Ep 2: Real Talk with Rena Gower and Dara Godfrey
Fertility Foward Episode 2:
Today on the Fertility Forward Podcast, we introduce your hosts Rena and Dara, and they share some background about their own struggles with infertility. Rena Gower is a licensed social worker here at RMA. She is currently a state advocate for RESOLVE: The National Infertility Association where she lobbies for healthcare reform and improved insurance coverage for those needing infertility treatment. Dara Godfrey is a registered dietician at RMA. She supports patients’ nutritional goals at every stage of infertility treatment and pregnancy, including pretreatment health and weight loss, polycystic ovary syndrome (PCOS) and thyroid conditions, as well as pregnancy nutrition during each trimester.
Rena: Hi everyone! We are Rena and Dara and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward podcast brings together advice for medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
Dara: Rena Gower is our licensed social worker here at RMA. She's currently a state advocate for RESOLVE: The National Infertility Organization where she lobbies for health care reform and improved insurance coverage for those needing infertility treatments. Rena also has a three year old daughter from IVF and outside of work is an avid marathon runner and a triathlete.
Rena: Dara Godfrey is our registered dietician here at RMA. She supports patients’ nutritional goals at every stage of infertility treatment in pregnancy, including pretreatment health and weight loss, PCOS and thyroid conditions, as well as pregnancy nutrition during each trimester. Dara has two daughters via IVF, ages seven and nine. Originally from Toronto, Canada, she moved to New York to pursue her career in nutrition alongside her fashion designer husband, Jay Godfrey.
Dara: Today we have a very special episode between myself and Rena and we discussed our personal fertility journey, our struggles, our successes, and much more.
Rena: All right, so today's episode is going to be myself, Rena and Dara. We are going to share our own personal journeys with trying to conceive with our listeners. You know, I think I find a lot of people on a scale of kind of end up in this space because of their own experience. And so, I know both Dara and myself, that's sort of what led us here.
Dara: It did, and I think that's very unique for us, but it does give us a chance to, when we speak with our patients, it's a chance for them to realize that we are on their side as well and we've been on their side before and have that special empathy that I think is quite necessary when working in the field that we both work in. So Rena, I'm going to start with you.
Rena: Way to throw it at me.
Dara: Yeah, I'm super interested. I've worked with you for many years and have heard over the years that you have struggled with fertility, but I want to know specifics. Take me to the beginning, your whole fertility journey.
Rena: Sure. So, you know, I'm very open about it. Um, so I was, you know, I guess what's considered fairly young in the fertility space. When I started pursuing treatment, I was 28 and I,
Dara: Me too.
Rena: Oh yeah, well I think we both have PCOS so I had PCOS, and may or may not have hypothalamic amenorrhea.
Dara: Did you know, were you already diagnosed with PCOS at that time?
Rena: Yes. I knew when I was 18, I went to the gynecologist. She said, “Oh, your tests show, you know, you have PCOS.” Really no other explanation. I said, well, what does that mean. She said, “oh...whatever.” Okay, thanks. You know, I went to college, you know, of course, spent, you know, those years trying not to get pregnant.
Dara: Did they put you on oral contraceptives when you were diagnosed?
Rena: You know, I had been all contraceptives because I’ve never really had a regular period. You know, I've always been an athlete and on the thinner side, so I never really operated regularly. So I've been on the birth control pill or some form of birth control since I was maybe 13-14 years old just to regulate my ovulation. Is that the experience you had also?
Dara: Yes. And I know - the reason why I asked is often patients with PCOS that is often the first line. Okay. You're diagnosed with PCOS, your periods are irregular, which they often are. With PCOS -- here take an oral contraceptive, you'll get your period regularly and,
Rena: And that's kind of it. Wrap it up with a bow, no explanation
Dara: It’s often a bandaid, which I think it's, it can be used, it can be something that can be great, but it often doesn't help with the underlying issues with PCOS. But that's another session.
Rena: Right, exactly. I was saying, you know, they don't tell you, you know, how does this affect, you know, your, your chances to conceive, how does it play a role in your insulin, you know, all those things, which as you said, I mean that discussion is certainly something we're going to talk about specifically in other sessions here because that’s a whole discussion on its own.
Dara: But you didn't know in terms of they didn't, they just said you havePCOS, had the separately, we'll put you on birth control and no issues until you were trying to conceive.
Rena: Sure. So no idea. You know, I went off the pill, didn’t ovulate, you know, I went to the gynecologist and they pretty quickly sent me over to a fertility clinic and they started me with IUIs which, you know, that already, you know, being in the office and I was sitting there with, you know, I was married at the time. I'm sitting there with my husband, my mom and sitting there in the doctor's office across the desk from the doctor, just being absolutely terrified, you know, why am I here? What does this mean? It felt so invasive. I didn't understand anything, you know, being told you're going to do, you know, be on medication to try and conceive, you'll come back, you know, we'll, you know, use this method to artificially inseminate you.
Dara: I was just gonna say, so the reader for the speakers who don't know what is IUI in a very general, so it's intrauterine...
Rena: Insemination, right? So you sometimes there's an injection involved with that. Sometimes it's just taking, you know, some oral contraceptives to go. Your partner ejaculates in a cup, they take a sample, they, you know, they place it in the correct spot in your uterus, make sure the sperm goes to the right place, and then it's kind of, okay, well see if you get your period in two weeks, if not, you're pregnant, bye, and I found it, you know, absolutely terrifying. Is that the experience you had also?
Dara: Um, yeah. Um, I was a similar age around I think 27 when I first realized that I was ovulating, but not as regularly. Like once I got off my oral contraceptives, I wasn't ovulating as regularly, um, and waited some time and wasn't getting pregnant on our own. Um, and found a friend who, um, her sister went to RMA and successfully got pregnant and gave birth and sent me to RMA. And went there. They did all the testing. Something very similar I found out beforehand, you know, to back things up. I went to a, an OBGYN, he said, uh, I think you have a mild form of PCOS, which I'm not sure if that's what they diagnosed you with, but I was like, what does mild mean? Like, well, you don't fit the typical profile because in terms of your weight, you're not overweight, but you do meet the criteria to be diagnosed as PCOS.
Rena: Right. That's exactly what I said to make sure.
Dara: And same thing they said, um, before, I mean, we can do IUI, but before we do that, we need to check your uterus and your fallopian tubes to make sure that everything is kosher. So I'm not sure if they did that at your -
Rena: Sorry. You mean the…
Dara: HSG yes, exactly.
Rena: HSG test which
Dara: Oh, oh my God, that was painful.
Rena: So painful.
Dara: No one really talks about that.
Rena: No they say no big deal. Okay.
Dara: Well I understand that it's because they don't want to get you too nervous, but it is, there's quite a lot of pressure…
Rena: A lot of cramping.
Dara: A lot of cramping. But for me, so with different, in my experience than yours is they found that both my tubes had this toxic fluid.
Rena: Oh, okay.
Dara: So I said to my, okay, do I need to just drain them and can I get pregnant?
Rena: Right. What does that mean - a toxic fluid? How are you living with a toxic fluid in your tubes?
Dara: Well, it's not necessarily toxic for me. It's toxic if I were to get pregnant, it would kill the baby. It would suction to my uterus and kill the baby. So I said, Oh, can we suction it out? No, we can't do that. We need to have, we need to give you surgery to block off both of the fallopian tubes.
Rena: oh I didn’t know you had surgery.?
Dara: So I had Dr Mukerjee here who was a rock star. Um, he did the surgery at Mount Sinai to block off both my tubes. So for me, my situation's a little different. I went straight to IVF. They said, now that your tubes are blocked, the only way you get pregnant is through IVF. So for you, IVF, IUI, first round - successful? Unsuccessful?
Rena: Unsuccessful, many rounds, unsuccessful. And it was, you know, really absolutely devastating. I remember, you know, I was on a family vacation at the beach with my whole family and it was, you know, in a time period where, you know, I was going to find out my results, get my period or not get my period. And I remember I got my period there - horrible. I locked myself in my room. I couldn't come out. You know, I think that was maybe the third one I had done. And
Dara: Did your family know? Anyone in your family? T
Rena: They knew, but you know, and I think a lot of, I say to my patients, you know, they didn't really understand. They didn't really understand what I was going through, how I felt so out of control, how I felt like my body was failing me, how I felt so much shame and isolated and alone. And so they just thought, you know, I think kind of dramatic. And, um, I remember that was, you know, absolutely horrible.
Dara: I'm sorry.
Rena: Really, really a tough time. I found that I, my experience, really difficult.
Dara: Did they change the protocol with each cycle? Did they say maybe we overstimulated you or under-stimulated you do they…
Rena: Well with IUI, you know, there's no stimulation and I think, you know, I didn't have any insurance coverage, which is why, you know, I'm really a big advocate for that today, but uh, but I didn't know then that I know now is many insurances require you to do three to six IUIs before you can move to IVF. So now even if that's not, you know, necessarily giving me the best stats because IUIs really only give you a marginally better chance of getting pregnant and getting pregnant naturally. Not to say it doesn't work. It certainly works for many people, but a lot of times it really is because of insurance.
Dara: And that can be challenging for people who are in somewhat more of a time crunch.
Rena: Exactly. Exactly. So you, okay, so now back to your story. So you jumped right to IVF. So what was that like for you when you were told, okay, well the only way to conceive is IVF? You know, surgery, then IVF.
Dara: Well besides my friend’s sister, I didn't really know anyone else who was going through it. I had a good support system and my husband, but um, I didn't really know anyone else who had that experience that I felt really comfortable asking them. So, um, a lot of it we went in blind and didn't really know much about it. But my whole philosophy mentality in life is do what I have to do to get to the end result. And I think looking back, and this is what I also often try to portray to my patients is that the power of positivity, if you can go in and say, you know what, it may not be the journey that I expected or that I wanted, but I know in the end it will happen in one shape or form. Maybe not the way that I perceived it. But I think that really did help push me forward, especially into like that unknown world. Uh, I did a first round of IVF and the first time doing those injections was quite, you know, terrifying. And even though we're in the medical world, um, it's not like I'm giving myself injections every day. I’m not a diabetic. Um, and it was the first time was I think the most challenging. Um, and it got a little bit easier as I went through. But, um, I found out that I was pregnant from my first round of IVF, but, uh, found out a day or two later when you go back for your blood work after, um, you're pregnant, you keep going back every couple of days to make sure that your pregnancy hormones double. And that helps, you know, show that it could be a viable pregnancy. Like my hormone levels did not double. So they told me that that doesn't not mean anything, but just to give you the heads up that often is a sign of something called a chemical pregnancy and a chemical pregnancy for people who don't really know is, you know, a pregnancy that happens, uh, where like a miscarriage early on, which actually a lot of people get who are not going through fertility issues, but they are trying to get pregnant and they actually mistake it for a period when it's actually a loss.
Rena: Right. And I think, you know, I see, I myself had a chemical also and you know, many patients that do, and I think that's actually a very difficult experience. I think that's actually much worse than being just told a flat rate, a flat out, you know. No, because it's like yes and then no. So you go with that high, high of yes. And then it's taken away from you. Um, and I think, you know, chemical pregnancy and miscarriage, any of those, it's all, it's an intangible loss. I mean it's loss that you can't see. So it's very hard to explain to somebody that hasn't been in this. So they, it's hard to explain what that means, the emotionality of that, you know, to be told yes. And then no.
Dara: And I'm not sure about you. I ended up, you know, as soon as I found out my husband and I, you know, called our parents, told them, you are so excited just to have to call them a couple of days later and be like false alarm. And it was actually, that was harder for me. I'm not sure about you. For me that was more challenging as the idea of the guilt that I felt that Oh great. Like I'm, I'm disappointing my parents.
Rena: Sure. That's tough. So now had you disclosed your journey to friends and family?
Dara: Not to friends and family, but to my parents.
Rena: Okay. So they knew you were going through IVF.
Dara: But my brother didn’t and my, you know, in-law, my brother and sister in law didn’t, yeah, brother-in-law and sister-in-law didn't even know, it's only very few people. So I think that was harder. Um, on my end is like, you know, I'm disappointing everyone, they're all expecting me to have something that's successful and, and it wasn't. So, for you, post multiple IUIs what was your next step?
Rena: So then I turned to IVF, you know, of course the initial of that was hard, but at that point, you know, I had been through so many IUI I was very ready to go to IVF. I just felt like the numbers were better, the stats are better. I was so sick of doing IUIs and I felt like that was, you know, many people feel kind of IVF is it, it's going to be successful. You're finally there. So I didn't have, that was a pretty easy jump for me. I was very ready, you know, like you, I'm very goal oriented. Why am I doing something that's not going to get me the results that I want? Um, and I felt like that would, so that was sort of my next step and I was definitely ready to be done with the IUIs.
Dara: And was your first round successful?
Rena: It was not successful. And I also had a chemical pregnancy. And the interim, I, uh, had some cyst explode in my ovaries…
Dara: Was that painful?
Rena: Extremely painful. I did not heed the doctor's recommendation to not exercise while stimming, um, and they tell you not to do that for a reason. And I'm a very big physically active person and so not exercising was very hard for me.
Dara: This is good for another podcast talking about...
Rena: Yeah, don’t do it. I tell my patients I've been there. I lived it for you. Was in the ER, possible ovarian torsion. Don't do it.
Dara: Oh wow you had that, yeah.
Rena: I didn't thank God but the cyst burst and it, I mean I was in a spin class and I felt like my stomach was exploding so that, you know, also halted my…
Dara: That set you back a little bit.
Rena: Sure. You know, I had to wait for all of that to come down. It was pretty nice.
Dara: So going into it, the next go around were you, did you heed the advice to take it down a notch?
Rena: I did. After that I did. I like to learn things the hard way. So yeah. And, and uh, but then my next round wasn't successful either.
Dara: Well I didn't realize you had unsuccessful, well one that led to a chemical, the second one not successful. And then what was the turning point?
Rena: So at that point, you know, the clinic I was at they at that time, um, you know, and it was four years ago now, my daughter will be three at the end of October. But the clinic I was at then, you know, they didn't really advocate for PGS testing. Um, it was not something really pushed. It was whatever. And I, you know, I'm very type a, I like to be in control. And as we've talked about in many of our episodes, you know, so much of, of IVF and fertility is a loss of control. So I felt like, look, I was very blessed. I had a good number of embryos to work with and I said, I'm not doing this again. I've been doing this. I've been almost two years. I had been doing fertility treatments for, I felt like my life had been on hold. Um, you know, I hadn't been able to, to live my life. I said, I'm not doing this again. I want to genetic test my embryos and then out.
Dara: So for the listeners, PGS is, it is the genetic testing for those embryos.
Rena: So they sent them out and they, you know, eliminated the ones that were abnormal and I just, all I continue to feel to this day, you know, if I hadn't done that, they would've been planted again. Another one that would have been another miscarriage, another failure and I was done. I was ready to say I'm not doing this anymore. You know, I'll pursue other roads of becoming a mother. But after I sent them out, you know, the next transfer was what became my daughter.
Rena: So you know, I always believe in advocating for yourself and really asking questions
Dara: And taking it. Yeah asking if you could have a different protocol the next go around or you know, getting, gaining more insight into maybe getting some answers of perhaps why did this not work or if we're not quite sure why that didn't work, can we try something different moving forward?
Rena: Sure, sure.
Dara: My first one was a chemical and then the second one actually led to my first daughter. But it was interesting back way back, way back when, back in 2009, you know, in terms of there's so much more advancement since then. Um, back then it was day three or day five transfers, meaning they transferred either on day three an embryo or day five an embryo. And I remember back then my, my eggs were, were pretty good. My, um, the sperm is pretty good, but once they were in an embryo, they did not develop as great as we had hoped. And so way back then I remember I was, you know, told that I would suggest putting in three embryos. So I was, you know, that fear, it was like the morning of, I was ready already in my in my scrubs, my scrubs, my, you know, my coat and I three, I could have triplets. But the first thing I remember Dr. Sandler who was unbelievable here, I really adore him. The first thing I said was, what would you do with your kids? What would you like, if your daughter was here and you're working with your daughter, what would you, how many would you put in her? And he's like three. I'm like, that's the answer. And look at three turned into one. So I'm, I'm happy I listened to him. And my daughter Allegra was born in July 2010 and because we did actually change the protocol the second time around, I was hyper-stimulated a little bit. So they did lower my medication, my dosing, um, the second go around it worked. So when it came time to trying again, none of my embryos were good enough to freeze. So I had to start...,
Rena: Oh you had to start again?
Dara: From square one. Yeah. I, uh, you know, I had worries. They actually ended up putting in two embryos with my second daughter, but they did the exact same protocol with my first daughter and in 2012 my daughter Bardot was born. And that's how
Rena: I love your kids’ names so much
Dara: Thank you! And that's how I started working here. I'm not sure if you know this. So I started working here the day, well, I got the job the day that I was discharged to my OBGYN. They're like, you're, you've graduated, you're fine. Your numbers are okay. And I like, I don't want to leave. Number one. I had such a good experience, the whole staff, so warm and welcoming and really it was a wonderful experience. So I, you know, I spoke to Dr Sandler and I'm like, you need to hire me. I'm an asset. Women, we, I know we've discussed this plenty of times, but the idea of control or that loss of control with this whole experience, a lot of times you feel like you are, you don't have control. The doctors are telling you the dosages and what you have to do, the protocol, you don't have much say in it. And like I was thinking throughout all this and like we do have a say what we put in our body, how we nourish ourselves, plays a huge, huge role in our hormone development and are hopefully helping us de-stress, hopefully not stressing us out more, but giving us some control back. So I, um, yeah, that's how I started working here.
Rena: Oh, I love that. I really love that.
Dara: So back to you - daughter was born and right from then, were you already in the wellness world and how did that evolve into working or specializing in fertility?
Rena: Sure. So, uh, I'd always been a social worker, um, but you know, this process really, really changed me. Um, you know, I spent the first year really depressed, really isolated, really alone and the second year I said, what am I doing? I'm trying to create a life that I'm not living a life anymore. And so I started getting very involved in with Resolve and doing advocacy for insurance reform, connecting with other people. Um, and I, you know, similar to you, I had my daughter and I just felt like I've been talking to so many people kind of as a, you know, sort of off the record counselor. Um, at that point about my experience, cause I've been so open about it that, you know, I really kind of blind emailed clinics and just said, you need this person on staff. This is why patients shouldn't get a bill. This is why. And just right place, right time, you know, RMA, Dr. Copperman Copperman was so aligned with what I was saying and they hired me and they started me part time and it grew into full time.
Dara: We are so lucky to have you. I always say this to all my patients: use Rena as a resource. I wish I had you when I was going through this.
Rena: Well that's what I say about you. You know, if I, you know, I had access to a nutritionist, um, to help me through it. You know, I think, you know, they've been so helpful and I think a lot of people don't understand how important I think the collaborative and integrated wellness is for this process
Dara: And support, support and having that champion and also having that champion that is not your family. So, and also getting some, you know, unbiased, uh, feedback, um, can be really helpful.
Rena: Yeah. Just connecting with others and you know, not feeling like you're alone. And you know, I always tell patients like, you know, when I went through it, I really, I was not, I felt like very alone. I didn't feel like I was getting support from family and friends. And you know knowing what I know now, I think I didn't do what I tell my patients to do, which is set them up for success. Okay. Tell them what you need. Everybody needs different things and they don't know. They're trying to help. So when someone tells you, why don't you adopt, why don’t you use a surrogate, you know, just relax. Yes to you going through the process it sounds like, what? What does that mean? That's stupid advice. You're not helping me. But to somebody else, look at the end of the day, what you need and what you want is a healthy, live birth and nobody can give that to you. So they're just saying things to try and help. So I always say, you know, set someone up for success. Tell them what you need. Tell them you need a hug. You need them to ask about you. You need them not to talk about it. And everybody needs different things at different times. And I think, you know, it's important to have kind of other people in your life to fill different roles of support.
Dara: So true.
Rena: You know, you can't only rely on a parent or a partner to be your sole support through this process because ultimately they're going to fail. So, you know, have a nutritionist have a therapist, you know, have a wonderful nurse and I think all those people can help make this process more bearable and manageable. And I really wish I knew then what I know now. Um, you know, I don't believe in regrets and I believe the universe guides you where you're supposed to go, but my life is certainly different now than I thought it would end up being.
Dara: Isn’t that how it usually is?
Dara: The path that you, you often think they're going to take often, you know?
Rena: Yeah. Yeah. I wouldn't change anything.
Rena: Right. Let me carry my daughter. It took me on a really big journey of self-growth, um, and I think really ultimately made me a better person. And you know, I don't know, for you, it helps you sort of tap into this inner strength and, and resilience that maybe you never had to tap into before.
Dara: Women are warriors no matter their journey no, no matter their path.
Rena: Oh yeah, for sure.
Dara: It's nice to, it's really, we're so grateful figuring out to have this support here and that guidance and work as committee to help each other out.
Dara: So we always end our podcast with gratitude. Words of gratitude. So today, Rena, what are you grateful for?
Rena: Well, I guess staying, you know, kind of in line with our podcast today, I'm really grateful for my experience and, and going through that and where it led me, you know, it just to hear with you, you know, I don't think I would have met you otherwise and it's been such a joy and honor to meet you and learn from you, work with you, start this podcast together, you know, really have someone else great in my life. So I'm so grateful for that. Really.
Dara: You took the words out of my mouth. I was gonna say Rena you are really you, I'm grateful for you grateful for you today and I'm grateful for you since you've been here. Really you have added a breath of fresh air, some sunshine. I think because we're both in the, the health and wellness community, being able to, to feel aligned on that way and help support patients together, work together. Also outside of work we are meditators and it's nice to also be able to have that support and do things outside of work that make us feel great and do it together. I'm so lucky.
Rena: Yeah. You know, I have to say, I mean really, you know, I think this podcast, you know, is really keeping it real. And you know, when I started here right after I started, I know I went through a divorce, which you know, is besides the fertility was the most difficult thing I've ever gone through. And I definitely feel it was such a stressful time for me trying to figure everything out and you know, I’m in a much more peaceful place here. And I feel like that year I was going through here, I really wasn't my best self here. And I feel like you've known me now to be through that stressful time and the me now. And I feel grateful that you stuck with me, you and you know, you know, throughout it and work and you know, I really, yeah, it's been such a journey.
Dara: That’s what friends are for. I think supporting your community, supporting your friends is, is crucial. So lots of gratitude, lots of love. And so happy I got to hear your story
Rena: Same and listeners, you know, if you have any questions, you want to share your story, you know, reach out to us, email, website, Instagram, we'd love to hear yours. Anything today resonated with you. If you have questions about our journey, you know, I think both Dara and I are very open. Reach out.
Dara: Thank you!
Dara: Thank you so much for listening today. And always remember: practice gratitude, give a little love to someone else and yourself and remember you are not alone. Find us on Instagram at fertility underscore forward. And if you're looking for more support, visit us at www.rmany.com and tune in next week for more Fertility Forward.