Eggs Over Easy: Black Women & Fertility

A couple of years ago, during my annual exam, my gynecologist looked at my chart, smiled and said, “You have a birthday coming up. Your eggs are turning 40! Do you want to do anything with them? It’s not too late for you to have a baby, but we’d need to start now.” That one jarring question became the catalyst for Eggs Over Easy: Black Women & Fertility, a documentary that focuses on Black Women, our fertility options, and the reasons we don’t talk about it. 

It is heartbreaking to know that for most women who suffer from infertility, the choice to carry a child is virtually non-existent if they don’t have a six-figure income because insurance companies don’t provide coverage for infertility treatment. So, instead of being able to pursue the traditional routes towards motherhood, these women stay silent… and take care of nieces or nephews or cousins whose own parents can’t take care of them. This is such an interwoven concept in our community that we rarely even look at it as “adoption”, even though it is.

The actual act of having IVF (in vitro fertilization) and Oocyte Cryopreservation (Egg Freezing) isn’t as “taboo” as discussing it is. In the Black community, we tend not to talk about fertility. Period. Since slavery, there’s been an idea that Black women are naturally fertile. The price of a woman of childbearing age was more than that of a woman post-menopause on the auction block. So, of course, there are 400-year-old stigmas attached to our fertility in the US but also in our own community. These deeply rooted notions keep mothers and aunts from talking to their daughters about fertility issues like Fibroids, which affect 80% of Black women by age 50. 

So, we don’t talk about fertility. In addition to the historical implications of fertility conversations, there is also another, bigger elephant in the room: Costs. Infertility treatments are not covered by most insurance companies, unless a company requires a fertility rider for their respective staffs. This means that the average middle class woman can’t afford a $20k IVF cycle, which may or may not require multiple cycles to achieve a successful pregnancy. This means that the average woman doesn’t have an extra $15k to freeze her eggs. And by the time she reaches a salary level that can support the weight of these out-of-pocket costs, she’s late 30s or early 40s, which greatly diminishes her chances at a successful process because of the dramatic drop in egg reserves after age 35. [The suggested age for Egg Freezing is before 36]. These costs affect women of every race, but when compounded by the fact that Black women earn 61 cents for every dollar earned by white men, the goal of motherhood seems all the more difficult.     

There is a range of available fertility treatments for a range of medical conditions. IVF is a process whereby an egg is removed from a woman’s body and turned into an embryo using sperm taken from a man’s body. There are less invasive processes, like IUI and Clomid pills for women who don’t need advanced treatment to conceive. Egg Freezing is the recommendation for women who aren’t at a place in their lives where they are ready to have a baby, but still want to be able to conceive when the time is right—even if that time is later in life. For Black women who are climbing the ladder in their careers or waiting later for marriage, this is a viable option—if they can afford it.

And for women who are fortunate enough to be able to afford infertility treatments like Surrogacy, IVF or Egg Freezing, they are then met with almost complete erasure from medical offices that have few patients who look like them and even lesser representation in brochures or commercials. The thought is that black women don’t have fertility problems, so we’re marginalized and rarely given a second thought within the reproductive industry.

Over the course of this past year, I have spoken with women who have experienced the full range of fertility challenges. Did you know that women who are childfree by choice have some of the most agonizing conversations with their own mothers who want to see them birth a child? It takes courage to be childfree these days. Did you know that you should never ask a woman whether or not she’s planning to have a baby? You have no idea what her struggle may be. And, it’s none of your business if you aren’t her spouse or physician. The documentary addresses this topic with women who suffered debilitating symptoms from fibroids– including infertility, as well as doctors, both board certified and holistic, on what treatment options work best. One of the more astonishing topics focuses on women who suffer miscarriages and the stigma that causes many of them to suffer alone. They don’t talk about it because, in many cases, they feel ashamed

Great strides have been made in the space of fertility, which is evidenced in so many celebrities bucking the norm and having healthy pregnancies past the age of 40, but the reality for many women without millions in the bank is that the process to motherhood is sometimes a daunting one. 


Take-Away: Don’t wait to have the conversation with your physician about your reproductive options. Ask for a fertility test if you don’t know your numbers. Specifically, ask for an AMH, FSH, and antral follicle (ultrasound) test. These tests are simple blood tests and an ultrasound. This will let you know the state of your egg reserve. Knowing these numbers will help you navigate your priorities in regards to becoming a mother. Also, don’t panic! There are many ways to become a mother, if that’s your desire. You can adopt children. You can also adopt donor eggs and embryos if you want to carry a child. The goal is to be equipped to make decisions about your body, which means that knowledge is power. For any woman over 25 who may one day want to be a mother, be proactive in gaining knowledge so that you can make informed decisions about your future. This means that maybe you choose to work for a company that provides fertility treatments in their insurance plans, instead of a company that doesn’t. “Prepare for your body the same way that you prepare for your career.” (~ Phylicia Fant, Executive Producer Eggs Over Easy Film)

***

About The Author

Chiquita Lockley is producer and director of the forthcoming documentary, Eggs Over Easy: Black Women & Fertility (2020). She is also the producer of the award-winning documentary Kunta Kinteh Island: Coming Home Without Shackles. She holds a BA in English from Spelman College and an MA in Film Studies from Emory University. She currently resides in Atlanta, GA where she continues to give back by serving on the Boards of AIR Serenbe (an artist-in-residency program) and the Black Women Film Network.

You can follow the film’s progress and join the conversation at: www.EggsOverEasyFilm.com, www.facebook.com/eggsovereasyfilm or IG: @EggsOverEasyFilm.

OMG, the Positive Pregnancy Test – What This Doctor Wants You to Know!

When infertile patients, who have been trying for some time, get the positive pregnancy test result, they go through a roller coaster of emotions where their fear of “Will I get pregnant?” quickly turns into “How do I stay pregnant?”. 

These fears and mixed emotions are totally understandable. A lot of infertile patients that get a positive pregnancy test result usually feel anxious about what they can do to help keep the pregnancy. This is why most of these patients often turn to spending hours diving down the internet rabbit hole, researching how they can keep the pregnancy safe. 

Although doing your research and getting yourself educated is great, I really want you to know that it is so much better for you to simply enjoy your victory (it’s a big deal!) and directly ask your doctor questions about how you can keep the pregnancy safe. This way, all the tips are tailored to fit your particular situation and are not based on some generalization that you find on the internet. 

To help ease your mind, let me list the top 10 things that I tell my patients and friends to do, during the first trimester. You can go over these tips with your doctor so that they can help guide you through the things you should and should not be doing. At the end of the day, we all want one thing: for you to get your dream of being a parent! 

  1. You May Not “Feel” Pregnant. This is a fear that some newly pregnant persons can experience and it unnecessarily leads to a lot of stress. Not experiencing major changes in your body or how you feel, overall, is perfectly normal! Not everyone feels a definite change in their body during the first trimester, even if you have been pregnant before. 
  1. Your Appetite. Appetite during pregnancy differs from person to person. Even though many people use the analogy of ‘eating for two’, you definitely do not need to eat more than what you are comfortable with. As a matter of fact, some pregnant persons experience a drop in their appetite, while some others experience early and very specific cravings. 
  1. Minimal Bleeding is Okay. Light to moderate vaginal bleeding is normal. For some women, this is their first sign of pregnancy. So, do not panic if you experience minimal bleeding. However, if you are pregnant and the amount of bleeding is excessive, you should notify your clinic as soon as possible. A general objective rule of thumb: we consider bleeding where you are completely soaking through two normal maxi pads per hour, for greater than 2 hours, as excessive.
  1. Avoid Raw Seafood. During pregnancy, there are some seafood that you have to avoid, even when they are cooked. Eating raw seafood can expose your baby to mercury, harmful bacteria, and parasites. If you regularly eat fish high in mercury, this heavy metal can accumulate in your bloodstream, cross the placenta into the fetus’ own circulatory system and then damage your baby’s developing brain and nervous system.
  1. Take Your Prenatal Vitamins. If you can tolerate it, I suggest you take your prenatal vitamins daily. If you cannot tolerate the vitamins, at least make sure you take folic acid. You need at least 400 micrograms of folic acid per day. However, if you are pregnant with two or more babies (i.e a multiple gestation), or if you have a history of a seizure disorder, or if you have a prior pregnancy, or had a baby that was born with signs of a folate deficiency (e.g a baby born with spina bifida or meningomyelocele), your doctor will want you to be on a higher dose of folate in subsequent pregnancies. So, check with your doctor before choosing between prenatal vitamins or starting higher doses of folic acid.
  1. Stop Herbal and Non-prenatal Supplements. There is not much data available on Herbal supplements and their impact on a pregnancy or the fetus. Therefore, we recommend discontinuing all non-essential herbs, vitamins, and supplements, including CoQ10 and DHEA, during pregnancy. If you are not sure whether your supplement is essential, contact your doctor to confirm, right away.
  1. Continue Taking Your Thyroid, Diabetes, Blood Pressure, Prolactin, or Heart Medicines. Managing these medicines is highly essential for a successful pregnancy. If you have not told your doctor about these medications before, let them know as soon as possible. Patients with poorly controlled thyroid, diabetes, blood pressure or prolactin levels are at increased risk for miscarriages, stillbirth, small (growth restricted babies), certain special birth defects and poor neurological development in the fetuses.
  1. Exercise Heartily. We suggest moderate exercise during pregnancy. However, you should always first verify what type of exercises and the level of intensity you should be doing, with your doctor. For certain underlying medical conditions in the person carrying the pregnancy, your doctor may even recommend against any exercise at all. 
  1. Continue Taking DHA or Fish Oil and Only Consume Pasteurized Milk Products. DHA (Docosahexaenoic acid) or fish oil intake can help prevent preterm labor and delivery, lower the risk of preeclampsia, and may even positively increase the birth weight of your baby. Consuming only pasteurized milk products can help protect you and your baby from harmful bacteria. 
  1. Avoid Hot Tubs or Saunas. It is advisable to avoid hot tubs and saunas because they may cause dehydration, overheating, and even fainting. Exposure to elevated internal body temperatures, like what occurs with soaking in a hot tub or sitting in a sauna for a while, during the first trimester, can also lead to some genetic changes in the developing embryo which, in turn, can result in certain congenital birth defects in your baby. In one study, special heat shock proteins are produced in the fetus as a response to exposure to stressful events such as prolonged high temperatures and these negatively affect your fetus’ development, during the critical period of organ formation and result in anatomical malformation.
  1. Avoid Alcohol and Limit Intake of Drugs like marijuana, cocaine, heroin, other opiates or other chemicals. These substances are known to cause serious malformations in different organs as well as severe mental disability in babies who were exposed to these drugs while they were in the womb.

All these tips that I have listed above are meant to help you keep your pregnancy safe. However, you should still go over them with your doctor so that they can help safely guide you through your pregnancy. It is also important that you do not let your fears interfere with celebrating your pregnancy. Enjoy this joyous moment and make sure to follow your doctor’s instructions, throughout your journey.