Chanukah-5782-Magazine_1_LR

The day was perfect. As prepared everything. I

the alarm went off in the knew the embryologist was

morning, I turned to my THEN ALL just about to pass over my
husband and said, “This is embryo to the doctor and I

the day I am going to get OF A SUDDEN honestly could have burst
pregnant!!” THERE IT WAS — into tears. The anticipation
was overwhelming. Then
After a hot cup of tea, my MY my doctor said calmly, “Take
husband said, “All right, let’s BEAUTIFUL a look at the screen.”
do this." We had been given
quite an early appointment, LITTLE As I looked at the screen,
so we were at the hospital SHOOTING I felt like I was staring at a
by 9:00 a.m. My husband beautiful starry night. It was,
stayed with me, pacing of course, just my uterus on
anxiously, until my nurse the ultrasound machine, but
told me to get into a gown. at that moment, it was a sky
I think he was more nervous full of stars.
than I was.
Then all of a sudden there
I took a long, deep breath it was — my beautiful little

and smiled. I was ready to STAR. shooting star. My embryo,
join forces with my little traveling through the starry
embryo — my soon-to-be night. My little girl, or boy,

little baby. on its way. It was the most

incredible sight I have ever

The transfer room was so witnessed — it was the

calm. It was quite dimly lit, and the most beautiful sight of hope, love and energy.

classical music was playing.

So, although infertility is not something I asked for,

For the first time on my journey, the space didn’t this is a beautiful moment that only us, IVF warriors,

feel medical — it felt magical. will ever get to see.

I lay back on the table while the medical team ivfbabble.com

CHANUKAH 5782 | SHAAREI TIKVAH 51

| CHIZUK FROM WITHIN • BY: DINA

THANKING
HASHEM

THROUGH IT ALL

52 SHAAREI TIKVAH | CHANUKAH 5782

It was a little over two years ago that we did I didn't do much. I’m one of those people who
our first IVF cycle. I was working at a new loves to give out mishloach manos, so I used
job at the time, but I lost the job right before that time to start baking and cooking for Purim.
Chanukah. Truth be told, I was uncomfortable
there and it was all clearly miShamayim, but it I did another cycle in Adar. I was so filled with
was a challenge. hope — mishenichnas Adar marbin b'simcha!
But this embryo did not take. My husband and I
During this hectic time of holding a new job celebrated our anniversary right before Purim.
and cycling, I also attended two of my very I don't remember that we did anything super
close friends’ weddings. One of these friends special, but that was okay. It was still a simcha
was 31 at the time, and I was so excited to be to have another year of a successful marriage.
able to dance at her wedding – because I hadn't
done my transfer yet. What a bracha that was. We celebrated a beautiful Purim seudah
We’ve been friends since seminary, and it was with our community before Israel went into
such a simcha. coronavirus lockdown. The Sunday after Purim,
my brother called with shocking news: My
Two weeks later, a day after my transfer and mother had been niftar over Shabbos in the
right around the time I knew I was getting fired, States. I had just spoken with her on Thursday
I went to another wedding. At this wedding, I to wish her a good Shabbos, and she sounded a
couldn’t dance but I was so happy to be there. little worried about the new virus, but otherwise
she had seemed fine!
On the eve of the fifth night of Chanukah, my
father's yahrtzeit, I found out I was pregnant. With coronavirus running rampant in New
To say I was excited is an understatement. York and Israel, I chose not to attend the
Sadly, this pregnancy ended in a miscarriage funeral, but I was able to travel to my brother’s
about a month later. I was only six and a half home in Beit Meir and watch the proceedings
weeks along at the time. When I found out I was over Zoom and sit shivah with him there. This,
expecting, I felt such joy. It was an incredible too, was a comfort and a blessing within the
feeling. When I miscarried, oh, what pain I felt – deep pain.
and guilt. Baruch Hashem, thank you, Hashem,
for the amazing and compassionate staff of On our way to my brother's house, my
Shaare Zedek Hospital, who referred me to a husband left his hat on the bus. We tried during
counseling center that dealt with infertility and the week of shivah to contact the bus company
miscarriages! to see if it had been turned in — to no avail.

At the same time, one of my best friends got However, when we got on the bus to return
engaged, and because I was in Yerushalayim home the Sunday after shivah, we realized
recovering from my miscarriage, I was able that it was the same bus we had taken to
to be at her l’chaim. This, too, was hashgacha Yerushalayim... and my husband's hat was
pratis, because I would end up missing her vort sitting right where he had left it! The clear
and wedding. hashgacha felt like a reassuring wink from
Hashem.
February was actually quiet. Other than
looking for a job and getting ready for Purim, We returned home to a different world than
the one we had left. At this point, Israel was

CHANUKAH 5782 | SHAAREI TIKVAH 53

almost at full lockdown, and people and a walk around the city!

were self-isolating at home. Soon, there We learned that I was expecting once
would be no more indoor minyanim – if again, but the numbers were iffy. I had
minyanim at all. Yet there was a bracha to do the test again two days later… then
in this, too. Because the world was shut five days later… then after a week. This
down, I no longer felt pressured to find a pregnancy, too, ended in a miscarriage.
new job, and my family stepped in to help

us out. It also gave me time to process I had not yet found a new job, which
everything that had happened in the prior allowed me to take time to recover.
few months. Physically, this miscarriage was a lot

During this time, my husband and I easier to cope with than the first one.
got ready for Pesach — to make our own Emotionally, it was much harder.

Seder for the first time ever. While it’s We tried again straight away, without

true we didn't have the nicest Seder success. It was the most unusual

plate or any children at our Seder, what cycle I had done to date. There was no

a beautiful and mashgicha present, for the

relaxed Seder it The clear clinic was not allowing it. It
was, with lots was only two weeks since I

of divrei Torah. hashgacha had passed the miscarriage
Minyanim were still felt like a that they did another
illegal at this point, transfer.
so my husband was
davening at home
Meanwhile, I had been
reassuring winkfor the most part. sending out resumes,
from Hashem. and I went to a few job
Baruch Hashem, I interviews — all without
had made Pesach

before, so I wasn't success. I was told during

without experience and dishes.  the Nine Days that a company wanted to

Over the next month, my husband and hire me. Baruch Hashem, I got a new job.
I did lots of puzzles and we enjoyed the As we were taking a break from cycling, I
low-pressure time. I participated in online was able to focus on my job and try to get
shiurim and set up telephone learning up to speed with it. 

with friends. Cycling wasn’t an option, as My husband and I went away to Tzfas

the clinics were closed.  last year before Rosh Hashanah. We went

When they reopened, we were able to for Shabbos and stayed until Monday
do a cycle after a negative coronavirus morning, staying in a beautiful tzimmer
test. I did my cycle, and the day I went for in the artists’ quarter. We went to daven
blood work to find out if I was pregnant, in Meron and at the kever of Nachum Ish
my husband and I went for a trip to Gam Zu. We got to do some shopping and
Tiberias. What a beautiful day we had dined out. It was just what we needed: a
together, with davening, lunch, boating, chance to get away and refresh ourselves

54 SHAAREI TIKVAH | CHANUKAH 5782

before the new year.  months for all the tests to come back.

Davening that Rosh Hashanah and Yom We did another retrieval in the meantime,
Kippur was very different from what I was as I had no more frozen embryos. Baruch
used to, as our shul rented a bigger space, Hashem, we managed to get a similar
and everyone was masked. I remember amount to freeze as we did our first time,
the stares of the people around me. I and we did another transfer in January. 

imagine that they were wondering about Oh my… what a nerve-wracking

me, thinking about me, and hopefully, experience that was! Baruch Hashem, I

davening for me. On Yom Kippur I got a got pregnant again, but this time, I started

physical reminder that once again, I was experiencing anxiety attacks. I attribute

not expecting a child. the frequency of these attacks to the

Sukkos was an interesting experience level of hormones I was taking — and the

for me, as I had come down with a sinus weekly blood tests to check my hormone

infection and bronchitis. It was very hard levels did not help. My numbers all looked

to cook for yom tov good. I even felt a little bit pregnant. I

since I wasn’t able was very sore in
to smell anything.
That is why I am all the right places,
Still, it was a lot and I constantly
of fun. We finally
sharing my story. had reflux. We
bought our own were so excited —
sukkah. Because
If I can be of help everything looked
we live in a building good! During this
that is not part of to anyone, then
time, a close friend
the community why not? reached out to me
eruv, we built our
for advice regarding
sukkah on the roof. a miscarriage, and

But the only way to I was able to help.

get to it was through a window! I climbed That is why I am sharing my story. If I can

up a ladder, over a windowsill and down be of help to anyone, then why not?

another ladder to get to our sukkah. In Israel was emerging from the

our building, most of the people do not pandemic, but very slowly. As the Health

identify as religious Jews, so by building Ministry did its best to make vaccines

the Sukkah on our roof, we didn’t have to mandatory, my husband and I celebrated

smell the exhaust fumes of cars or watch our anniversary with pizza and a few

chillul Shabbos. It was a beautiful Sukkos gifts. I painted him a sign that says You

overall. make me smile! Painting and learning

After Sukkos, we got ready to cycle were my lifesavers during this time,
again, but we first decided to see a because they gave me other things to
hematologist to make sure that I did not think about. Since I was still in aveilus,
have any blood clotting disorders. Baruch my husband was not yet allowed to get
Hashem, I do not — but it took quite a few me gifts, and I was allowed to give only

CHANUKAH 5782 | SHAAREI TIKVAH 55

the minimum mishloach manos. We had already started to bleed. The first few

our Purim seudah at a different place days, I was in agony. By the time I saw the

than usual, as our usual Purim seudah gynecologist a few days later, the pain

did not happen this year. All in all, it was was more manageable, though it came

a very surreal experience. My husband and went in waves. The gynecologist

got vaccinated, and people had recovered prescribed pills to help the miscarriage

from corona and did not along. It was very hard

keep the restrictions It was just for me to take the pills as
anymore. what we I felt like I was killing my
needed: a baby. In any case, I did
Right after Purim, chance to something that was not
we went for our first get away the smartest move I ever
ultrasound. I was about and refresh made — I took those pills
7.5 weeks along at this the same day I got my
point. The ultrasound first corona vaccine. 
did not show good news,
as the baby was not Before anyone
the right size for my accuses me of being
dates. This was such a irresponsible, let me

confusing and stressful ourselves clarify: I specifically
week. As the doctor asked the gynecologist if

was not sure of what before the new I could take the vaccine
would happen, he told while taking the pills and

us to come back in a year. having a miscarriage, and
week. That week was he said it was fine. Well,

so hard. I wasn’t sure I ended up in Laniado’s

if I was pregnant or women’s emergency

what was going to happen. All I wanted room that night because I had become

was a healthy baby. It was so hard to keep very lightheaded for about an hour after a

davening and not give up hope. Plus, I hot bath. We called the emergency nurses

was dealing with matters for my mother’s and they said I should go to the hospital.

estate, and everyone was waiting for me We chose Laniado because my good friend

to get the paperwork back to them. This was a nurse, working the night shift on one

included me schlepping to Yerushalayim of the wards and she would be able to help

and back in one morning. We did not tell us. One of my husband’s rebbeim borrowed

people what was going on during this very a car, drove us to the hospital, and also

stressful time period.  gave us money for a taxi home in case we

We went back a week later, only to needed it. Mi k’amcha Yisroel!

be told to prepare for a miscarriage as My husband was not allowed in the

the baby had not grown. We went to emergency room with me. The doctors

the hospital in Hadera, but they sent us put my dizziness down to the vaccine,

home. We tried getting an eitzah from Rav and they gave me IV fluids and Acamol

Chaim, shlit”a. If I remember correctly, (Tylenol). I was not bleeding very heavily

we were told to wait — but by the time during my time in the emergency room.

that information got back to us, I had The doctor asked me if I wanted a D&C. I

56 SHAAREI TIKVAH | CHANUKAH 5782

answered, “Only if I need it.” The hospital I was told that I would need to wait a
discharged me after a few hours, and our minimum of two months from the time I
friend found us a couple of empty beds finished bleeding before trying again. In
that we could sleep in until her shift was the meantime, I saw an endocrinologist
over. At that point, she drove us home. for the first time, and I went on a diet and
exercise program. Baruch Hashem, I have
I bled for a full month and three days. seen good results from this diet. And on
It was an extremely hard time, both top of that the results of the blood tests
physically and emotionally. This was my the endocrinologist ordered came back
third miscarriage, and it seemed never- clear of any issues! 
ending.
There were also quite a few simchos
All this took place after Purim and all that took place as well: four out of the
the way through Pesach. Baruch Hashem six people I know who got married during
for my amazing husband, who basically the lockdown had their first babies. Quite
cleaned our kitchen and living room for a few people who were seriously ill with
Pesach. I was able to help a little bit, but the virus recovered completely. There are
then I would get cramps or run out of many more good things I can tell you that
energy and end up back on the couch. We happened over this past year, but that
were invited out for the Pesach Seder and would be a whole story of its own.
the Shabbos preceding it to my rebbetzin
in Yerushalayim. I do not think that I would It has also been a year of tragedies
have been up to making a Seder this year. for Klal Yisroel, but I do think that those
They even found us our own apartment to tragedies are bringing people closer
sleep in!  together. People have started learning
about avahas Yisroel and learning that
Though I was still bleeding, I felt well we can all respect each other and see the
enough to visit friends of ours as we had good in people and life. Yes, it has been an
in previous years. I hosted my niece for incredibly difficult two years for me. I still
dinner that night (full disclosure: she struggle with the same old issues, but I
did most of the cooking). After Pesach, I keep trying, and I keep going. 
finally got the all clear from the doctor.
We then asked when we should expect The most important thing is to know
our next cycle to start, as I wanted to go that even with all the difficulties that I
away for a few days. We found a lovely have gone through the past two years, I
apartment in Ashkelon that is rented out can still see the good in life. It’s important
to couples who are experiencing primary for me to remember that everything that
infertility for a reasonable price. It was has been happening is for the good, even
a beautiful apartment, with two huge if I don’t see it or understand why. I know
porches. It was also within easy walking that my job is to trust that everything is
distance of the beach, the national park, for the best.
and the mall, and it had a supermarket
right downstairs! We went the week Now as Chanukah, the time of Hallel,
before war broke out in Israel, and we had approaches, I look back at the past two
a lovely time. years, and try to focus on the blessings I
thank Hashem for.

CHANUKAH 5782 | SHAAREI TIKVAH 57

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58 SHAAREI TIKVAH | CHANUKAH 5782

| CHIZUK FROM WITHIN • BY: AUTHOR UNKNOWN

VNAIONINT Who will bathe our great big world,
To live a life devoid of pain, If the seas won't wash the shore,
Ah! The stuff of youthful dreams, And who will bring us the sunrise,
Where the world is but a playground, If the night must come no more?
Ensconced in sunshine beams;
If we do not go through suffering,
Where hardship is a foreigner, And find it in our souls,
Long beyond the seas, To persevere with fortitude,
And all is joy and sweetness, And reach for the highest goals,
Ah! To live a life of ease.
Who will give us self-respect,
So come with me, my yearning friend, And the strength and dignity?
Come, and take my hand. Who will dare to set us free
Let's stroll together through that dream, From prisons of mundanity?
The ancient wonderland;
How can we discover
Where thunder never sounds it growl, The beauty and greatness within
And storms don't lash their hail, If we do not fight life's battles
Where waves don't pound the rocks and sand, Courageously, and win?
Spurred by a mighty gale;
So come with me, away, my friend,
Where the sun is up forever, From this life devoid of pain,
And the dark night will not fall. To struggle and grow and strive for meaning,
Where the sky is a blue-white feather, Ah! Not to live a life in vain.
That never casts a pall.
CHANUKAH 5782 | SHAAREI TIKVAH 59
But who will bring us the music,
Of flowers that bloom in spring,
If the rain can never come again,
And the thunder must not sing?

| CHIZUK FROM WITHIN • BY: TOBY STERN

MoWmheennt the
C ome s

Just like so many others — we were an innocent Silence.
couple, certain that we’d be blessed with a large
family of adorable children, one after the other, in We stayed glued to our chairs, while the doctor
perfect succession. clicked several times on his keyboard. I assume that
he pressed the print button, because soon he handed
Just like not as many others — we entered the con- us a paper. “This is the name of a specialist who could
fusing tunnel labeled “infertility” entirely oblivious to help you with your issue. He's been doing this for many
the fact that we had no clue where the exit was, how years.”
long it would take to reach it, and how in the world we
were supposed to find it. On our way home, I kept replaying the conversation
in my head. It simply could not be true!
We started our journey with innocence and excite-
ment, waiting for that “second line” to appear “just like When my husband and I discussed it, we laughed.
everyone else.” When months passed and it did not Why should we be the ones having trouble? We tossed
happen, we were still not worried, consoling ourselves the paper in the trash and moved on.
that sooner or later, “It’s gonna happen.”
But… time passed, with much more to come. Again,
A routine physical exam at a GP’s office had the we scheduled a routine checkup at the same doctor.
doctor squinting his eyes a bit longer than usual. He reviewed all the information in his computer and
He moved his glasses to the tip of his nose and pro- then glanced directly at us. “What did the specialist
nounced, “If you want children, surgery is your only guide you to do?”
option.” “Um… um… we haven't gone yet. Do you think it’s nec-
essary?” My voice faltered as I whispered this ques-
tion, hoping for a negative answer.

The doctor just repeated the same words he’d told us
a while before. “If you want children, surgery is your
only option.”

•••

Ignorant as we were at that point, we called the
number the general practitioner had written on the
paper, without doing any prior research, and requested

60 SHAAREI TIKVAH | CHANUKAH 5782

the next available slot. specializing in this field.”

At the given time, we arrived at the address and That’s when we learned that there’s no quick fix

entered an ancient, dilapidated building. A senior to our problem, and that while our journey had just

doctor welcomed us and made us comfortable in his started, we’d need to start again.

office. After asking some questions and a quick exam, Our next step was to schedule a consultation with a
he wrote his diagnosis — with a pen, on a paper! With specialist. We were warned ahead of time that while
much compassion, he reviewed the diagnosis with us. this doctor has a high rate of success, he is known
“You’ll have to undergo surgery in order to have chil- to be somewhat sharp and not exhibit the greatest
dren. Take your time to digest this fact, discuss it with bedside manners.
someone close you trust, and then call in to schedule.

I know it’s hard, especially since you’re from a reli- The appointment, as we were disheartened to learn

gious Jewish community, which raises the pressure is standard when it comes to infertility doctors, re-

about building a family. Lots of luck.” quired a wait of a few months. Days passed, blurring

As the car headed toward home, we sat in total si- into weeks and months, when we finally walked into
lence. No words would be able to speak as powerfully the strange waiting room that would soon become
and painfully as that silence. so familiar and part of our routine. The doctor per-

formed a brief checkup and then
A doctor is here we sat down to be questioned
It was the first time we’d heard about so many million details.
an exact description of our case to guide, advise, Everything that had been private,
just between my husband and
and the steps that should be inform and treat.
taken. It was a chesed that the But he cannot

doctor was so caring and broke it and will not take me, was now exposed. The doctor
to us so gently. listened to all the answers with
his eyes focused on the computer,
And so, we awoke from our repeating each word we said into
sweet dream to face reality. his speakerphone. To whom was

••• away the strong he revealing all the private stuff
emunah we have we shared with him? It took me a
That was when the world-re- few minutes to realize that while
nowned organization, which I in Hashem. he was talking, those words were
knew only from their exciting raf- being neatly typed! I was amazed
fle booklets, entered our personal by this technology; I'd never wit-
lives. nessed anything like it before.

Very shy and unsure, we made When done, he wrote a full report of his conclu-
that first phone call to ATIME. Since then, we have sions, including a detailed diagnosis and treatment
never thought twice before calling, confident that plan. “Take it home. Discuss it with your rabbi, decide
we are, be”H, in the hands of the devoted, dedicated which of the plans you want to follow, and schedule a
ATIME family, who has so much knowledge, experi- follow up,” he said.
ence and desire to guide us along the path to success.

Through it all, I know that our path was custom-de- At home we carefully read all the information, but

signed for us, with so many ups and downs. one transcribed line struck me: “I’ll try what I can, but

••• I can’t promise that you will have children at all.”

After the initial diagnosis, we were referred to an- Heavy tears blurred my vision as I read that line
other doctor for a procedure that had a possibility to over and over again. It filled my mind and I couldn't
prevent the need for surgery. think of anything else. The words danced glaringly
before me, teasing me, as if ignoring my pain.

When the procedure was done, the doctor shook My husband took this encounter in a totally differ-
his head. “I’m so sorry,” he said. “This wasn’t the right ent manner. “The doctor is only here to help us as
treatment for you. Continue on to a different doctor a shaliach from Hashem, Who is the One and only

CHANUKAH 5782 | SHAAREI TIKVAH 61

Owner of the third key, granting people the ability to for right after yom tov.
have children. If He didn’t trust the malachim with
this key, why would it be entrusted to this doctor?” I was quite anxious, but my Rosh Hashanah was
still special and heartwarming. As I was begging
This emunah thought slowly took root in my mind: and crying for children, I was simultaneously full
Hashem has an exact master plan that only He un- of gratitude for all the good of the past year. I was
derstands — and He will definitely bless us, proving determined not to focus solely on the empty half of
to the doctor how limited he was. A doctor is here to the cup; life is so much sweeter and more enjoyable
guide, advise, inform and treat. But he cannot and when viewed through rose-colored glasses.
will not take away the strong emunah we have in
Hashem. Every detail is planned by Hashem and we ***
are here to do His ratzon.
Rabbi Unger spent a lot of his precious time edu-
Now my perspective had shifted. Nothing had cating us and reassuring us that we will see the light
changed except my “glasses,” from dark to bright. We at the end of the tunnel. After speaking with him,
had armed ourselves with emunah; we would make it the stone rolled off my heart and our worries were
through. lightened.

Another thought that I bumped into was why do A full year passed. My family didn’t grow, but I did.
we do all this treatment, which is so hard, stressful I was at shul again — same machzor, same sweater,
and uncomfortable? Because we really, really want the same tefillos as the previous year. But on the
children. And why do we so want children? Of course, inside, I was no longer the same person. Life’s chal-
to be just like everyone and stroll down the block lenges are the best teachers, they say, and — oh, yes,
with the latest model carriage and to be part of the my challenges have taught me many lessons.
conversations and…
I learned to be less vulnerable to insensitive com-
Stop! ments. I learned to count the blessings all around
me. I learned that sometimes, a pity party is healthy
You know the real answer, right? It’s because we and can relieve emotional pain. And I learned that at
want to do ratzon Hashem and build a family, adding some point, it needs to end.
more soldiers to His army. So if the ratzon Hashem is
to withhold it now from me, my tafkid is to let go of The calendar pages were flipped over and over
my ratzon and accept wholeheartedly what Hashem again as we endured hormonal imbalances, medica-
wants from me. tions, tests and appointments. Another year passed,
and then another.
This awareness made me feel so much less
stressed. And then the coronavirus took over the world, and
changed life completely — financially, emotionally…
My Chovos Halevavos was placed on a prominent and medically. The personal impact it had on me
shelf as I started a daily shiur. I practiced and studied was that we were forced to abruptly drop all infer-
again and again the foundations of bitachon. The tility hishtadlus. Our doctor’s office was “closed due
connection I developed with Hashem was deeper to COVID-19.” We didn’t know whether we should
than I had ever felt. Subconsciously, I had a thought: continue the medication without monitoring. This
Perhaps this is the purpose of my nisayon — to de- decision was made for us when the prescription was
velop a connection with Hashem? The sweetness of used up and there was no doctor available to pre-
being so comfortable in the hands of Hashem is a joy scribe something new. We were left directly in the
like no other. care of the biggest Doctor in the universe, the Rofeh
Chol Basar.
The ominous sentence on the doctor’s report re-
mained, but it wasn’t such a huge threat anymore. I All we could do now was daven and have bitachon.
dialed 718-686-8912, and reached out for profession- Hashem isn’t limited by a lockdown, a pandemic, or
al guidance. anything else.

A meeting was scheduled with Rabbi Unger, shlit”a, After five months of lockdown we got to see our

62 SHAAREI TIKVAH | CHANUKAH 5782

doctor again — well, we saw his eyes, anyway. The the time, I told myself. It’ll pass on its own.

rest was covered in a mask and PPE. He was quite One morning I took an EPT out of my drawer. (I’m
upset that we had stopped the meds, and advised surely not the only one who has spent a great deal
that we try a different method of treatment. of money on EPTs, and still has the urge to try them

We knew some basic information from reading despite the futility, right?) On my way to the garbage

about it in the ATIME magazine. We discussed the can to dispose of the small stick, I glanced down and

options with our dayan and infertility adviser, and my heart skipped a beat.

were referred to another specialist. Impossible!

After answering the countless questions on the Another glance at the
second line kept frozen for
form, the receptionist con- several minutes. Then I burst
into giggles.
sulted her computer for I worked on my
availability. Are you crazy? I told my-
self. Do you really think a $1
“Okay. I can schedule you perspective and test can divulge a miracle?

for February.” reminded myself Surely it was a mistake.
“What?” My calendar was
that we are meant
flipped open to September!

They were “backed up due to do hishtadlus — Something must be wrong
to COVID-19,” what else? with the test. But when I

“As a new patient,” she said, and now, the right showed it to my husband, he
“you’ll have to wait until that opened his eyes wide and

date. I’m sorry about it.” hishtadlus was to looked at me in shock and
do nothing. excitement. “Zeh hayom asah
I’m not sure how sorry she Hashem!” he said. “I’ve been
was, but I was unequivocal- dreaming about this morning
ly sorry. Some errant tears for so long. Unbelievable that
dripped onto the paper in it really happened!”
front of me as I jotted down

February 25, 10:00 a.m. “Um, why are you excited?” I asked him. “The doc-

Our appointment was scheduled for Taanis Esther. tor gave us no chance for a natural pregnancy. I don’t
Purim is a time when so many miracles happened. think it’s true.”

Would this be the time for our personal neis? My husband looked at me. “Is the doctor the one in

Since we could do nothing in the wake of the coro- charge?” he reminded me gently. “We're not allowed
navirus but wait to be seen, we decided to enjoy our to forget Who is the Only One with the key to chil-
“time off” for the next five months. I tried moving my dren.”

focus away from this appointment and instead kept One day, and another few tests later, I was no lon-

myself busy with projects, including exercise, sewing ger skeptical.

and puzzles. I called Bikkur Cholim to offer my time. I had said Hallel that day, since it was Rosh
My intention was just to fill my time, but it made me Chodesh. Now I was ready to sing Hallel again.
feel so accomplished. I’m helping Hashem’s children

in need, when I’m in need of children, I thought. And The time for our yeshuah had come, and

helping others brought so much light to my own life. nothing could keep it back. Not the doctor’s

I worked on my perspective and reminded myself ominous words, not failed procedures, not
that we are meant to do hishtadlus — and now, the canceled treatment cycles and not the
right hishtadlus was to do nothing. long wait for an appointment. Nothing
could interfere with Hashems’s will.

As the winter crawled by, I was subconsciously

waiting for the upcoming consultation. Don’t push

CHANUKAH 5782 | SHAAREI TIKVAH 63

| SUPPORT • BY: DR. SILVIA FOX

SIBERIA
OF THE

SOUL
“In the depth of winter I finally learned that I was curious to understand these differences and
within me there lay an invincible summer.” to see if the “feminine” style of coping was more
effective than the “masculine” (which I suspected),
Albert Camus or the other way around. I decided to research the
couples at the clinic and document the results in my
Infertility is very much about surviving a Siberia of doctoral dissertation. I spent a year studying infertile
the soul. If you are infertile, you know this place well: couples and writing my paper (to my surprise, men’s
it’s the social and emotional exile women experience coping strategies, such as emotional distancing,
when they’ve been trying, unsuccessfully to have a distraction and humor, seemed to work better than
child. It’s the frozen tundra inhabited by women who women’s). Throughout this I continued to see infertile
are not mothers. clients and began building what would become later
a thriving clinical practice focused on infertility.
I am quite familiar with the tundra myself. In
my late twenties, I was finishing up my doctorate But first, it was time for my husband and me to
in clinical psychology and doing a residency at a have a child. We started trying to get pregnant, then
Chicago hospital, when I first began learning about trying and worrying and then trying and panicking.
infertility. The hospital had a large fertility clinic Eventually we learned that we were part of the small
and, as part of my training, I began leading support group of infertile couples who are dealing with both
groups for the couples who were going through in a male and a female factor. We ended up undergoing
vitro fertilization, or IVF. I was taken aback by the five years of medical treatment that culminated
emotional demands of infertility, and by the drastic in several cycles of IVF. I learned, during those
differences between men and women when coping
with those demands.

64 SHAAREI TIKVAH | CHANUKAH 5782

years, that neither academic nor clinical be having a nice time with the men outside.
knowledge of infertility could prepare me
for the actual emotional experience. I did not belong anywhere. I lacked
what every other woman in the room (in
Nothing had prepared me for how the the world, it seemed) so naturally had. I
desire for a child can burn your heart till felt alienated, forsaken and damaged. I
it blisters. Nothing had prepared me for turned around, looked for the bathroom and
what it’s like to hope for good news, only locked myself in for a long cry. I became
to have your hopes struck out by the single acquainted with many bathrooms in the
red line in the window of a pregnancy test. course of our fertility treatment as the
Nothing had prepared me for the desolation feelings of loneliness and isolation were
of feeling like you are the only woman in frequent and powerful.
the world who is not a mother. Before and
since, there has been little in my life as During those years I was haunted by a
challenging, demanding and overwhelming fantasy in which I was standing alone in the
as those infertile years. dark, outside a beautiful manor. Through its
gleaming windows, I could see comfortable,
I remember one spacious rooms, illuminated by dozens of
lights. Sounds of music and laughter were
night, about a year drifting out in the cold winter air. People
were smiling, laughing and greeting each
My world, into our fertility other with familiarity and warmth. Their
treatment at an event faces seemed lit from inside with joy,
confidence and pride. I understood in my
of negative with some friends. dream that they belonged to an exclusive
pregnancy The women took and prestigious group. Standing outside
seats and engaged this mansion, shivering in the frigid night,
enviously looking in, there was nothing
tests, of self- in an animated more that I wanted but to join the blissful
administered conversation about party inside, to be like everyone else, a
injections, and the preschools, baby member of that group. But I knew that no
of endless grief gyms and “mommy matter how much I wanted it, no matter
seemed as and me” classes in how much I tried, no matter how hard I
the area. Outside, the prayed or how loudly I cried, I would never
men were having a be able to join. I was destined to be an
good time. outsider looking in, forever.

remote from For several minutes, The long winter of my soul did eventually
end. And, as someone once said, the
theirs as the I found myself harsher the winter, the more glorious the
far side of standing in the spring. My wish for you is that your winter,
kitchen, feeling and too, ends soon; that from the frozen plains
of your soul a green sprout emerges and
the moon. looking totally lost. I the warmth of spring thaws your pain. Until
dreaded joining the then, I hope you find your flame to help you
thaw some of the frozeness in your soul
women. I dreaded the and warm the relationships with your loved
ones.
moment someone
fertilityresilience.com
would ask me: “Do you

have any kids?” They, of course, all had

children, and at least two were pregnant.

My world, of negative pregnancy tests,

of self-administered injections, of sperm

counting, and of endless grief seemed as

remote from theirs as the far side of the

moon. Meanwhile, my husband seemed to

CHANUKAH 5782 | SHAAREI TIKVAH 65

| SUPPORT • BY: ALEXANDRA ROSS

How Men and Women

Handle Infertility Differently

(And How They Can Cope Together)

Infertility is a difficult struggle. Aside For example, women are generally more open to
from the stress it brings, it can also cause trying infertility treatments such as IVF and other
assisted reproductive technologies. They are more
depression, anxiety, and even lowered self- likely to believe in — or at least hope for — the
esteem and guilt. As a success of these treatments.
result,
coping Women have been found in studies to be more
likely to want to speak openly about their infertility,
mechanisms to deal with these while men were more restrained in this regard. They
emotions are crucial. are significantly more likely to reach out to their
close friends or family, sharing outside of the home
We all have our own ways instead of just with their spouse. They are also more
of dealing with negative likely to talk to a professional, whether it is their
situations and emotions in life. family doctor, infertility specialist or therapist.

Sometimes, these ways Establishing social support networks is a crucial
of coping are divided part of coping with infertility for many women.
along gender lines — Reaching out to others for validation, comfort and
including in issues even escapism can relieve some of the depression
of fertility. But while and anxiety brought on by fertility struggles.

women and men tend to In fact, escapism is another coping mechanism
cope differently, couples that many women utilize when dealing with
can find common ground infertility struggles. Escape and avoidance strategies
in their shared emotions — like fantasizing, misplaced optimism, and avoiding
and goals, and show one people/places/things that remind one of infertility —
another full support and are common.
compassion despite, and at
times because of, their very Men: “Strong and Silent” Isn’t the Whole Story
differences. At times, adult men are wrongly stereotyped
by society as lacking emotional depth. They are
Women: Seeking Both Support and Escape considered to not feel as much sadness, or need as
When it comes to dealing with infertility much support, as women. This creates a cycle where
struggles, women are more likely than men to many men do not feel welcome to seek support or
seek social support and engage in confrontative speak openly about emotions. Unfortunately, this can
coping strategies. In other words, they are very extend to men who are struggling with infertility.
open to admitting that the issue of infertility causes
emotional distress, and more likely to seek direct This misconception may be fueled in part by the
answers to that issue. coping mechanisms many men use when facing
infertility stress. Men often appear to distance

66 SHAAREI TIKVAH | CHANUKAH 5782

themselves emotionally from the issue of infertility Supporting Each Other
when it arises. There is nothing wrong with any of the coping
mechanisms previously discussed. However, some
It is common for men who struggle with fertility to are more effective than others. Here are some coping
appear focused on other issues. While it may be easy mechanisms and advice that can help you and your
to judge from the outside and claim that this means spouse— not only individually, but your relationship
someone does not feel strong emotions about their itself — in times of infertility stress.
infertility, it actually indicates the opposite. Focusing
on other issues can serve as a form of escape and • Talk openly. You may not feel ready to talk to
emotional regulation for many men.
friends and family about your infertility issues,
Additionally, men are more likely to see infertility
as a problem to be solved. Rather than demonstrating but talking to your spouse is essential. Regular
more vulnerable or emotion-sharing strategies like
talking to friends and family, men more commonly conversations about your emotions and
engage in planful problem-solving strategies.
concerns will allow you to fully understand
When considering how men cope with infertility
struggles, it is important to remember that not all and feel understood by one another,
emotions are shown. Not all men feel comfortable
opening up about the struggles they face — in part and will bring you closer
because of the stereotypes that claim they aren’t
supposed to. Regardless of how well a man appears together.
to handle the rough emotions of infertility, he must
be shown empathy and support. • Don’t discount each Couples

Finding Common Ground other (or yourselves). can find
It may seem like there are more differences Both you and your
than similarities in the ways that men and women
experience infertility. However, that really isn’t true. spouse deserve common
to feel heard and ground in
Men and women feel many of the same emotions supported during this their shared
— depression, anxiety, stress, low self-esteem and journey. Sadness, emotions
even guilt — when experiencing infertility. The guilt, and stress are and goals,
apparent differences are really only found in the normal emotions,
ways that these emotions are handled — and even and shouldn’t be
then, there are similarities under the surface that we discouraged or shoved
may not see. down. Feeling these

Both men and women use coping mechanisms emotions fully will help and show
in an attempt to control their situation and protect you heal.
themselves emotionally. Whether one is meticulously
planning out a fertility treatment, distracting oneself • Find time together. It can one another
with work, or daydreaming about the children they
hope to have one day, they are aiming for this goal. be totally draining to have full support
the stress of infertility on

your shoulders. That’s and
why you need to make compassion.

time for your favorite
hobbies, spending time

with friends, going on

adventures, and any other fun

activities that will relieve your

stress and put a smile on your

face.

When you feel like you and your spouse are on At the end of the day, the two of you
different pages or they don’t understand your pain are a team! Tackling this issue honestly
because they are coping in different ways than you, and considerately together will strengthen
try to remember this: Your spouse is going through your commitment and connection to one another.
the same pain you are going through, and may need
more support than they are willing to ask for. https://www.eivf.org/

WE DON'T SEE THINGS THE WAY THEY ARE;
WE SEE THINGS THE WAY WE ARE

CHANUKAH 5782 | SHAAREI TIKVAH 67

Bulletin Board Volunteer

Great News! Need to be near your Become a part of the ATIME Family
center for Shabbos?  Help our very best office staff
Call us for updates and Chaya and Vivienne at  D istribute Labor Tehillim Packets to
information about upcoming 718-686-8912, ext. 114
doctors' offices
events and phone support
groups  Deliver magazines to doctors' offices
 C oordinate fundraisers in different

neighborhoods

 H elp with our annual Chinese Auction

Email [email protected]

ATime 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 ATIME helpline
Email [email protected] or [email protected] for more details.718.437.7110
or call 718-686-8912 for the info

Need to have your blood drawn on
Shabbos & delivered to your center?

Call 718-686-8912 ext. 114

Meals Inspiration! Car Rides

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:
1-845-81ATIME 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

68 SHAAREI TIKVAH | CHANUKAH 5782

| SUPPORT

AlFlFTEoEHEfELETLShem
It’s natural for humans to have various feelings — 1. W rite down your truth. By this I mean the
happiness, sadness, excitement, fear, nervousness, actual hard-core facts that surround your story.
disappointment. We sometimes categorize them Acknowledge it. Sit with it.

into “good” and “bad,” but really they are just feelings 2. N ext focus on what’s not serving you. What’s not
with some being “bigger” than others. working? Acknowledge it. Sit with it.

Being told to “just relax,” is a common trigger when 3. Name the feelings that come up — all of them.

trying to build your family, yet there is some truth to This includes the “good ones” too. It is possible to

the phrase. When we do not express and tend to our feel more than one emotion at the same time so

emotions — all of them — we are not able to release you may be excited and scared for your

them. If we don’t release them, they get suppressed retrieval. You may feel

and manifest in our tWowoheuernarewemenoodttioonansbol—te etxoparrleelsleosafsatenhdtehmteemn—d. nervous and happy about
bodies physically as transfer day. Give yourself
stress — tight shoulders/ permission to identify,
neck, aching belly, acknowledge and sit with
headaches, tight jaw, etc. all of the feelings that
Stress is always going surface.
to be present, and it’s

important to find ways to Then, after you gave each of them the space they
manage it through a practice that resonates with you, needed to expand… let them go. Release.
be that exercise, meditation, mindfulness or coloring.

If we do not manage it effectively our bodies will not By simply acknowledging and honoring the

function optimally, which is the opposite of what we facts about your story and the authentic feelings

want. surrounding it, you will begin to heal and move

So what do we do? forward, and every step forward is to be celebrated.

www.kindredbeginnings.com

CHANUKAH 5782 | SHAAREI TIKVAH 69

| SUPPORT • BY: DR. SILVIA FOX

BHaAndBlinYg If there is one
invite that every
DCELUEBRRAITNIOGNS infertile woman
dreads getting, it
INFERTILITY is the pastel-colored
invitation with dreamy
baby-related
paraphernalia.

For most of those who
go through infertility, a new
baby event is not a cause for
celebration. Instead, it is a
reminder of painful realities: that
other women get pregnant easily
while we suffer for months to get a
positive pregnancy test; that they
have transitioned to a new phase
of life while we are remaining
behind; that they have joined The
Parents' Club — in which we have
been denied membership and to
which, we fear, we may never
belong.

We know that attending baby-
related events may make us feel
sad, hopeless, isolated, anxious,
and — more than anything —
terrifically envious. And still, the
celebration is often for someone
we love: a sibling, a cousin, a dear
friend. They are people whose
well-being we cherish and upon
whom we would never wish
any pain, least of all the pain of
infertility. So we find ourselves

swirling with complex emotions:
bitterness and jealousy,
apprehension and sorrow,
resentment and despair. Emotions

70 SHAAREI TIKVAH | CHANUKAH 5782

that confuse us, and that make damage to an important spot periodically and checking in

us feel guilty and ashamed, and relationship with them throughout.

that leave us feeling freakishly You are in a period of hiatus Prepare a few canned
different and utterly alone. from treatment, and are more responses that you can pull out

And so, with the invitation, focused on catching up with life of your sleeve on short notice,

there is a period of fretting: than on pursuing

To go or not to go? To honor motherhood INSTEAD, IT IS A REMINDER
another's joy or to respect our OF PAINFUL REALITIES:
own vulnerability? To join our You have been THAT OTHER WOMEN
community in celebration or skipping a lot HAVE TRANSITIONED
to protect ourselves from the of baby events TO A NEW PHASE OF LIFE
possible scrutiny and probing and you don’t WHILE WE REMAIN BEHIND.
questions of curious friends and like yourself as a
family members? result

I’d like to offer you a few rules You anticipate should anyone ask you nosy
of thumb to guide you in the a future invitation questions. Practice delivering
decision. to an event within this family them in a neutral, matter-of-fact
that will trigger you even more fashion.
CONSIDER NOT GOING IF: and at which the guests will be
Your relationship with the the same. In this case, consider
family is relatively superficial and going now and saving your “Get

will not be significantly damaged Out of Jail Free” card for the more Ask your husband, mother or
by your absence painful occasion a close friend to shop for the

Your relationship with the If you decide to go to the baby gift. Otherwise, shop for
family is close and they will celebration, plan ahead and a “neutral” gift, which you can
lovingly understand and respect consider the following survival buy online and away from baby
your choice to abstain from strategies: boutiques or children’s stores.

attending Have an excuse ready in case Bookend the event with some
you become overwhelmed and pampering and self-care. For
You are in the middle of a need to leave early. instance, go out for a manicure
treatment cycle or on the heels of before and a refreshing walk
a painful loss Find an ally who will be after. Enlist your husband's

support and ask for extra TLC

AND SO, WITH THE INVITATION, before and after the event.

THERE IS A PERIOD OF FRETTING: Reward yourself for having
gone and survived by buying
TO GO OR NOT TO GO? yourself a small gift or treating
yourself out.

You don’t have emotional attending and who will be a Ultimately, remember that
support among the other guests source of support for you. infertility is one of the most
— either because they don’t know significant crises you will
about your infertility or because Put someone who knows about encounter in your life. And
they don’t understand it your infertility (your husband, a as such, your priority is to get
close friend, a therapist) on high through it with resilience and
CONSIDER GOING IF: alert. Ask them to be available grace.
Your absence will be highly for calls or texts during the event.
visible and result in enduring Consider retreating to a private http://fertilityresilience.com/

CHANUKAH 5782 | SHAAREI TIKVAH 71

| SUPPORT • BY: LISA ROSENTHAL

OAthmeursUemneanmtuPsianrgkTsrauntdhs

Infertility and fertility treatment are often compared to either a roller coaster or a Ferris wheel, and for good
reason. Throughout your journey, there are many twists and turns, ups and downs — and it often feels like the
entire thing is out of your control.
That got us wondering, “If all the pieces of fertility treatment were like rides at an amusement park, which
ones would they be?”

Let's Be Clear: Infertility Is NOT Funny
But that doesn’t mean we can’t occasionally have a good laugh along the way.
As you read, know that while the metaphors here are meant to inject some humor, we will
also (seriously) discuss what we do and don't know about fertility, and how to navigate the
roller coaster that is infertility.
We know just how frustrating it is to feel like you don't know what lies ahead, and
we also have a sneaking suspicion that fertility treatment might have more than a
few things in common with amusement park rides than you'd expect.
So, let’s look at a few "old favorites" that one expects to find at the
amusement park of infertility, shall we?
Insert drum roll here...
The Fertility Treatment Amusement Park

#1 Roller Coaster: The Emotional Unknowns

We can all agree that we love hearing good results during fertility
treatment — those are the high points. And we’re devastated when we hear
results that are disappointing — those are the unexpected, stomach-dropping
dips on this ride.

72 SHAAREI TIKVAH | CHANUKAH 5782

Here are some thoughts that add to the roller coaster of fertility treatment:
● Will this treatment be successful or not?
● If this doesn’t work, what’s next? Will that work?!
● Can I be okay receiving answers that are disappointing? How?
● My pregnancy losses have convinced me this will never happen
● How can I move on after the disappointments?
● Can I actually get pregnant when I’m so convinced it won’t work?

#2 Ferris Wheel: The Mental Gymnastics

The Ferris wheel is usually considered a pretty benign, gentle ride, right? Sure, unless it won’t
let you get off. Then you're just stuck, going around and around in circles. What does that look and
feel like when it comes to fertility treatment?

● Coming back to the same thoughts over and over again
● Making a decision, only to doubt it and rethink it later
● Becoming convinced that because something hasn’t worked before, nothing ever will
● S pending time researching everything on Google for hours — even after you’ve already gotten

answers from trusted and reliable sources.

#3 Tilt-A-Whirl: The Physical Side Effects

Oh yeah, let’s go with this one! This is the ride that makes you feel completely off-balance, like
you have no anchor to the world. Fun? Not so much.

Here are some thoughts that might be running through your head:
● Am I more emotional (even crazy?) because of the hormones, or is it just me?
● My belly feels tender and is bruised from the shots, is that okay?

CHANUKAH 5782 | SHAAREI TIKVAH 73

● I can’t sleep because I’m worried all night long.
● I can’t do my regular exercise routine that keeps me sane — is that part of what’s making me feel tired and

not myself?
● My knees hurt, is that because of the medications?
● All the ultrasounds, otherwise known as “You have to stick what, where?”
● I have to come in for how many blood draws?! Say that again?
● I’m hurting all over from the shots. When will the soreness go away?
● Another hysterosalpingogram (HSG)? Why?
● I’m afraid of anesthesia. Can I do my egg retrieval without it?

#4 It’s a Small World: Family, Friends & Colleagues

A very common internal struggle for many of us dealing with fertility issues is “I don’t want to talk about this"
or “I want to talk to everyone about this.”

Sometimes we want to talk about infertility; sometimes we don’t. Sometimes when we do feel like talking, we
don't know who to go to, or worry that if they say something hurtful, we won't know how to respond.

And that’s often just the beginning. Here are a few more examples of how the world can feel smaller when
you’re challenged by infertility:

● Is there anyone out there who actually understands what I’m going through?
● Which of my friends are going to have an empathetic reaction to my story?
● Who can I trust to keep this information private?
● I don’t want everyone knowing my business — but then I feel sad when I don’t get any support.
● How can I keep doing this with no one knowing what I’m going through?

#5 Log Flume: The Language of Infertility

Sometimes you can feel like you’re drowning as you navigate trying to conceive, understanding your
treatment options and finding the right doctor or fertility practice. And then you're still expected to learn a
brand-new language: the language of infertility.

HSG, FSH, AMH, A1C, IUI, IVF, FET, ET, PGTA, HCG… How are you supposed to keep track of what all of these
acronyms mean?

● Becoming multilingual wasn’t what you signed up for.
● It’s hard to understand, even when the people explaining things to you are speaking in your native language.
● N ot only do you feel confused about the language of fertility, but you don’t speak it either, so asking

questions feels difficult and doesn't always yield the answers you're looking for.

#6 The Ring Toss: Statistics & the Game of Chances

Is it all in the way you look at it? Statistics always have at least two sides when it comes to fertility
treatment, and it can feel like one's the winning side and the other is the losing side.

Land on the right side of the statistics, and it’s a yes. The wrong side? It’s a no.

74 S HA A REI TIKVAH | CHA N U K A H 578 2

Here are some possible scenarios that may run through your head when looking at the data:
● I have a 70% chance of becoming pregnant with a tested embryo (PGTA), doing an FET (Frozen Embryo
Transfer). Wait...why didn’t I become pregnant then?
● Okay, it didn't work this time, but a 30% chance of NOT becoming pregnant, with my diagnosis, still means a
70% chance I WILL become pregnant.
If you're naturally more optimistic (or trying to be), you can view the statistics this way:
● M y chance of pregnancy is 10% from this treatment. So, that means there is a 90% chance I won't get

pregnant. Or, I could be the 1 in 10 women who does!
If you can't bring yourself to be optimistic right now, try shifting to curiosity instead. We know it's hard to
stay neutral when so much is at stake, but being curious rather than expecting the worst can help!
● I was quoted a 5% chance of success this month by my doctor. Will I be the 1 in 20 who gets pregnant? Or

part of the other 95% who doesn't?
We get it. Statistics can really suck. But knowing what your odds of success are can help set expectations,
give you a better understanding of what might work best for you and make you feel more empowered
throughout your fertility journey.

#7 Funhouse Mirror: My Life Looks Unrecognizable

Here's what our lives often look like when we try to make plans as people going through fertility treatment:
● Vacations? Nope. I may start my cycle (or it may be unpredictable).
● Baby showers? Depends. Seeing babies when I’m trying to conceive and full of hormones might not go well.
● Accepting an invitation to a party? What if I have to sneak off in the middle of the event to do an

injection or trigger shot?
● F urthering my education? Hard to concentrate when fertility treatment feels like a full-time job, and

should I even try if I hope to become pregnant soon?
● B uying a home or car? Well, spending money on those things feels impossible if we need the

money for fertility treatment.
All or some of these unknowns may run through your mind and heart throughout the fertility
treatment process. And we've barely scratched the surface — you know just how many more
questions and worries pop up along the way.
So no, infertility is NOT fun. But it sure does take one on a ride!

rmact.com

CHANUKAH 5782 | SHAAREI TIKVAH 75

| PREGNANCY LOSS • BY: ALYSSA AGES

“It Wasn’t
Meant To Be”
And Other Things Not To Tell a Friend After a Miscarriage

“So, how are you doing?” I ask When you suffer a loss, everyone we talk about the loss. Sometimes
my friend who just suffered a late wants to rush you into a place we talk about what goodies we
first-trimester loss. She stiffens of acceptance so you can just are stocking our freezer with.
for a moment then lets out a deep “move on.” As if grief is something Always I remind her I am here.
sigh. “I’m really tired of people you can simply fast-forward. That I don’t expect her to move
telling me ‘it just wasn’t meant to Four years later, I still pause on on. That I expect her to feel every
be,’” she says. the anniversary of my D&C to stop-in-your-tracks shot of pain,
remember. I think about the life rush of hot anger, and moments of
I have been there. I’ve heard that could have been. sadness so heavy you buckle at the
those words so often after my own knees. And that all of it is okay.
loss that I started peering into Since she lost her second
people’s bookshelves for some kind pregnancy at eleven weeks, my We don’t talk enough about loss
of how-to book on talking to your friend and I go for a weekly walk but more than that, we don’t talk
fertility-challenged friend. together. I don’t ask if she needs it, enough about how we talk about
or if she wants to talk. Sometimes loss.

76 S HA A REI TIKVAH | CHA N U K A H 578 2

We know not to say things like, At one point, during my roller
“Hey, get over it,” because we fertility struggle, I was invited coaster. But,
aren’t savages, but fail to realize to a baby-related celebration. I that doesn’t mean we stop trying.
that the phrase “It wasn’t meant had worked up the courage to
to be,” and its brethren “Maybe go, and prepared myself for the According to the Mayo Clinic,
it was XYZ thing that happened” baby hype. The morning of, I between 10% to 20% of known
and “You’ll move on with time” unexpectedly got my period. I was pregnancies end in miscarriage
feel patronizing. They suggest crushed. (and that number may be higher
that because the life that could for losses that happen earlier
have been is a life that never was, I called a friend who was also in pregnancy when a woman
the mourning period should be an IFer and asked her what to do. doesn’t know she’s pregnant).
stunted. In an effort to project “Don’t go,” she said, and in that Yet women grieving a loss feel so
optimism we’ll say things like, “It moment I exhaled the weight of devastatingly alone.
will happen, don’t worry,” a refrain the world. The simple two-word
repeated almost exclusively by permission slip to stay home You don’t need to say the
people for whom it did simply and take care of myself was “right” thing; you just need to
“happen.” A seemingly innocuous invaluable. say something. It might seem
statement, it fails to recognize counterintuitively robotic, but set
the agonizing reality that, well, it Grief — over the loss of a a calendar reminder if you have
might not. pregnancy or your dream-sized to. Say “I’m thinking of you.” Tell
family vision — isn’t something them “I’m here.” Assure them you
What don’t we say enough? that can be rushed to conclusion. don’t expect them to “move on.”
“Take all the time you need to Just when you think you’ve Let them know that as lonely as
grieve.” “I’m here for you.” “I don’t escaped it, fresh pain — a they feel, they are far from alone.
expect you to be okay.” coworker wearing maternity
clothes, walking past a stroller And to those of us on the
When I miscarried, there was sale, a baby's cry on the bus – receiving end of the comments
an initial rush of outreach. People slams the gate shut again and and care, remember, your
called or texted that they were you’re trapped. pregnancy was real; your
thinking of me, that they were grief deserves to be the same.
sorry, and asked how they could Upon learning her co-worker Surround yourself with those who
help. The pain was raw and while was expecting once again, a support you, because they are
I appreciated the sentiment, I friend — who has been struggling there - tongue tied and awkward
had no idea how to receive the to conceive — told me “I’m 100% perhaps, but unbending in their
outpouring of love. I didn’t want happy for her and 100% sad for desire to understand, to care, and
to respond to messages or take me.” to love.
calls. I needed to grieve alone
at first, but I didn’t know how Trying to conceive, conceiving pregnantish.com
to explain that feeling. I wanted and then losing the pregnancy,
support… but not right now. So I throwing your dreams of a large
said nothing and, over time, the family out the window is 100%
check-ins stopped. But the pain messy. It’s sad and optimistic and
lingered. The less that people devastating and hopeful and other
reached out, the more I began to strange couplings of emotions
feel profoundly alone. that are impossible to understand
for anyone unfamiliar with the

IT DOESN'T TAKE A LOT OF STRENGHT TO HANG ON.
IT TAKES A LOT OF STRENGHT TO LET GO. -J.C. WATTS

CHANUKAH 5782 | SHAAREI TIKVAH 77

| MEDICAL

ASRM Press Release

DAidfCfOVeIDc-1t9
ART?

Infertility treatments remained strong
with good outcomes in spite of COVID-19,
according to three studies presented at the
ASRM 2021 Scientific Sessions

HIGHLIGHTS FROM THE AMERICAN SOCIETY FOR
REPRODUCTIVE MEDICINE’S 2021 SCIENTIFIC CONGRESS

78 SHAAREI TIKVAH | CHANUKAH 5782

The COVID-19 pandemic pandemic” and, therefore, The researchers compared the
disrupted many aspects of health patients and their providers can number of egg retrievals and IVF
care and caused a great deal be reassured that IVF cycles can cycles from May to February 2019
of psychological stress among be continued safely during a to May to February 2020 (during
patients and temporary barriers pandemic without compromising the pandemic). Altogether, there
to traditional care, leading to outcomes. were 39,087 egg retrievals and
questions about the impact of 14,365 IVF cycles.
the pandemic on fertility and O-141, I. Chamani, et al, IVF/OOF
assisted reproductive treatments. OUTCOMES DURING THE COVID-19 The authors report that there
However, the results of three PANDEMIC was a substantial drop in
studies presented at ASRM’S March to April 2020, but ART
2021 Scientific Sessions show Frozen Embryo Transfer procedures quickly recovered to
that with proper precautions, Outcomes During the COVID-19 the pre-pandemic baseline by
outcomes before and during the Pandemic June 2020. They conclude that
pandemic remained very similar “despite concerns regarding
in several aspects of infertility This study specifically compared suspension of ART and delivery
care — including egg retrieval and the outcomes of frozen embryo of infertility care during the
IVF cycles. transfers conducted each month pandemic, our study shows no
from January to September 2020 significant difference in oocyte
IVF Outcomes During to the corresponding months (egg) retrievals and IVF cycles
the COVID-19 Pandemic before the COVID-19 pandemic prior to and during the COVID-19
in 2019 to determine the impact pandemic.”
In a study of IVF cycles among of the pandemic.
patients at the NYU Fertility Despite the health crisis,
Center, researchers compared Patients in the study were those their findings showed
monthly treatment outcomes treated at the NYU Fertility no significant delay or
among patients from January Clinic. During the study period
to December 2020 to those in in 2020, there were 486 frozen interruption of fertility care
the corresponding months in egg transfers compared to 558 and ART procedures in the U.S.
2019, before the pandemic had in 2019. The researchers looked
begun. All of the patients during at the pregnancy success rates As a result, the authors say that
2020 had tested negative for the and concluded that there were despite the health crisis, their
coronavirus. no differences in treatment findings showed no significant
outcomes in the patient delay or interruption of fertility
A total of 2,467 patients were populations treated during 2019 care and ART procedures in
treated during both years and compared to 2020. the U.S. They call for further
the researchers report that the research to examine how social
number of cycles was very similar P-445, I. Chamani, et al, FET OUTCOMES determinants of health such as
— 1,239 in 2019 and 1,228 in DURING THE COVID-19 PANDEMIC ethnicity, income and geographic
2020, as were patient ages and location affected access to and
the number of egg retrievals and Assisted Reproductive use of infertility care during the
other parameters studied during Technology Procedures pandemic.
both years. in the US Prior to and
During the COVID-19 P-459, J. Chae-Kim, et al, ASSISTED
The researchers conclude that Pandemic REPRODUCTIVE TECHNOLOGY
“there were no consistent PROCEDURES IN THE US PRIOR TO AND
quantitative or qualitative This study evaluated claims data DURING THE COVID-19 PANDEMIC
differences in outcomes among on assisted reproductive therapy
COVID-negative patients procedures (ART) from Symphony
receiving care during the Health, a database that includes
the information of more than 280
million U.S. patients.

CHANUKAH 5782 | SHAAREI TIKVAH 79

| MEDICAL • BY: SIERRA DEHMLER

6 Things

Everyone
Wonders
About

TErmabnrysofer

It's finally the day of your embryo transfer. You've IVF journey, it's only natural to want to be sure your
worked so hard to get here. You've dealt with so little embryo will be safe and secure after transfer!
many morning monitoring appointments, ultra-
sounds, medications, forms, phone calls, emails and So...can you sneeze, cough or jump too hard and
consults with your doctor — you've stopped keeping stop your embryo from successfully implanting?
count. Nope! Once that embryo is transferred, it's going to
stay put.
You're finally ready for the big day.
More good news? Even if you happen to get sick
But you might have some lingering questions (may- after your embryo transfer and experience some
be even a few that you're nervous or embarrassed vomiting, your embryo won't be bothered — it will
to ask). If this is you, you're in the right place. In this stay right where it's meant to be, tucked cozily inside
article, we'll answer six of the most commonly asked your uterus.
questions about embryo transfers — and hopefully,
give you a little more peace of mind in the process. Your embryo cannot simply be dislodged from the
Let's dive in! uterus post-transfer due to your sneezing, coughing
or other bodily functions. Though the embryo will
o#1uCtamnyIesmnbereyzoe?If you've ever been worried about this, you're not float around in your uterus a little before finding a
comfortable spot to implant, these tiny embryos
1alone! You'd be surprised just how many patients aren't as fragile as you may think!
have similar concerns. After going through an entire
In a nutshell, don't fret! Your embryo is safe and
sound. And of course, if you have any concerns you
can't shake, don't hesitate to reach out to your care
team for reassurance.

80 SHAAREI TIKVAH | CHANUKAH 5782

Your embryo simply cannot
be dislodged from the uterus
post-transfer due to your
sneezing, coughing, or
other bodily functions.

#2 Is there anything #3: How long does
I can do to increase it take for the em-
bryo to implant after
2 3my odds of success-
ful implantation? transfer?

Actually, yes! While so many pieces of the fertility This really depends on the maturity of your spe-
puzzle feel completely out of your control, there are cific embryo, but implantation typically takes place
some key things you can do surrounding your embryo anywhere from one and five days after your embryo
transfer to help increase your odds of successful transfer.
embryo implantation.
The next big question: When do I find out if I'm
Here are a few tips: pregnant or not?

Laser acupuncture — This non-invasive, painless If there's one thing you know at this point in your

treatment has been shown to increase implantation fertility journey, it's that there is a lot of waiting in-

rates by up to 15% when performed before and after volved in it. You'll have to wait about nine to ten days

embryo transfer. after your embryo transfer to get an official preg-

Stress reduction techniques — While one of the nancy test performed in the office (this is done via a
most annoying tips to get while cycling is to "just re- simple blood test).

lax," lowering your stress levels surrounding embryo We strongly recommend waiting for that official

transfer day is so helpful (not just to your physical pregnancy test instead of trying to do at-home tests

health, but your mental health too). Speak with a during this waiting period post-transfer.

friend or counselor, connect with your IF community, We know it's tough to hold off, but the blood test

practice mindfulness, dress in your comfiest clothes, done in the office will provide the most accurate
result (and likely save you a lot of confusion).
and keep your environment as relaxing as possible.

Follow your medication protocol closely — Reach
out to your fertility nurse with any questions or

#4 What should Iconcerns about timing or dosage. Also make sure
do after my embryoyou have enough of each of your medications, es-

pecially if you are traveling during your cycle. Your

4transfer?team works hard to carefully design a personalized
medication protocol to give you the highest chance of Great question! The answer depends a lot on how

success! you're feeling, but there are some standard guidelines

all patients should follow.

CHANUKAH 5782 | SHAAREI TIKVAH 81

The embryo transfer procedure has
little to no side effects other than
(hopefully) a pregnancy!

Directly following your embryo transfer, you

#6 Are there anywill rest for twenty minutes before you are
side effects fromdischarged that day. Many patients ask if they

need to go home and be on bed rest afterward,

an embryo trans-but there has been no benefit found to going on

6fer?bed rest after transfer. You can go about your

daily life as you feel comfortable!
However, you should be mindful of how While there are not any side effects typically
you're feeling, and not do any heavy lifting or associated with the actual embryo transfer
intense exercise for the next few days, be- itself, the side effects of taking progesterone
cause you want to feel confident that you have and estrogen can often feel like early preg-
created the best uterine environment to allow nancy — however, they tend to be mild. The
implantation to take place. embryo transfer procedure has little to no side
effects other than (hopefully) a pregnancy!

Here are a few other things to avoid Common side effects from progesterone and
post-transfer: estrogen:

No hot baths or jacuzzi time (sorry!) Tenderness
Bloating
5No douching Cramping
No heating pads Constipation
Fatigue
#5 What if my Bruising at the injection site
embryo transfer
isn't successful? Every person is different — some patients
report little to no side effects, and some feel
While no patient wants to receive the news more uncomfortable. You can always reach out
that their embryo transfer wasn't successful, to your IVF team if you have any concerns.
be aware that sometimes, as frustrating as it
is, it takes a few cycles to achieve success. And lastly… get your hopes up!

The day of your embryo transfer is such an
exciting, hopeful day. Take good care of your-
self before and after this big milestone in your
fertility journey, and celebrate how far you've
come. You've gone through a lot to get here.

rmact.com

82 SHAAREI TIKVAH | CHANUKAH 5782

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> Phone Support
> Website > Kol Chaya

CHANUKAH 5782 | SHAAREI TIKVAH 83

| MEDICAL

How In vitro fertilization, or IVF, is one of the most
Long common fertility treatments, and also one with
Before I high rates of success. However, there are many
Can Try instances when an IVF cycle does not end as
Again? intended. In such instances, when a patients
fail to get pregnant, they are often eager to
learn how long to wait after an unsuccessful
IVF cycle before trying again. Let's consider the
best timing between IVF cycles, and whether
taking a break can be beneficial.

Ideal Spacing Between
IVF Cycles

There are many factors that go into determin-
ing the ideal spacing between IVF cycles. It is
important to consider the patient’s age, their
fertile health, and their emotional well-being.
Additionally, IVF spacing may be dependent on
whether the cycle will be started completely
from the beginning (meaning the patient needs

to undergo ovarian stimulation and egg
retrieval) or whether there are frozen
embryos from a previous cycle that
are ready for use.

84 SHAAREI TIKVAH | CHANUKAH 5782

While doctors look at the details • Financial considerations: IVF Inflammation
of each patient’s situation to treatment can be pricey. For some,
advise them how long they should a break is necessary to get financ- is not a big
wait between IVF cycles, there es in order and prepare to pay for
are some general guidelines. The another cycle of treatment. concern, but
standard spacing between IVF
cycles is around four to six weeks Preparing most doctors
after a negative pregnancy test. for Your Next agree it is
Basically, it is ideal to wait until IVF Cycle best to let
the patient has gone through at inflammation
least one full menstrual cycle be- After a failed IVF attempt, doc- subside before
fore starting another round of IVF. tors will consider what may have
caused treatment to be unsuc- starting a new
Why Do I cessful, and whether any adjust-
Need a Break? ments should be made for the next IVF cycle.
IVF cycle. While adjustments are
After undergoing an unsuccess- possible, keep in mind that there
ful IVF cycle, many couples are is nothing that patients need to
understandably eager to try again. do to prepare for the next round
Although waiting four to six weeks of treatment, other than keeping
can feel like a long time, there are the mind and body as healthy as
some important reasons that this possible. In the weeks leading up
short break is recommended. to your next IVF cycle, we suggest:

• Let inflammation subside: The • Eating a well-balanced diet that is
medications used for ovarian stim- high in nutrients
ulation are likely to cause some
degree of inflammation in the re- • Staying physically active, but
productive system. Inflammation is avoiding high-impact activities
not a big concern, but most doctors
agree it is best to let inflammation • Finding moments to relax and let
subside before starting a new IVF the mind focus
cycle.
Finally, remember that every cycle's
• Reduce stress/anxiety: Any fer- results are ultimately out of our
tility treatment can be stressful, control. Keeping this in mind may
especially if it is unsuccessful. It reduce unwarranted urgency, and
is healthy to take a break, focus on help you determine the timing of
something else for a while, and let your treatment from a place of calm
the mind unwind a bit. and focus.

www.azarh.com

THE TWO MOST POWERFUL WARRIORS
ARE PATIENCE AND TIME.

CHANUKAH 5782 | SHAAREI TIKVAH 85

| MEDICAL • BY: GOSIA KASZUBSKA
86 SHAAREI TIKVAH | CHANUKAH 5782

Researchers have found a way to The research found a
better pinpoint the "golden window"
when a womb is ready for pregnancy, significant
in a discovery that could help boost IVF difference in
success rates.
IVF success
It's long been known that correctly rates when
timing an embryo transfer is critical to the embryos were
chance of achieving pregnancy. transferred

Identifying the right moment in a while this molecule was
woman's cycle with absolute precision present or absent on the
remains a challenge, however, contributing
to low IVF success rates, which remain on surface of the uterus.
average under 50%.
The research found a significant
But now RMIT University researchers difference in IVF success rates when
may have found a way forward, by embryos were transferred while this
identifying a Teflon-like molecule that molecule was present or absent on the
makes the surface of the womb slippery surface of the uterus.
and prevents embryos from implanting.
"Every embryo is precious for families
The team discovered that the levels struggling with infertility, so getting the
of this molecule on the womb's surface timing right is critical," said Nie, who leads
decrease at a certain point in the the Implantation and Pregnancy Research
menstrual cycle. This allows the womb Laboratory in the School of Health and
to become stickier, opening the "golden Biomedical Sciences at RMIT.
window" for pregnancy success.
"We hope with further development
Previously, scientists believed our discovery could help clinicians
implantation hinged on molecules that identify precisely when each patient
actively promoted the adhesion of an has the greatest chance of achieving
embryo to the wall of the uterus. pregnancy, delivering fully personalized
IVF treatment."
Lead researcher Professor Guiying Nie
said the team's discovery changed long- The findings, published in the journals
held scientific thinking about embryo Fertility and Sterility and Human
implantation. Reproduction, could have significant
implications for IVF treatment and success
"We've been looking for something that rates.
helps embryos stick when the vital part
of the puzzle turned out to be a slippery
molecule that has the opposite effect — it
prevents them from sticking," she said.

CHANUKAH 5782 | SHAAREI TIKVAH 87

Pregnancy treatments.
Success Rates
Nie said the analysis of this molecule
The retrospective clinical study, co- could be done in a standard pathology
designed by Nie and Professor Luk laboratory, making it relatively cost-
Rombauts from Monash IVF, examined effective to implement a future screening
levels of the anti-implantation molecule, test.
known as podocalyxin (PCX), in the
endometrium of 81 women undergoing "The only way we can currently test for
IVF treatment. A biopsy of the uterus PCX is through biopsies of tissue, which
was taken at the mid-luteal phase (about cannot be taken at the time when embryos
seven days after ovulation) of the women's are transferred," she said. "We need
menstrual cycle, one full cycle before a further research to develop non-invasive
frozen embryo was transferred. and real-time approaches for measuring
PCX on the day of embryo transfer. Our
While the women with low levels of PCX hope is to deliver a simple test that can
had a 53% pregnancy success rate, those help patients and boost the precision and
women where the molecule had not been personalization of IVF treatment."
reduced had a success rate of just 18%.
A patent application has been filed
Rombauts said measuring levels of PCX for the technology, with collaborators
at the mid-luteal phase can be used as a from Monash IVF now looking to further
screening test, but it could also indicate a evaluate the potential clinical applications.
reason for infertility, making the molecule
a potential target for treatment. The work began at the Hudson Institute
of Medical Research, before Nie's team
"These findings offer a promising path moved to RMIT in 2020.
for us to both improve IVF success rates
and potentially treat an underlying cause The research was supported by the
of infertility," he said. European Society of Human Reproduction
and Embryology, Monash IVF, and the
The research team has already begun National Health and Medical Research
work to better understand the role of Council of Australia (NHMRC). Human
PCX and how it is regulated in the body, embryo work in Brussels was supported by
with the aim of developing infertility Wetenschappelijk Fonds Willy Gepts.

HASHEM'S TIMING IS ALWAYS PERFECT.
TRUST THE DELAY. HE'S GOT YOU.

88 SHAAREI TIKVAH | CHANUKAH 5782

| MEDICAL

Bleeding after IUI may be something patients may experience. Bleeding is a nor-
mal side effect of the IUI procedure. Yet even so, it’s important to understand when
bleeding is normal and what else bleeding may mean.

About the IUI Procedure results in pregnancy, some women
may experience light spotting around a
Intrauterine insemination (IUI) is a week after undergoing IUI. Often called
non-surgical fertility treatment in “implantation bleeding,” light spotting is
which sperm is washed and mixed with a normal symptom of early pregnancy
a sterile medium and placed directly and may be accompanied by cramping.
into the uterus. This is done by inserting
a small, soft catheter through the cer- Implantation bleeding occurs around
vix around the time of ovulation. the time that the fertilized egg attaches
to the uterus around six to twelve days
By placing the sperm directly in the after the egg has been fertilized. As a
uterus, it is hoped that sperm will more result, implantation bleeding may occur
be able to easily reach the fallopian around six to twelve days after the IUI
tube and fertilize the released egg. procedure.

Should I Expect It’s important to note that implantation
Bleeding After IUI? bleeding happens around the same time
menstruation would typically begin if
Although the IUI procedure is non-sur- pregnancy doesn’t occur. Seeing blood
gical, bleeding is a normal side effect at this time can be depressing for wom-
and may occur after treatment. Not all en trying to get pregnant, but implan-
women will experience bleeding but tation bleeding should not be confused
those who do should only experience with menstruation.
light spotting.
Implantation bleeding is spotty where-
When spotting occurs after IUI, it as menstrual bleeding starts light but
generally happens immediately after becomes heavier.
treatment. Additionally, spotting is
typically minimal and is likely a result Menstrual Bleeding
of the tissues of the cervix and vagina After IUI
being irritated by the catheter used to
place the sperm within the uterus. IUI can greatly increase the chances of
pregnancy, but it does not always work.
How Long Does When pregnancy does not occur, wom-
Spotting Last? en should expect their normal cycle to
continue. If pregnancy has not hap-
Spotting after IUI should stop within pened, menstrual bleeding will begin
a few days of treatment. If bleeding about two weeks after insemination.
persists or is accompanied by pain or
cramping, it should be brought to your Although it may be disheartening to
doctor’s attention since this is too early start your period after IUI, IUI is repeat-
for pregnancy symptoms. able and other fertility treatments, such
as in vitro fertilization (IVF), are avail-
Bleeding About a Week able.
After the IUI Procedure
www.azarh.com/
If the IUI procedure is successful and

CHANUKAH 5782 | SHAAREI TIKVAH 89

| MEDICAL • BY: LAUREN CAHOON ROBERTS

Dr. Paula Cohen and colleagues embark
on multi-institutional NIH grant to
analyze sperm development

90 SHAAREI TIKVAH | CHANUKAH 5782

Male infertility is on the for this is poorly understood, “This prestigious new NIH
rise, with significant declines and scientists suspect Center grant is a tremendous
in sperm quantity and quality spermatogenesis, the process accomplishment for Dr. Cohen
occurring across the human of how sperm develops, is a and the entire interdisciplinary
population worldwide in the crucial piece in this puzzle. research team she has
past two decades. The reason assembled,” says Dr. Robert
Dr. Paula Cohen, professor Weiss, associate dean for
of genetics at the College of research and graduate
Veterinary Medicine (CVM) education. “The newly funded
and associate vice provost research builds on decades
for life sciences at Cornell, is of cutting-edge reproductive
leading the effort to solve this science at Cornell as well
puzzle. Thanks to a multi- as Dr. Cohen's leadership of
center, $8M+ grant from the the highly successful Center
NIH National Institute of Child for Reproductive Genomics
Health & Human Development, on campus. The new award
Cohen and her collaborators from the NIH will support
will untangle the complex several exciting basic and
genetic rulebook for making clinical research projects
sperm, while also looking for that hold tremendous
hidden causes of infertility promise for advancing human
related to spermatogenesis. reproductive health and
Cohen is uniquely positioned powerfully synergize with
to tackle these questions Cornell's radical collaboration
— as director of the Cornell initiative in genome biology."
Reproductive Sciences
Center (formerly the Center RNA Regulation
for Reproductive Genomics),
she unites Cornell’s scientific Dr. Paula Cohen, Dr. Charles
experts on reproductive health Danko, and Robert N. Noyce,
and fertility and emphasizes Associate Professor in Life
the genetic and epigenetic Science and Technology,
mechanisms that lead to head up the first portion of
healthy egg and sperm cell the grant, which is aimed
production. Together with at understanding how
her colleagues at Cornell RNA is regulated during
and beyond, this grant will spermatogenesis — how
tackle the questions of certain RNAs are made at
spermatogenesis in three certain times, and what might
phases, plus involves an happen if they aren’t created
educational outreach portion. in the right order, or at all.

CHANUKAH 5782 | SHAAREI TIKVAH 91

“Spermatogenesis is an “Everything the mystery, Dr. John Schimenti,
amazing process,” says Cohen. we do here professor of genetics, and Dr.
“There are so many steps the cell adds to our Andrew Grimson, associate
needs to go through, and each arsenal to professor of molecular biology
step has a very different genetic help patients and genetics at the College of
program.” trying to have Agriculture and Life Sciences, will
a baby,” says be collaborating to unravel these
Because sperm cells have so questions.
much genetic action happening in Cohen.
such a short period of time, they Specifically, they’ll be looking
make the perfect test subject to at a mysterious portion of
better understand how RNA is messenger RNA (mRNA) known
regulated in general. “In terms as the three-prime untranslated
of regulation, what a sperm cell region, or 3’-UTR in science speak
goes through is phenomenal,” — a “tail” at the end of the mRNA
says Cohen. “If we want to strand that was long considered

understand these processes to transcription. to be “junk” RNA. Studies have
better, the sperm is a really now established this to be far
fascinating system to use.” “My lab studies transcriptional from the truth — with the 3’-
regulation and genomics,” says UTR suspected to be the mRNA’s
Specifically, Cohen and Danko Danko. “Both disciplines are instruction manual. Scientists
will look at bromodomain- necessary to understand what have already found that sperm
containing proteins which happens during the tremendous cells have a lot of variation in the
regulate gene expression by amount of chromatin compaction length of their 3’-UTR tails, but
controlling the rate that DNA that occurs in sperm — how this no one knows exactly why this
is transcribed into RNA. This is process is coordinated provides variation exists. “There is some
done by either compacting or a fascinating window into evidence that 3’-UTR length can
loosening chromatin, the protein transcriptional control.” affect infertility,'' says Cohen.
strands that form up the double
helix structure of DNA. When Investigating “Junk” RNA Schimenti is an expert in
chromatin is compact, genes reproductive genetics and using
are prevented from getting Once RNAs are made in the genetically engineered mice to
translated into protein. When it’s sperm cell, there’s still the determine effects of human DNA
loose, those genes become open matter of how they behave and variants upon fertility, while
where they go. For this part of

92 SHAAREI TIKVAH | CHANUKAH 5782

Grimson is an expert on post- The reason for the decline
transcriptional gene regulation. is poorly understood,
Dr. Kathleen Hwang, the urologist and scientists suspect
at the University of Pittsburgh, spermatogenesis, the
will provide samples from fertile process of how sperm
and infertile men. These sperm develops, is a crucial piece
will be sequenced and examined in this puzzle.
by Schimenti and Grimson
to determine if there are any
patterns within the 3’-UTR tails
that might be associated with
infertility.

“We know that untranslated
sequences of mRNAs have
important roles, but nobody has

ever addressed the relationship is an expert in the very new field With this goal in mind,
of variants in these sequences to of epitranscriptomics, a branch Jaffrey will be looking at
infertility before,” says Schimenti. of epigenetics that looks at the epitranscriptome modifications
“I am excited about working with modifications that can impact of mRNA to see how they impact
my colleagues, which together, RNA and how it functions. the mRNA’s 3’-UTR tails.
provide complementary expertise Different proteins monitor these
to tackle the problem.” modifications — “readers, writers Ultimately, when the grant
and erasers,” Cohen calls them. concludes, Cohen and her
Monitoring RNA Modifications “This opens up a massive can of colleagues will have uncovered
worms,” she says. “If you alter new insights to sperm
With Schimenti, Grimson, these reader, writer and eraser development — which will in
and Hwang helping to identify proteins in the RNA, they can turn shed light on many crucial
possible 3’-UTR defects, an all result in infertility in mice problems, including infertility and
additional branch of the grant — and are really important for IVF. “Everything we do here adds
will look at what might be the spermatogenesis. In the future, to our arsenal to help patients
cause of those defects. This if we knew there were certain trying to have a baby,” says
project is headed up by Dr. RNA modifications that caused Cohen.
Samie Jaffrey, Greenberg-Starr infertility in men, we could
Professor of pharmacology at screen for them.”
Weill Cornell Medicine. Jaffrey

CHANUKAH 5782 | SHAAREI TIKVAH 93

| HUMOR • BY: ROCHEL LEVINE

When Chanukah comes near, every periodical and weekly magazine is
chock full of party themes and ideas. And all I keep thinking is: Hey, how
about a real-deal IF-themed party? Oh, Heaven knows we deserve one for
putting up with all the Chanukah shtick and myriads of awkward parties.
So I decided to plan just that. You can implement some of these ideas — or
use your own. Just make sure to let the rest of us know if you have any

other great brainstorms. And of course, you are invited!
All items are available on Amazon. Since we get our fair share of waiting,

I’m not going to make you wait more than two days for your deliveries.

94 SHAAREI TIKVAH | CHANUKAH 5782

→ THE DECOR Or, Just Paint the Town Red

No-Baby Blues With Now, some of you might
a Silver Lining rather want to go with
a splashy red decor.
Well, step number one is the color theme, of course. For those times we see
I chose to go with blue and silver, as a nod to the no- red, both figuratively
baby blues I’m swathed in and the silver linings all and literally, and for all
those people expect I find in that blueness! those bloodletting we
Or better yet, like the card my friend sent me that so graciously extend our
read: “Well, they say every cloud has a silver lining, arms for.
so I’ll cash in mine and exchange it for money.”
Because, oh, yes, man, we can use some cash! So if that’s more your type — there are plenty of
Oh, but to be perfectly honest, maybe I just chose options for you, like
blue and silver because, frankly, that’s the easiest this really pretty set!
Chanukah paper goods to find.
And you can rev up the
\ fun by throwing in a
few of these too.

Whoppers of Table Toppers

Here are some lovely additions to the table.

First are these seriously awesome plates. So what if
they look like petri dishes — that’s exactly the point!

The biggest usable ones I
found are almost 6 inches
in diameter, so they make
a perfect salad plate. (A
little eeuwy, I know… but
so worth it to make us feel
right at home.)

CHANUKAH 5782 | SHAAREI TIKVAH 95

There are just too many awesome
mugs and tumblers to go around
to stick to a uniform look. So instead,
I’ll just place a random mug for each
attendee — and then we can have fun
assigning them to the people who match
them. Or we can have each person sit
down near the one they identify with
most. Curious, where would you sit?

Say It
With
Signs

We’ll have plenty of
these thrown about
so you know exactly
what you’re up against
at this groundbreaking
IF Chanukah party.

96 SHAAREI TIKVAH | CHANUKAH 5782

→ The Food The Sushi Station

The Chocolate Station A sushi board — raw fish allowed (even though I really
don’t like that) — because no one will DARE show up
Yeah, don’t worry, I did not forget about this one! pregnant!

Except for the many, many chocolate options we’ll The PCOS and Other Diets Station
have (with doggie bags available, because I totally
understand that you all must take home some for This will be a selection of foods without sugar and
emergencies) there will also be an array of these without oil.
awesome chocolate bars!
What am I talking about? This doesn’t even feel
SEVEN DAYS My soul’s like Chanukah. We’re going to load this station with
had doughnuts and latkes, calories on us!
without chocolate enough
chicken Tell your nutritionist to take some Chanukah vacation.
MAKES ONE WEAK. soup. She deserves it!
Now it
There is nothing better wants Cheese Boards
than a friend, unless it is chocolate.
a friend with chocolate. I’m including these not because I like all these fancy
Chocolate six-hour cheeses or even the smell of them. And you
yIfoluifleegmivoenss, is natures know what, it even put Eliporni to sleep, and believe me,
hand them back. I’m tired enough without these sleeping aids. But I just
You deserve chocolate! way of can’t pass up on a really amazing “The Cheese Stays
Alone” theme.
Chocolate is cheaper making
than therapy — up for You’re invited to partake if you, like me, are constantly
Mondays. being left behind — by sisters, neighbors, friends, and
and you don’t need even IFers! — who scoot on to parenthood, and… the
an appointment. Chocolate cheese stays alone. With us for company, of course.
says I’m
Research tells us that sorry so → The Program

fourteen out much better Games and Giggles
of any ten than words.
individuals Pin the…
Neh, we don’t pin the flame
like chocolate. on the menorah or the tail
on the donkey, here we…
Failure wouldn’t pin the sperm onto the egg,
be so hard to blindfolded, of course.
take if it were
Were you ever wondering
chocolate-covered. how the lab technicians
feel about your stubborn
specimens? Well, perhaps
now you will.

CHANUKAH 5782 | SHAAREI TIKVAH 97

Shames to Shames This journal is a great outlet for dealing with bad
news or just the appearance of Aunt Flo, even when
Everyone writes their most embarrassing IF expected.
encounter, and then we play Apple to Apples, with
each player selecting the most dreadful situation, Sample pages:
until a winner is determined. The winner gets a mask
behind which to hide!

Tunnel Vision

Blindfold the eyes in a manner that the person can
only look downward. Now, ready, set, go: Don’t look
up! Identify people by looking at their stomachs
only. Too hard of a challenge? Some people out there
manage to do that, so it must be possible!

An Awesome Auction

Do you know the game where people earn points
based on their answers to questions and then use
their accumulated points to bid for prizes?

Here, every participant brings along their sharps
containers with all their used syringes, and every
syringe is a point toward the auction. With these
points they can bid for prizes.

Some awesome prizes prepared:

I’ll wrap this in a big box. Throw in two or three to up
the excitement.

This relaxing windshield shade can be put up in a
jiffy so you can give yourself that injection without
anyone being the wiser on your way to work.

98 SHAAREI TIKVAH | CHANUKAH 5782

Ooh, I’m sure Baking Bonanza
you can use
one of these. What’s a Chanukah party without some
(If only it doughnut decorating? And what’s an Infertility party
were that without doughnut-decorating with syringes?
simple…)
Every participant will receive prefilled (new, don’t
worry!) syringes with fillings like custard, chocolate
cream and jelly, and you get to make your own filled
doughnuts.

Because we Because well… tissues.
can all use And you know… issues.
these!
But we won’t end there. We’ll be decorating these
adorable syringe cookies too. Icing-filled syringes do
the trick here too!
I know this is kind of
typical, but to be honest,
I found amazing egg and
sperm cookie cutters on
Amazon but my friend
warned me I shouldn’t
dare! So I didn’t.

I hope you have a
wonderful Chanukah!

THE BEST WAY TO CHEER YOURSELF UP IS TO TRY
TO CHEER SOMEBODY ELSE UP. - MARK TWAIN

CHANUKAH 5782 | SHAAREI TIKVAH 99

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100 SHAAREI TIKVAH | CHANUKAH 5782