for infertility. By abiding to ‘just relax’?”
DH will say the following, ICSI was confusing, Pineapple core, a glass of wine,
at our miracle baby’s bris: Till we realized it could mean, But only white will do,
I’d like to thank the endo, I Care So I can say whatever I want, Labor cake, rubies red,
The urologist, gynecologist, too, (Primarily employed by close family!) …we’re just naming a few!
Geneticist, andrologist, phlebotomist… Think OHSS is painful? Now, we can be here for hours long,
– Hang on, I left out a few… It did take us a while, But we can’t take much time from you
(Let’s not forget the wackos, – Oh, Hashem Send Simchos Surely you don’t have all day,
Though they lacked a medical name, To which we’d respond with a smile. As infertile people do…
And all the thousands of dollars, Now in case you were wondering, So in honor of Plastic, Silicone and
That slipped slowly down the drain…) Why we put the cock’s crow to shame, Badatz*,
For pushing and prodding us along Why our fridge shelves were off-limits, (our little boys numbered three)
(literally) Why our sense of humor lame… Named that way due to hashgacha,
For giving us a shot (you bet!) Why our chocolate disappeared real and cuz they were conceived “unnatu-
To our devoted medical team, fast, rally,”
Who gave it all they got. While our moods went for a swing, We’d like to bless you all who came,
Now lest you think we only gained, Why you got a disjointed answer, May you just never know,
In hormones and in stress, When we waited for the phone to ring. All we’ve seen and felt and heard,
We also acquired knowledge, Why when asking what day’s today May our simchos overflow!
As we journeyed through this test. You got an incomprehensible reply P.S.: The one stumper that our bris
We thought we knew our alphabet, And why from a simple “How are you?” entails
Abbreviations meant “LOL,OMG” Did we in shock run off to cry… We haven’t got a clue,
But our appreciation for shorthand Well here’s the answer to it all, Who will be our kvatter?
expanded, We’ve waited to tell you with glee, Not me, I promise you! •
As we tried to build our family. It’s simply none of your business,
We used to think I-you–I It’s all part of non-(re)productivity! *This is a joke. Loosen up.

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OWHO,RIKT'STHYAOTUYAOGUASINT.ARWTHTEHRIES DO YOU
EARLY?

SHAAREI TIKVAH/ PESACH 5780

By: Faigy Jacobowitz 95

SHAAREI TIKVAH/ PESACH 5780Humor

THE IF

By: Dini Hirsch

HOW WELL-VERSED ARE
YOU IN INFERTILE MATTERS?

1. Which of the following is the most effective segulah?
a) Kvatter
b) Esrog jelly
c) Labor cake
d) Ruby stone
2. Why is it that people going through infertility have so much money?
a) They don't have to pay for diapers and formula
b) They can work full time
c) They don't need big apartments, so can pay less rent
d) Come to think of it, why DO they need so much money?
3. What's the best use for extra storage space?
a) To stash enough chocolate for “one of those” days
b) A home for the stroller dear MIL has purchased as segulah
c) An insulated, padded room for letting off steam
d) A safe spot for meds and sharps containers

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4. Babies that are not natural, are so because: ANSWERS:6. Not #2! 7. Don't you tell me again how lucky I am! 8. Select any according to your mood. 9. Is it really #3?? 10. It really is none of anyone's business.

a) They were conceived via treatment 1. I don't know. What does your great aunt say? 2. None of the above. 3. I think #1 may be winning… 4. If this is not natural, then what is? 5. #3. Umm, I meant all of them.
b) Natural is to have a baby within a year or two of getting married
c) They contain MSG SHAAREI TIKVAH/ PESACH 5780
d) They're unnaturally cute

5. What most often causes a woman to cry?

a) Hormones
b) Insensitive comments
c) Nothing
d) Seeing a young mother pushing a stroller

6. Why doesn’t telling a woman to “relax,” help with pregnancy?

a) Just hearing this makes her tense
b) It really does work — just relax!
c) It's inconsistent with her doctor’s treatment plan
d) It’s not covered by her insurance

7. IFers are sooo lucky, because:

a) They have tons of extra time (and money)
b) No one wakes them at the crack of dawn
c) They're always free to go anywhere
d) Their grandparents give them special attention

8. The best response to “When will you have a baby?” is:

a) “When do you suggest I do?”
b) “I placed my order already. Waiting for it to be filled.”
c) “I need my calculator to figure it out.”
d) “Let me ask my mom (or doc).”

9. What is the TWW?

a) An endless stretch of time
b) An acronym for Torturous Wrenching Weeks
c) A 14-day wait period
d) A time to feel, and Google, all implantation and early pregnancy symptoms

EXTRA CREDIT:

10. What's the reason for a couple's infertility?

1. None of anyone's business
2. None of anyone's business
3. None of anyone's business
4. None of anyone's business

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SHAAREI TIKVAH/ PESACH 5780Humor

LaughsHumor From the Trenches:
that only
IFers get!
Enjoy this collection of
real-life stories collected
from real-life IFer’s.

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It was mid-fall and I was in my • • SHAAREI TIKVAH/ PESACH 5780
center for monitoring. For some
reason, the phlebotomist was having A while ago, after a number of After an FET that we were so
a really hard time with my veins that failed Clomid cycles, my doctor hopeful would succeed, I took one
morning. After several unsuccessful told me it was time to try Letrozole. pregnancy test after another only to
attempts, she sent me to the nurse Remembering the nausea, moodiness get false after false.
practitioner, who did succeed in and back pain that came with the
getting a blood sample. As I rolled Clomid, I asked the doctor, "What are Frustrated, we took apart a
my sleeves back down over my arms, the side effects of the Letrozole, as pregnancy test so we can see once
which were dotted with small pieces compared to the Clomid?" and for all where that second line
of gauze and tape, I remarked, “Since was hiding. We never found it, but
I started here, I’ve added long sleeves He answered, "The Clomid we did get to see the inside of these
to my list of things to be grateful for.” should have no side effects, and the sticks that have a pick on us…
Letrozole, even less!"
The nurse looked at me blankly for •
a second and then smiled politely, •
“Yeah, it is getting rather cold out We had a small class reunion just
there, isn’t it?” I told my mother that we'll be for those in our neighborhood and
staying for Pesach in Eretz Yisroel for we did a paint party! The theme was
• the first time, after having traveled abstract/geometric painting..
back to the U.S. for a number of
We were riding up the elevator years, and her reaction was: “But I was deep in the middle of
to the andrology department, my why? You should come now! It will be treatments then, and I let it all out
husband holding whatever we had to more expensive once you have kids!” on the canvas. I painted a whole
take to the lab in a brown bag. abstract painting that included
• sperm, eggs, ovulation, gloom and
Wanting to make conversation, HOPE!
apparently, the guy next to us piped I have a neighbor downstairs
up. “Hmm, good for you, Mister! So who rents out a small apartment. I remember looking around at
what’s for lunch today?” The tenants had just moved out so my friends' paintings and laughing
she asked us if we wanted to move to myself when they asked me to
• in. I couldn't understand why we explain mine! It was interesting to be
would want to move to another sitting shoulder to shoulder, yet to
Puttering in my kitchen at 7:30 apartment within our building that be worlds apart! •
one morning having just returned is more expensive, when we were
from my center, my phone rang. perfectly happy with ours, until she
told me, “Because meshaneh makom,
It was my friend, a mother of a few meshaneh mazel!”
kids.
She literally waited for us and
“Oy, I’m so sorry for calling this didn't even advertise the apartment
early. Did I wake you?” until we told her, “No, thanks!”

Have a funny IF story to share? Email it to [email protected] so the rest of us could laugh along!

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Important Numbers Always here for you

to take home with you and use.

Helpline....................................................................................................................................................... 718-437-7110 • [email protected]
Chava Helpline.............................................................................................................................................. 718-475-1415 • [email protected]
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Website............................................................................................................................................................................................. www.atime.org
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R’ Chaim Aron Unger....................................................................................................... 718-686-8912 ext 117 • [email protected]
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Mrs. Vivienne Moskowitz............................................................................................................. 718-686-8912 ext 208 • [email protected]
Mrs. Brany Rosen....................................................................................................................... 718-686-8912 ext 202 • [email protected]
Mrs. Yehudis Grunwald...........................................................................................................718-686-8912 ext 117 • [email protected]
Mrs. Simi Hershko....................................................................................................................... 718-686-8912 ext 304 • [email protected]
Mrs. Ruchie Freilach/Chava.................................................................................................718-686-8912 ext 260 • [email protected]
Mrs. Chumi Freidman/HUG..................................................................................................... 718-686-8912 ext 113 • [email protected]
Memberships/Magazines...................................................................................................... 718-686-8912 ext 200 • [email protected]

A Time Locations

Main Office: Florida: Israel:
1310 48th Street Suite 406 - Brooklyn, NY 11219 T: 305-260- 6377 T: 073-280-0800
fl[email protected] [email protected]
T: (718) 686-8912 - F: (718) 228-3721 T: (718) 686-8912 Ext: 144 Pregnancy Loss Packets
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T: (718) 686-8912 Ext: 145 Antwerp 2018 Belgium
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[email protected] W: www.atime.be
T: (718) 686-8912 Ext: 300 T: (718) 686-8912 Ext: 146
HUG
Lakewood: England: T: 323 500 1072
T: (732) 994-2120 42a Leweston Place London N16 6RH M: [email protected]
525 NJ-70, Lakewood, NJ 08701
[email protected] T: 44-20,800- 2153 Chani Cik
[email protected] A TIME Belgium
Mid-Atlantic Region: Rabbi Yaakov Stern +32 3 500 1075
T: (410) 394-7074 [email protected]
44-797- 328-6827 www.atime.be
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T: (718) 686-8912 Ext: 143

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