Ep 35: Mental Health and COVID Silver-Linings with Dr. Tia Jackson-Bey
Fertility Forward Episode 35:
In this episode, we welcome the talented Dr. Tia Jackson-Bey to the RMA of New York, who has moved here after recently completing her OB-GYN Residency at Duke University Medical Centre. Tia is incredibly passionate about reproductive justice and increasing access to fertility care for all. Through her work with the American Society for Reproductive Medicine (ASRM) and the National Medical Association, she’s committed to highlighting health disparities in fertility care, particularly barriers to care and poor treatment outcomes for black women. Her professional interests also include physician and patient education, IBF outcome improvement, mentoring underrepresented college students on careers in medicine, and global public health. She has traveled to Honduras, South Africa, Swaziland, Ghana, and Tanzania for various projects in women’s reproductive health. Today we talk about Tia’s journey into healthcare, mental health issues around the COVID pandemic, and why we should give ourselves grace during these stressful times. Tune in to hear more, along our COVID silver-linings on why now is an okay time to get pregnant.
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 from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
Dara: Dr. Tia Jackson-Bey is a board certified obstetrician gynecologist , and now joining RMA of New York as a reproductive endocrinologist and an infertility specialist. She recently completed her REI fellowship at University of Illinois at Chicago after OB GYN residency at Duke University Medical Center. Dr. Jackson-Bey is passionate about reproductive justice and increasing access to fertility care for all through her work with the American Society for Reproductive Medicine, which is ASRM, and National Medical Association, NMA, she's committed to highlight health disparities in fertility care, particularly barriers to care and poorer treatment outcomes for black women. Her professional interests also include, physician and patient education, IVF outcome improvement, mentoring underrepresented college and medical students on careers in medicine and global public health. She has traveled to Honduras, South Africa, Swaziland, Ghana and Tanzania for various projects in women's reproductive health.
Dara: We are so glad to welcome you to the RMA team. Thrilled to have another female in the mix. So we want to start off with the basics. Did you always see yourself working in reproductive endocrinology or is this something that came up throughout your residency?
Tia: Oh, well, thank you so much for having me and I am so excited to join a team as well. Literally kind of counting down over here. No, I didn't always know that I wanted to go into reproductive endocrinology and infertility. I think a lot of people may have a similar story is that you may have had like one experience that kind of sparked your interest, or just a few days as a medical student or rotation as a resident. I had an inkling that I might want to be a doctor early on. I actually kind of helped my grandmother. She was home sick when we were kids and she was kind of recovering at my house, which was a big honor to have your grandmother who was kind of like the grand Dame empress of the family to stay with us. So I was, you know, on my best behavior and I wanted to help with her meds and everything like that. And I made like a little chart of which meds she takes at which time. And I came to her and I was like, you know, I think I really want to be a nurse. And she said it like, without batting, you just said a nurse? Why you couldn't be a doctor? And I was like, this lady is crazy. Let's take these meds. Cause I'd never really seen doctors that looked like me in my community. And it wasn't really part of my consciousness at all until she said that and it literally changed the trajectory of my life. So I kind of always knew that I want to be a doctor. I had a lot of interest in science and math. And I think, you know, once you tell people that, they kind of continue to guide you in a lot of science and math as well, but in medical school, I thought I was going to be a pediatrician. A lot of my undergraduate research was in infant mortality. I was really big into how can we prevent prematurity and what are the kinds of things that we can do? But somewhere during that first year in medical school, I just had an idea like what if we took one step back and actually helped women to be healthier before and during pregnancy and during the lifespan. And as a way in my mind at that time as a way to prevent prematurity, not just focusing on, you know, little babies in the NICU and really started to get very involved in women's health projects, as you've mentioned, you know, overseas projects, multiple projects in medical school, very interested in, you know , why women chose or did not choose or have access to contraception. And so that really kind of sparked my love of the field. I was exposed to the infertility side of things as a medical student, from my mentor, who is very now involved with ASRM and actually I still keep in contact with him. And he's like, Hey, come over here, let me show you what we're doing and how we're doing things. And invited me as a medical student to start attending the research meetings. And that's how I got involved. That's how I got more exposure. So I made sure to have, you know, an REI elective, which most medical students don't have, but I was able to, you know , kind of work that in and it's been history ever since. I absolutely love taking care of women. Absolutely love preaching the gospel of contraception and women's rights. But I really felt that I, you know, felt like a strong calling to help them people create families. And so that was something that I really enjoyed doing. And you know, here we are.
Rena: Oh I love that. Well your grandmother’s a strong influence.
Dara: What a story.
Rena: That's wonderful. And so you're coming to us from Chicago, correct?
Tia: Right. So I grew up in Queens where I'm residing again now. I grew up in kind of Southeast Queens. So it's like Jamaica, Hollis, St. Alban's area and where a lot of my maternal family is from, but education has literally taken me everywhere. I went to medical school in Ohio. I did my residency in North Carolina at Duke and then fellowship in Chicago.
Rena: Cause I’m from Durham.
Tia: Yeah, I loved my time at Durham. I always say North Carolina is probably the most beautiful state I've lived in. It was gorgeous from like the beaches to the mountains to like full, you know, explosion of color during fall and stuff like that. But now I'm back and I'm really excited to be back to kind of, you know, just so into the community that gave me so much, it's like a kind of a full circle thing.
Rena: I think that's wonderful.
Dara: Welcome back!
Tia: Thank you.
Rena: And what a time to move back, right? In the middle of a pandemic and…
Tia: Oh my goodness.
Rena: Add so much change and transition on top. So much change and transition with the world. That's a lot.
Tia: It really is. And I think, you know, a lot of people kind of questioned my decision to move back in light of the pandemic, but, you know, I had a lot of commitment to not just the field, but to this position, you know, I'll be mainly practicing out of the Brooklyn office and I was really excited about the opportunity. And so, you know, despite everything that New York has been through, you know, we've definitely been through worse and tougher and longer. So I'm excited to be back and be part of the next phase.
Dara: And I'm sure your family is so excited to have you back.
Tia: Oh yeah.
Rena: At a time when everyone's leaving New York and you're coming? I think that totally speaks to your grit and strength, you know, cause Dara and I are New York tough here. We've been here, we haven't left. You know, our kids are still in school in the city and so yay for someone moving to New York instead of out of New York.
Tia: It’s so hard, but I'm happy to be here.
Rena: So I guess, I dunno if this is a curve ball question, but prior to the podcast, I was speaking to a patient who asked me a question that I frequently hear from my patients cycling and you know, obviously as time has passed, we've collected more data on COVID. You know, the question I'm hearing so much is I have my frozen embryos. They look good, but I'm afraid to transfer right now because I'm afraid of being pregnant during COVID. So again, I don't want to throw you a curve ball. You haven't even set foot in the office yet, but I guess, you know, I think that's a burning question in so many people's minds, you know, how can we, is there a link between COVID and pregnancy? Does it make you high risk? What would you say if you had a patient ask you about that?
Tia: Yeah , so we've had lots of patients question this and you know, early in the pandemic, I think as a field, we were unsure of, you know, what does this mean for our patients? What does this mean for, you know , patients who are already pregnant, you know , during this time or what, what could it mean if you had an infection during an early pregnancy? Now that we have, you know, just a bit more data in terms of what it could look like during the course of a pregnancy overall, I've been pretty surprised that we didn't get as bad outcomes as we were anticipating. We were really nervous that, you know, women who had COVID would be really sick, like the way that we see with the flu, but it didn't seem that women who were pregnant during this time were any more sick than women who are not pregnant or any more symptomatic. Now, when you I've worked on labor and delivery as a fellow during this time, and you know, there's still always the potential for women to get sick, particularly after or around delivery in the third trimester. But luckily we did not see these huge numbers, these huge ICU admissions that we were anticipating. And so it was really reassuring in a sense, I think for people who are kind of planning a pregnancy, I think the best thing to do again, it's going to be prevention. So the same things that the general public is doing - hand hygiene, mask wearing, distancing. You know, if you have the option to work remotely or work from home or reduce your time around other people, that's always going to be beneficial. Not everyone has that opportunity. And so that's why we stress the other points as well. But we've seen, you know, lots of babies born during this period and they're doing well. I think, you know, a lot of things look different in the medical space, during COVID, particularly at doctor's offices, we may have may or may not be able to bring partners with you to the doctor's office. We may ask, you know, sometimes for you to space in the waiting room or even some places, have you wait in your car or have you wait in another location and then we're calling you in even, you know, doctor's visits may be kind of 50/50, some may be virtual and some being in , in person. And so, you know, there's a lot of flexibility and a lot to just be aware of going into the pregnancy, but we have not in any regard said by no means get pregnant. And you know, luckily we've been able to support that with data that says there is no huge contra-indication to pregnancy. We just want to avoid COVID infections as much as possible.
Dara: I think that's really reassuring for, you know, for a lot of people to hear. Um, and it's interesting because I, I always think, you know, when you're pregnant, your immune system is automatically lower because you're sharing your immune system with a growing embryo or growing fetus. And I, it's nice to hear that, but I do agree with you. I think a big part of it is, I wonder if we are being much more aware of proper hand-washing, wearing our masks when we're outside. I mean, I wouldn't be even surprised to see this, this flu season that the flu, you know, people are getting the flu a little bit less because of these simple practices, which I think we should have always, you know, at least with the hand washing that now we're really paying much more attention to. And the fact that there are so many options, the idea of, you know, do I need to come in for this? If I'm getting blood work, that's one thing. But if it's just a discussion, can I do this virtually?
Tia: Right. And so that's something that we're doing as well in terms of if you're cycling and you're monitoring, then absolutely, we have to see you to do the ultrasounds and to get blood work, but just know that we're extending those visits so that there's less people in the waiting room at any given time that we're doing it for a longer period of the morning, so that we can have a little bit more space in between each visit. And so that's definitely important. I hope that this has an impact on the flu season. I was recently talking to some colleagues about that as well, but it's a little double-edged because people aren't out and they aren't moving about. And I hope that they go get flu shots. So keep it, the hand hygiene is paramount, wearing masks. I think that is going to be great. You know, I've just been in New York and around since moving for about a month and I've been so impressed with people wearing masks. It kind of puts tears in my little public health eyes like people are listening and then a lot of train ads , you know, about wearing the mask and stuff too, but just to see people complying and taking it seriously to that extent is awesome. I think as providers, we're really, you know , going to be pushing the flu shot early this year, as well as another level of protection. We know that the coronavirus vaccine, they’re working hard, it may be out later this year. It may not really be fully available until later in the flu season year sometime 2021. But we're hoping that, you know, at least if you're vaccinated against flu, then you'll hopefully fare well, this winter.
Dara: I'm glad that you said that. I'm with you. I'm not sure about you Rena, I got my kids’ flu shot already. I just had my flu shot last week. It's already out guys. So just to let you know whether it's your internist or whether you walk into a Duane Reade or a Walgreens or wherever your local pharmacist is it should be available now.
Tia: Yes, you do not need a prescription for a flu shot, but if you have medical insurance, it should be free. They'll run your insurance to double-check. If not, I've noticed that most places are doing it maybe around $30, but you do not need a prescription. You can go into a drug store and the pharmacist will administer it.
Rena: It's super important. I'm going to tell you a silver lining IVF story. Before going through IVF I used to have panic attacks. Every year I put off getting the flu shot because I was terrified of needles. I put it off, put it off . I'd go in there . I was literally famous in Duane Reade because I would have panic attacks for the stupid flu shot. Now since IVF, I'm literally the first person to get my flu shot. I did it like a month ago, and I’m like no big deal. And I'm like, thank you, IVF, for curing my needle phobia.
Tia: Did you have to do IM progesterone?
Rena: Oh yeah.
Tia: I feel anything in this world is possible after IM progesterone.
Dara: Women are unbelievable.
Rena: So for all you out there, silver lining for IVF is you two will no longer be afraid of the flu shot.
Dara: Rena, I actually have a question for you. And maybe both of you can answer to this, you know, with the discussion of, of COVID and the precautions - my biggest concern is long-term mental health. And so we may not be seeing in terms of, you know, we're seeing patients get pregnant and have healthy pregnancies and healthy deliveries. My concern is the long-term effect of our, of one's mental health.
Rena: So, I mean, I think so just from a broader speaking mental health perspective, I think something I'm reading a lot in my field, like in my industry, you know , publications that are coming out and what people might feel are talking about are just it's there's clear, it's clear that there's going to be long-term ramifications of mental health repercussions from this. We don't know what it is, but the reality is all of this, everything we've all been experiencing, let's say since say March is there's a level of trauma and PTSD. So whether you're going to cross by that as acute stress disorder, PTSD, trauma, I mean, you know, whatever quote unquote diagnosis you're going to get, we're all experiencing that. And I think because we're still in it, no one can say, okay, here's what's going to happen, but it's very clear it's something. And it's going to be really important for people to continue to check in with themselves to work through it. And I think also something I talk a lot about with my patients is you can't be expected to go from we've now adjusted, right? We've been doing this for six months, whatever. It's not like one day, you're going to wake up and you're going to be ordered back into your office and you're going to have to pick up your life as it was. That's not going to happen. And that is unreasonable and unrealistic for somebody to expect that from you, you know, you have to think of it as like, if you're turning a faucet on, you're going to turn it on and not have this huge stream of water, you're going to turn it on. And it's going to start with drips as we sort of dip our toes back into quote unquote normalcy, whenever that is. And so I think it's really important for people to remember that it's not going to be a switch flipped and all of a sudden we're back to our normal life. Right? And I think to be really gentle with yourself and kind with yourself and realize like life isn't going to go back to, as we know it, because we've experienced a global pandemic. So whatever it returns to it is going to be different. And again, it's, it's working and checking in with yourself to adjust, right? And to return to whatever that is after experiencing a trauma, which for some people, you know, was bigger than others. You know, some people experienced multiple losses, they had huge upheavals in their life. Some people weren't as affected, um, by it, you know, seemingly, but they still were. So, you know, again, I think there's certainly going to be effects. We don't know what it is, but it's really important to be aware and again, be kind and gentle with yourself.
Tia: Yeah. There's definitely a sector of the population though that is being forced back into normalcy with a mask on. And that, that is tough too, you know, having to go back to work, having to kind of, you know, resume at full capacity. So I'm really trying to empower, you know, people that I know and, you know, people that I see to speak up, like if you're uncomfortable, if this is inducing panic attacks, if you don't feel safe at your job, like other people, maybe aren't respecting distancing, or they're not wearing proper PPE, like you've got it , you know, speak up for yourself. Unfortunately, some people are in financial economic situations where they just, they feel like I have to work like it . Even if I get Corona virus, I have to go to work. And so that's really tough as well, but you know, just trying to empower people to just stay as safe as you can. And, you know, just be kind of aware that people out there making really tough decisions during this time. I have a lot of good girlfriends that we've all been trying to support each other through this whole pandemic. And everyone does, you know, wildly different jobs. My physician friends, you know, are doing different things and some of my friends are in media and they're able to, you know, just work completely from home, which is , could be a double-edged sword because the isolation was really a problem for some people as well. So the city kind of opened up a bit, but as you guys may see outside of your windows, there aren't that many people out, you know, people are still kind of a little shell shocked that thing. So it's , it's a slow return to kind of where we are. I heard that they're going to open up inside dining tomorrow. And so that'll be interesting too . And we're gonna, you know, try to think of how can we extend the outdoor dining for longer. I know the museums are open again. So hopefully, you know, it encourages people to kind of be out a little bit more in a responsible way and maybe get back to some of the socializing that they were missing with being so isolated.
Rena: Right. I mean, I think it's, it's so hard and you touched upon a really good point. You know, one is that some people are, don't have a choice, right?. And I certainly have a lot of my patients are teachers. And so I've really been walking with them the whole time and seeing, you know, teachers are really scared and right now there's a shortage of teachers, even with the DOE because a lot of teachers walked, right? And then a lot of people got medical accommodations to be remote. And so there's just a lot of fear. And then what about the people that they have to go to work? They don't have a choice because finance or they have to go and they’re scared, you know? And I think it's, you know, I think it's really hard and I think it's really, you know, again, trying to find empathy and you know, one of the big tenants of positive psychology is random acts of loving kindness. And I think, you know, more than ever now is trying to think about, okay, the other people add they’re, you know, the three of us are really lucky, you know we’re in our jobs, we're safe. You know, we feel secure and how can we then think about people outside of ourselves, you know, and give them a little extra, you know, like, Hey, you're doing great, you know, because they may not have that. And I think now more than ever, it's those little things you do just support other people , you know, that's really important.
Dara: Yeah and I think having a gratitude practice can be great, but I feel like the silver lining with this pandemic is it really is bringing to the forefront, the need for support for, you know, the importance of mindfulness, you know, at least in my circle. So many more people are open to meditation and a gratitude practice and, and reaching out to get the support they need. So I'm hoping that this tough, challenging period will be the impetus for change in the mental health world. And that we're, you know, people will be much more open-mind minded to reaching out if they feel like they can't manage their anxiety or their stress.
Tia: I was just going to say with the , you know, many of us are very type A and we're productivity-driven and we're used to go, go, go. I think at the, you know, when this year first started, everyone had big plans, such a, you know, a big year, 2020, and these huge goals for the year. And, um, it can be really crippling to have when those things are kind of slowed down. When things that you thought were going to be progressing in a certain way, did not. I know in the academic world, you know, research and grants and promotions and all of these things, you know, are kind of either put on hold or have been slowed down and just, you know, my girlfriends and I talk so much about like giving yourself grace during this time, like, guys, we cannot operate like the world is not slowly imploding. Like we have to kind of acknowledge that and accept it. You know, pandemic, you know, social justice issues, reproductive justice, racial injustice, you know, political issues. There is a tremendous amount of stress on all of us this year. And so to kind of continue to act like, you know, everything is fine as you know, the world is on fire, it's not realistic. So we do have to like be able to give ourself grace.
Dara: I love that.
Rena: I think in going back to what you said, I think, you know, another really important aspect of this is how difficult the isolation is and how, you know, as humans, we're social creatures and we need socialization. It's something we need like to breathe or fresh air to breathe, food, sleep. It's really critical to us. And I think I've seen for my patients that are single, um, that they’ve really have had the most difficult time of this. And I think, you know, I feel so lucky. I, you know, have my daughter, I live in the same building as my parents, but they're my quote, unquote quaranteam. I don't know what I would be doing without them. And I think to also about people in your life, you know, that are single. I do think there's an element for them that is a lot scarier and a lot more difficult than people that do have supports because, you know, again, that just goes back to human nature. We need socialization. And for those people that don't have a quote unquote built in quaranteam, you know, zoom meetings with friends is not the same. And so it's really important to try and figure out, you know, how can you help people in your life, you know, that are, you know, single and alone, because I think they're dealing with another added element too.
Dara: So true. So let's talk more about you. I know this is like an interesting transition, but I want our listeners to learn what you do on your time off. It sounds like you have a great group of girlfriends. But socially, what else do you like to do on your time off or do, hopefully you get some time off?
Tia: I know my, some of my time off is slowly winding down. You know, this year was very different because you can really do the things that are like your second nature. Cause mine is traveling. I love to travel kind of domestic and internationally, but I had to make a lot of changes and plans this year, but I will say that opened up new opportunities to explore like local. So while I was still in Chicago, there were lots of, you know, state parks and kind of hikes and biking, even go into some little, you know, kind of Lakeside towns. We went to Door County, Wisconsin before Wisconsin's corona got crazy and it was beautiful. Like I can't wait to go back there and some other small places as well. So that's, it's been like a different flavor on the typical travel. I've gotten to do some reading this summer which I haven't done in a while. And so that's actually been really nice cause I used to be quite a bookworm. And then through, through medical kind of training, all of your time is really consumed with studying and you know, and medical kind of reading. And so to read for leisure again was like really nice.
Rena: What did you read?
Tia: Um, what was my favorite? I read the water dancer. The book I'm reading now is by Isabel Wilkerson. It's called Caste. If you haven't, it was recently an Oprah's book club pick. And it's really interesting about just the social structure of the US and you may, have you guys heard of the caste system? It was just kind of, it's more of a traditional thing in like Indian culture. If you think about like old Europe and feudalism, you know , very stratified kind of social structure, but talking about how here in the US we also have had that social structure and it's a little less recognized and it maybe if we understood it more than we would understand more of why things are the way they are in our country and even some of the things of this year. And then, yeah, it's really good. I mean, it's, it's kind of like every few pages or paragraphs, you have to stop like, Whoa, that was heavy.
Dara: I need to sit on that.
Tia: But I got into baking. So I've always loved to cook. That's my thing. My family knows it, you know, I'm like one of the person who's energized by the holidays, Thanksgiving and Christmas, cause I can cook with reckless abandon. But again, in medical training, you don't really have a lot of time. You have to kind of carve and pick which hobbies are most important. And so I kind of let that one go. And so quarantine did give an opportunity to like, you know, follow some recipes, follow some, um , kind of people on Instagram who are doing a lot of like great baking and I'm just so grateful that they give their stuff away for free on social media, but they're great recipes. And so I got to try out quite a few, you know, this year. So that was really fun.
Dara: We need to exchange because I grew up being more of a baker and less of a cook. And through quarantine I‘ve become, my passion has been cooking never in a million years, would I ever would have thought that. So I have some great baking recipes. We’ll have to trade.
Tia: I’d love that. Well Dara, I told you I had fresh figs for like the first time that I can recall, like maybe a month ago. Love. Oh my God. So even just, you know, the simple pleasures of quarantine life, you know, I've been trying to dig into those a little bit. Yeah.
Dara: How nice.
Rena: So I guess, so what are you , um , and what are you looking forward to the most, but starting back at work.
Tia: Just getting back in and interacting with patients. That kind of really energizes me as well. You know, even sometimes the training, it gets tough, it can be grueling, but I once had a roommate kind of make fun of me after coming home off a labor and delivery shift. And she's like, how are you still smiling and happy? You’ve been at work for like 15 hours? Like she was like, you're not normal. And I'm like, but you didn't get to see what I saw today. You know? And so I do look forward to interacting with patients and hearing their stories and hopefully lots of happy stories and just being part of that again.
Rena: Well, we're so, so happy that you're here and we're so grateful to have you. I can't wait for our patients to meet you. We are so happy to welcome you on board and we like to end each podcast by going around and saying something we're grateful for so who wants to go first? Tia or Dara?
Dara: I'll go first or…
Tia: I'm literally grateful for like a smooth transition back to New York. You know, it was really kind of stressful planning a move and gosh, getting things together and during a pandemic and people going to be in my house and it was just, it was very stressful, but I'm so happy that at each step along the way, I found really great professionals to work with. They're so happy to help, you know, people are happy to be working and taking a lot of different precautions. And that really kind of helped a lot of my fears about it too. And so now I'm here and getting settled in. So I'm just grateful for a smooth transition.
Rena: Yay. Dara?
Dara: I actually, from the beginning, when you first spoke about your grandmother, I am grateful for grandmothers. I have one living grandmother. Shout out to my grandmother who's turning 96 next week, but just the idea of having a champion. She is my biggest champion. And how grateful that you had your grandmother, who at such a young age believed in you and knew that you can work beyond your wildest dreams to work to, you know, your greatest potential to see that in you. And then on top of that, the fact that you had a mentor from ASRM. To have mentors, whether it's family mentors or, or people in the field, people who can really help you, push you and believe in you. So shout out to mentors and grandmas. Rena?
Rena: I think I'm going to go with back to the school of thought of let's kind of go easy on ourselves. I'm going to go with what I’m grateful for today. And I'm grateful that, you know, today we're doing our podcasts. We’re all here. We made it and that we're doing what was on our calendar. What's supposed to be going on. And, you know, as someone who's been sort of struggling with the transition of getting my 4 year old to do a combo of zoom school and an outdoor pod the last few weeks, I'm just grateful that things are rolling. We're moving, we’re figuring out our schedule and I'm here, I’m present. And I think it's just, I'm grateful and I'm grateful for a career that, you know, my whole life, I wanted a career, not a job. And now I finally have one where I get up super early in the morning to start working and it bleeds into my evenings and I've been so busy. I work, you know, still late at night, but because I love it. And I'm so grateful to finally be at that place. So that was more than one gratitude, but you can never have too many. So there you go.
Dara: A-woman to that.
Tia: That's wonderful.
Dara: So nice. Well, thank you so much for being on our podcast and we cannot wait to meet you in person, hopefully around the corner.
Tia: All right. Thank you ladies. I appreciate it. And I had a great time.
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 @fertility_forward. And if you're looking for more support, visit us at www.rmany.com and tune in next week for more Fertility Forward.