#202 – Conceiving Hope: Navigating the Emotional and Financial Challenges of Fertility Treatments with Abbe Feder

Welcome to the Money boss podcast. I'm your host Anna Sergunina. And today we're joined by Abbe Feder, founder of InCircle fertility, and we're discussing the emotional and financial challenges families are facing when they're going through fertility treatments. First of all, Abbe, welcome to the show.

Thank you. I'm so happy to be here we connected and it was like, instant, when can we do this? And I'm just happy we made it happen.

I know, right? It's like, this is a conversation I personally should have had on the show many, many episodes ago. But um, I am excited because I found the right person. So it'll Yeah, let's dive on in. Great. I think it would be really helpful for my listeners, because I think the minute somebody hears word fertility or infertility or you know, challenges with starting a family, maybe this is personal perception, but you kind of tend to sort of get a get quiet and see what you know, check the room and see what everybody else is doing or saying, what's the body language, but I kind of want to have an honest conversation here. So maybe it will help if you share your personal journey a little bit and, and how you actually came to do what you're doing today.

I would love to so I think you're absolutely right. I think so much of the response we have as humans, when we hear the word fertility or infertility is actually about our own discomfort with feeling dis or feeling uncomfortable. So when someone tells you perhaps that they're suffering, or there's that awkward Wait, how long have you been married? And then people you can see them doing the math in their head like, Oh, I wonder if they want kids? Oh, it's been so long, right? It's, it's less about the person going through it as the infertile person and more about the other person feeling a little bit uncomfortable, because it is such a delicate topic. So when I started my journey, which was honestly 11 years ago, right now, I did not want to talk about it with anybody because I still wanted to be able to surprise people and say we're pregnant. And that's something that you sort of lose along the way. I went through infertility treatment for six years, not six years straight, there were definitely times that I needed a mental health break. But I just couldn't believe it was my story. You know, when when we didn't get pregnant on the first try. I was shocked. Because you know, we all think, as we all do, we learn in sex for lucky. You know, you've it's so easy to get pregnant. We didn't get pregnant the first time I just remember my husband was like, Okay, well here starts our journey. And we had had friends that had gone through it. And I just remember thinking, I'm so grateful, this isn't going to be us, because nobody thinks it's gonna be them. Right. And we were healthy. And like, I always thought it took care of my body. I feel like girlfriends I had that were way less careful with their body and choices. And they had no problem getting pregnant. So why was this happening to us? And about three years in is when we kicked it into overdrive and went for a lot of medical treatment. And we can get more into it. But the long story short version is that we did four IUI guys, and including egg retrievals and transfers, which is when they transfer an embryo and we did 12 cycles of IVF we're probably certifiably crazy, but if we weren't certifiably crazy, we would not have gotten to the other side, which is where we are now with our twin four year olds. And when I did emerge on the other side, I felt this very strong calling to be able to help others go through it and to learn from not just my mistakes, but to navigate the steps that sometimes take forever to sort of speed things up, make the most of your time and money along the way. And because we're racing, we're all racing the clock on this journey. So that's why I found it in circle fertility.

I think it's a such an awesome service and offering that you have because you know, as you alluded to your own journey, it could take forever and I think it's just I haven't I haven't been there myself. I didn't know where to start and feeling like some of this Shame, shame, guilt. I mean, there's all kinds of feelings that come with it right? And know where to go and no one to ask questions, right? Yes, there's doctors that do all those things. But even with that, I had to go through three doctors until there was one that really helped and was successful, right so like It's a such a wild wild west to were to begin having silently

How I say it is Wild Wild West. Exactly.

Okay. All right. So still, it's still that. Yeah. Having someone to hold your hand along your this journey, you know, wherever you are is so, so amazing. Can you talk a little bit about the emotional toll that this can take on, you know, on anyone, whether you're the one going through the actual treatment, or you're the spouse or the partner? Because you know, or maybe you're, you know, just embarking on this on your own, I felt like that was a steal, I think is probably the most difficult part of the sync.

You're so right. I think you're so right. So included in the emotional toll is a lot of waiting, which, when you set out to build your family and have a timeline that you think you're going to be following, right, I want my first kid at this age, and my second kid at that age, and my husband will be right. That is a very hard timeline to release, especially as women and I don't want to over generalize, but so many little girls grow up thinking about when they're going to become a mom, and some don't. And that's great, too, but so many do. So when they finally get married, if that's the traditional path you're taking, or again, like, you know, I think about single moms by choice who I coached many of them and they're so incredible. They're like, look, did I wish that maybe I weren't a single mom by choice, yeah. But now I have the ability to take this into my control and move forward. Right? So then once you've made that decision, and you go down this road, and you actually realize how much waiting there is, or, you know, a cycle doesn't work, and you thought it was going to or you're ready to move forward with treatment, and the doctor finds a cyst, and you have to give it another 30 days, whatever it is like releasing that timeline, I think is a huge piece of the emotional toll. And I think that women process that timeline a lot different than men. I find, at least in my coaching of couples, like the the guy is 10. And again, these are all over generalizations. Every case is different. But the men don't understand that the women are like, I want this to happen yesterday. And so also that lack of understanding can start to affect the relationship which continues to contribute to the emotional toll that it's taking. And also, like you said, there is shame there shame at your body that it might not be doing what it's supposed to do. I kept feeling like I said earlier, how is this possibly our story? How is this possibly our story? And I do believe in God and universe and I'm a very spiritual person. And I was like, why would I be tested like this? So I really got more angry and resentful. A lot of women get more like you said, feel guilt and shame about their body, perhaps about the relationship, where if the diagnosis is on the female in a in a heterosexual partnership, they feel so guilty that they got into this relationship with a man who could have had potentially children with somebody else. Similarly, I've seen many men who have male factor infertility feel like, why didn't I test so that you knew what you were getting into? In case you know, and it's like, you really have to commit to being on this journey together, for better or worse, as cliche as it might sound because it's no one's fault, you're in it together. And if you both want the same outcome, you know, you just have to try to remember that. And I know that's easier said than done.

No, definitely. And it's also like, when you look at our society today, women right choose to have kids maybe a little bit later in their life. Yeah, it's not as our you know, our parents generation or even our grandparents. So knowing that right and there's lots of conversations on this topic because maybe even want to have a career or maybe you want to start a business right and so you kind of you know, generally push the childbearing you know, time into the later part of your gear, your, you know, young hood, when you're like in your 30s Right. And so, there's lots of conversation around like, Okay, is it too late to have a baby? Is this when you're, like, get into trouble? So like, how do we like begin this conversation sooner with those who are thinking like, Okay, I don't want to have kids intentionally right, which was my case, like I you know, I did not have a specific date. My husband, I got married, we were very young, we were 22 year olds, and I didn't want to have kids then. So it was like, okay, it will just happen when it will happen, right? But then once I turned 30 is like Well, it hasn't happened yet. So some something needs to you know, to change. So like how do we start to educate public right and everyone around it isn't just for the people that are going through this or will want to go through it but everyone like, because you know, those questions? They come to you all the time. What are you gonna have kids? Yeah, aren't you working too hard? Like, right? Like, let's break let's Spray some of that because it's it's, it's needed so much,

Right. Well, I think exactly. You're exactly right. Our generation. Our as women, we saw maybe our parents generation or our grandparents generation, like my parents generation, ever, all my girlfriend's parents were divorced. So everyone got married young, because that's what their parents did. Then they realized, you're, you're an exception to the rule, like my parents got married, my mom was 20. And she realized, Oh, this is not, this is not what I was meant to do. And so they got divorced. And so my generation saw these relationships crumble all around them, mothers who maybe didn't pursue careers because they were having kids so young. And I think that one of the things we learned from that generation is that maybe we can push to have it all right, like, we should pursue happiness in the form of career and family and not make it one or the other. And I do believe that with some tweaks in our social standards, like you're suggesting we can have it all, we just have to plan ahead. So in my dream world, you know, your OBGYN your regular gynecology appointment would start the approach talking about egg freezing. Now, look, egg freezing is not 100% guarantee. But it offers a little bit of support and insurance and time for you to figure out what you might want. I jokingly say after everything that I went through, like for my daughter's 25th birthday, we're gonna get her eggs frozen. And, and part of the reason and part of the way that that conversation continues to happen publicly is by people coming on podcasts and talking about it. And when celebrities speak up about going through IVF treatment or freezing their eggs. Also, more and more companies are taking on fertility benefits as part of their insurance packages, which sometimes includes egg freezing. So if you've gone the career route, and you're at this, you know, high profile company, hopefully they're going to have a great benefits package that will include fertility treatment, and your you can think like, oh, I never thought to freeze my eggs. But now this is being presented to me, and maybe I should take advantage of it. So it's a slow process. But I can even say within the six years, I'm sorry, the four years since I finished my treatment and had my kids, I feel like we've already grown leaps and bounds like exponentially. So if in the next four years, we grow at the same rate, I think we're making pretty good progress.

I agree. And the medicine is there that technology exists. I mean, we were just chatting before the actual recording happened about the the AI and all of that, you know, it's happening a fourth AI probably wouldn't help you with your fertility. Journey. Oh, no, no,

I'm sad that you knows.

You know, the world is a crazy place. Yeah, maybe we can cover this a little bit not to get into the weeds, because everybody's journey is different as what you have to do, but maybe just in general terms, that, you know, if someone is has hasn't really started, or doesn't even know, they need to, you know, maybe just, you know, explore and research this, like, what does it entail? Like how long might it take for even just get some ideas, maybe even if you have any latest costs and things? Sure that would be also helpful?

Sure. So it really depends on if you're B if you get a diagnosis or not. In my case, we had unexplained infertility, which in some ways is great, because there's nothing that they've had can find that's wrong with you. And in some ways, it's the most frustrating because there's also no way to figure out how to treat it. So if you're in that sort of situation, and you're young and you're healthy, you know you'll start with some basic bloodwork. And you can do this with your gynecologist or you can immediately go to a fertility doctor, I tend to think everything takes longer than you want it to. So I would empower you to go to the fertility doctor sooner rather than later no matter what. But if for some reason you don't want to or you can't, you can get your sort of basic fertility workup done with your regular OBGYN and what they test for are two main things which is a MH which is your basically your quantity of follicles. Again, it's not 100% guarantee of anything but it helps understand like, Is yours generally low? Is it high? What's going on inside your body, they can do an ultrasound and see all those follicles and just to be clear follicles turn into eggs which turn into embryos. And they'll test your FSH or follicle stimulating hormone which says like, is everything between your hormonal regulatory system communicating properly so that your brain is stimulating your body to ovulate at the right time, right? Like maybe there's something going on there. And if they can't really find anything wrong, usually they start with something called IUI which is intrauterine insemination. They start there because it's much less expensive and much less invasive. Some people call it the turkey Baker baster method. Basically what you do is sometimes it's with medication and sometimes it's not but you Make sure that you Sorry, you make sure that you are ovulating. And you time a shot that you take, you take that shot it has you ovulate it and exact moment you go into a doctor, and they inseminate you with a production is what it's called, like the sperm, basically, that has been washed. So they take the strongest ones from the wash, and seven ate them at the exact time that you've scheduled your eggs to release. And that way you can guarantee you're nailing the time. Now, in my opinion, you should if you have unexplained infertility, you shouldn't do that more than twice. I just think it's it's much less expensive than IVF, much less. I mean, we're talking like $1,500 versus $20,000. So I understand that some people like to do it over and over because they think it'll help but your chances don't really go up very much, because there's still so many unknown. So all we know by doing an IUI is that we've timed it correctly. We don't know if that sperm is hitting is fertilizing, we don't know if the egg is turning into an embryo if it's growing. We don't know just because you timed the ovulation correctly, we don't know that it for sure happened at the right time. We don't know if there are genetic abnormalities. So there's still a lot of unknowns, which is why it's a little less expensive. Ultimately, once you move forward to IVF. If that's the route that you go down, you get a lot more information. So you stimulate your body for several weeks, that stimulation produces multiple follicles, which turn into multiple eggs. So you try to get a lot of eggs at once, instead of just that one that you normally ovulate, then they take them out of your body and fertilize them outside of your body with the sperm. And they can see is the sperm penetrating the egg? Is it creating the right number of cells? Are you making embryos, et cetera, et cetera, et cetera, all the millions of things that need to line up perfectly in order to become pregnant with a viable embryo. So that's why the price is so much higher, you're involving a whole set of surgical team and an embryologist and all these other people. And it's still not a guarantee, you could do a round of IVF and still get no results, you could get results where you get no embryos, you could get results where you get embryos and put them back inside and then that doesn't take so the stakes are so high and the expense is so great. And it's still just a shot in the dark. Now,

That's I think that's the unfortunate part. But there's, there's definitely hope. Yes, there is hope. So. Yeah, that's why I mentioned or kind of started with this, like, the emotional side of of how, you know, how do you deal with this? How do you like navigate because the feelings come up. And it's just hard. It's just playing hard. Like, I don't sugarcoat it, because it is really that. But it is so rewarding, right? Once you go through it, and it's a success. So like, how, like what resources exists out there like for for families thinking about this? Obviously, they can reach out and speak to someone like you. What else is there?

Yeah, so there are so many wonderful resources now that were not available when most people went through it, because a lot of them are new resources. I highly recommend like acupuncture. I think that people should take a slew of supplements. And there are all kinds of really wonderful supplement companies out there that target fertility specifically, and then pregnancy and then motherhood, which I think it is important to go down one of those routes instead of a generic, you know, multivitamin. I think therapy is wonderful if you can do it. I don't think it's the be all end all. Like I don't think it's the only way to process your emotions. Because if your therapist hasn't really been through infertility, they might be super supportive and a beautiful, safe space for you to talk and share your feelings but they don't fully understand what you're going through. And I think that's the most important part of many things, many emotional obstacles is that having somebody hold your hand through it that's been there that really understands what you're going through, I think is so crucial. And, look, I always say it takes it we all know it takes a village to raise a baby and I truly believe it takes a village to make a baby and that a lot of women don't want to give themselves the time for self care until baby gets here. It's like once the baby's here they feel like it's an acceptable time to spend time and resources and money on a doula or a sleep trainer or, you know, a prenatal massage when you're pregnant. But like if you are struggling to get to the point of pregnancy invest in getting yourself there with the least amount of time the least amount of money and the least amount of emotional turmoil that you possibly can.

I like I liked the latter comment very much because you're right. I mean, you're, you're sort of kind of all of these things are like, Oh, now I need to do self care. Once you have your child and you're like, stressed out and tired, and it's a good way, right? So, so investing initially not I remember, even, you know, talking to folks like nutritionists, right? Or, or there's, there's a specific term for for those who like, kind of look at your, at you holistically and hormone

Like an integrative medicine. Yes. Functional. Medicine. Yes. Yes. Functional. Yeah. So, um, so yeah.

Which is there. I mean, aside from fertility, it's, I mean, it's something that I personally still very much, you know, geek out on, because there's, there's life after that. Yeah. And I love all of those pieces, because it looks at you as a person and as a whole. And there's challenges not just for fertility arena, but anywhere else, you kind of start to treat, you know, those challenges at the core exam versus like trying to address them, like, you know, put the bandaid on it.

So, at that point, it's like to one of your points earlier, when you're asking what can we do? We never know what we never know. So we might not know that there's an issue until it's two years after trying to have a baby, right? You started at 35. And now you're 37. And then they're like, oh, you should go to a functional medicine doctor. And then all of a sudden, you learn that, like your gut health has been off for years, and it might take you another year to get it back on track. Whereas if you knew that ahead of time, you could plan so that you don't feel like this process is dumping Shi T on you or my lads occurs, dumping shit on you, but like you're actually taking control of the process and making the most of your time body and money. You know?

Yes, I agree. I feel like and you know, my mission has been for for for for a long time is to help families get especially like younger families that are getting started getting married, buying their first home having first shot this like to get a really good grip on their personal finances. I feel like this topic, right of family planning should be like really addressed. You look much deeper, not just like, you'll happen one day, and that one day, maybe decades later.

Well, you're right. It's like we you were just saying, you know, once you have children, everyone's like, Okay, you need to fill out, you know, a trust for your kid. And you need to fill out this paperwork and nap to make sure everything's taken care of. But like, why didn't you? What if you didn't plan, like we did not plan to spend over $100,000 on fertility treatments that we didn't have, and we're still paying off. So it is important like as, again, as we continue to talk more publicly about this for couples to start having those conversations, when they talk about family planning before the they're married or partnered, or whatever they may be, you know?

Yeah, I'm determined, I'm gonna have that a line item on my agenda lists to like, really address. And again, also, it's like, it's a such a sensitive topic that you can just like, hey, well, you know, what, when are you going to do it kind of question and it's right. It's hard. Right? Right. Right. We'll get them comfortable. But at least I want to raise the issue. Yeah. Because it could be it could be a lot easier if you start earlier. So I know you have a lot of resources that you've collected to your clients. But I'd love for you to share with our listeners, like, you know, what are those like, helpful books, podcasts and other things? I'm sure I can't think of them right now.

And there are so many out there. So if you go to my website, which is inCircle fertility.com, there is a whole Resources tab. On that tab, I include podcasts books, I think I am making a Spotify playlist of supportive IVF songs. Just small ways after having been through it that can help you along the journey. I think podcasts are so important for this space because hearing what people have gone through is so incredibly helpful. I do a section on my blog called in the circle where we feature one story of somebody that went through something, whether it be embryo donation or surrogacy, I mean, you name it, you know, people who did fertility preservation after a cancer diagnosis, so many reasons to use fertility treatment. Also, we have like on my own one of my own products is infertility cards of affirmation. So when I was going through it, and especially when I went through miscarriage, no one knew the right thing to say or the right thing to do. People would be like, do I buy you flowers? Or does that feel like a funeral? Do I mention it or do I ignore it? And so I created these cards, which I worked on with an artist who creates all of her art from sterile IVF needles. So it's really they're really beautiful. And for example, like if you want to get a deck for somebody that you know who's going through it or a deck for yourself, we even include like things that you can say to the person because so many people was like, I don't know how to approach this topic. So we say like, I believe honesty is always the best policy. So not you might as well say like, I don't know the right thing to tell you. But I saw these cards and I thought of you and I want to send you some love. Do you know how meaningful that is to somebody, it just makes you feel so seen, which when you're in isolation, dealing with pregnancy loss or infertility, you don't feel seen, you don't feel heard? You don't want to talk about it. You don't want to put your stuff on to everybody else. And also, you need to tell it's like such a mess in your mind. And so I really tried to think about all the resources that can combat that piece of it.

Oh, this is so awesome. I am definitely one deck in order.

I'll send you a deck. Yeah, yeah, I

have somebody who's going is going through that. And, and I actually I wanted to reach out to her, but I hesitated because I'm like, I don't know why. But I don't know. Like, maybe it's not, you know, right time, because something is going on. So what do you say? It's like soft cost. But it's this is a great reminder that maybe something like that. It's just, it's just as good of as asking how are you doing it? Because I don't want to say like, work

totally. But if you know she's going through it, like you do, you can even just like I said, honesty being the best policy. Hey, last time I talked, you are going through this, you don't have to update me in any way, shape, or form. But just know that I'm here to listen, if you want the space, and I think that's so big, you know,

that's awesome. I'm gonna do that. Also Carlson recording. I love it. This is so awesome. Okay, I also want to, I want you to talk a little bit about your podcast, because there's more comfort like, right, there's a right now we're just summarizing things. So what is your podcast all of us.

So my podcast just released. It's called the fertility check. And what I really find striking about infertility is a lot of times we've learned that people went through it, and we're like, what they were going through it while they were a news anchor on television, I can't believe that. And so all of these stories of what we as women are portraying on the outside, and what's going on, on the inside really interests me. So it's like badass women who have great, interesting and inspiring career moments who also either a worker or are going through fertility treatment of some kind. And I think again, sharing those stories is the best way to continue to get the word out there.

Yes, I agree. Because there's probably probably somebody who's just maybe afraid to take the first step right and inspiring someone, because you share your story is, is is worth more than you can actually put a price on it. So I'm Yes, I'm doing and very, very, very much interested to please. Yeah. And congratulations. I know, it's a lot of work to launch a podcast, so almost 200 episodes over here.

I know I've been going at it a little a little slow. But yes, I love it. It's it's a great platform to have these kinds of conversations, right? So if I didn't keep going, and this is a reminder for anyone, like not just about starting a podcast, even on the topic of fertility of fertility, like if I didn't keep going on the podcast, I would have never had an opportunity to connect with you. So it's like one step in front of the other is all UK do. So how can our listeners connect with you anywhere social media online?

Yes. So my website again, is encircle fertility. You can email me via that website. Or if you are looking for support on your fertility journey, you can grab a free 30 minute support session, see if we're a fit to work together. I'm also a big fan of Instagram, you can find me at Abbey feeder. It's weird ABB e, f ed are just DME slide into my DMs, I always check them. And I'm always happy to talk with anybody about any of this.

Awesome, thank you so much any last minute, were different.

I will say one thing that you just sparked in me when you said one foot in front of the other, which is that there's the Steven Jobs quote that I think is so great that I don't know the exact quote, but you can only connect the dots looking backwards. So Hindsight is kind of like Hindsight is 2020. And so, really what I saw much of my hindsight, what I would have could have should have done differently is the reason that I do my work now so that you don't have to connect the dots only looking backwards but that you can feel empowered to actually create the line of dots moving forward.

That is that is very powerful. Thank you.

Thank you. Thank you for having me. It was a blast.