Posted on December 10th, 2020by RMANY

Ep 41: The Trying Game with Amy Klein

Fertility Forward Episode 41:

Amy Klein is the author of the new book The Trying Game: Get Through Fertility Treatment and Get Pregnant Without Losing Your Mind, a guide that is based on her successful ‘Fertility Diary’ column for The New York Times. She writes frequently about health, fertility, and reproductive rights for publications such as Newsweek, Slate, The Washington Post, and others. After four years of infertility, involving countless doctors, treatments, and miscarriages, Amy joins us today to talk about the personal experiences that inspired the book, how her perspective on fertility and pregnancy changed since she first thought of starting a family, and why she is so grateful for the accessibility of resources and information on the topic these days. Back in 2011 when she started her fertility journey, there were very few people talking about the struggles of infertility, which is why she decided to write the book she wishes she had back then. After touching on the importance of advocating for yourself, our guest shares how therapeutic the writing process had been, what she has in mind for future content, and why now is the time to send even more kindness into the world. Tune in today!

Transcript of Episode 41

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: Amy Klein is the author of the new book, The Trying Game: Get Through Fertility Treatment and Get Pregnant Without Losing Your Mind, which is based on her successful New York Times fertility diary column in which she chronicled her journey to have a baby - 10 doctors, 9 rounds of IVF, 4 miscarriages and 3 countries. Amy writes about health, parenting, and reproductive rights for publications like the New York Times, The Washington Post, Business Insider, The Forward, The Jerusalem Post and others. Amy, we are so happy to have you on today to discuss everything about your book and also your fertility journey. Thanks for being here.
Amy: Thanks for having me.
Rena: Yes. Thank you so much. I'm thrilled to have you on. I had such a fangirl moment when somebody, Rebecca Rosler, who's pretty known in the fertility community, connected me to you because I was such a fan of your New York Times column and then when your book came out, I was thrilled to have this resource to share with patients because my patients are always asking me for book recommendations and, you know, you came out with what I describe as this tome. It kind of has everything in there. So I'm, I'm thrilled to have it as a resource and to have all the material that you put together. It's really wonderful.
Amy: Thank you so much.
Rena: So I guess for those that aren't familiar with your book, maybe, do you want to tell us sort of maybe the impetus behind it? I know you worked for several years on it to put it together - what's in it? What your goal was or your driving motivator was to put it together?
Amy: Well, you know, as Dara said, you know, I went through, I guess, four years of infertility and when I started going through it, it was back in 2011, 2012, and it's hard to believe, but there was no real information out there that was accessible. It feels like, you know, there's so much information out there today. But back in 2011 and 12, nobody was really writing about it in a regular way and there was not like articles popping up everywhere. There was no Instagram, there was...Facebook had no no private groups. So I had a really hard time to trying to get information, but I also was shocked that there was this whole secret world that I just kind of stumbled into. It felt like Dungeons and dragons kind of moment because I had no idea that this world existed. You know, you go to your clinic and there's women waiting out the door. There's this sperm collection room where your husband has porn. And as a writer, it was kind of funny. It wasn't funny to me personally, but I was like, what is this place? And so I started writing about it for the New York Times because nobody, I had no information out there. And it was funny because my editor said to me, Oh, we'll just do this for three or four months and then turn it into a pregnancy column because we were both so not, you know, we all thought, Oh, you just try to do IVF and then takes a few months and then have a baby like magic. That's what I thought back then. So it was interesting because, you know, we were so naive and it took me three more years. And at that point I wanted to like, just show people what I was going through because I didn't think anyone had really written about it. And I always thought that if at some point I would have a baby, cause I wasn't sure, then I would write a memoir about my experiences. But by the time I had my daughter in 2015 and then emerged from the whole early motherhood and nursing and figuring out my life, by 2016, when I looked at everything, everything had changed from when I went through it, there were blogs and influencers and Instagrammers, and there was a million different groups that had emerged on Facebook. And thankfully there was a lot more information, but I think the problem then became that like, how do I find information, but Oh my God, there's so much, almost too much information. How do I get through all that information? So for me, I was just thinking like I was writing the book, I decided to write the book that I wish I had, which is kind of like the A to Z guide to infertility starting from, Oh my God, am I going to have infertility issues? What does that mean? How do I feel about that? What can I do before I go to a doctor then like, how do I find the doctor? How do I pay for this? All the way to, you know, emotional issues, Llke how do I deal with my best friend who wants me to have a baby shower? What do I tell my mother-in-law who's such a busy buddy asking me when I'm going to be pregnant already? What do I do after a miscarriage? Is it time to stop or to get a new doctor? I kind of just thought about like the whole process of how one goes through everything from the moment that you might find out that you have fertility issues til the moment you have a bab and what does it mean to, you know, have a baby after IVF. So that was like, my thinking was just to help people get through the process, not a doctor, but I wanted to give them all the right questions to ask their doctor or when they're talking to a doctor, how to find someone that they're comfortable with. So these support groups are amazing, but sometimes they can be overwhelming and everyone has an opinion and they're not doctors. So I just wanted to give people that book, you know, you call it a tome, but it's like, I was very specific that they asked me, one publisher wanted to publish it in hardcover snd I said, no, no, no, this is not a hard book. This is a soft cover book you put it in your purse you take on the subway. You know what I mean? It's like, it's a tome because it has everything in it, but it's like, I wanted it, I just wanted it to be a guide for a woman to help them emotionally, but also help them practically with like what questions to ask your doctor when it's time to see a therapist, how to get your partner involved. Definitely a how-to guide.
Rena: That's why I love it. I think it's so easy. You know, you can kind of if you have a question about acupuncture. Okay. Flip to the acupuncture section and you give, okay, what should I ask? What should I know? It's research-based and so I think it's, it's great. And I think right before this, I had a patient who was asking me like the same things that you wrote your book about, you know, they were asking me, what should I ask my doctor? And I feel like I have, you know, those conversations all day long. And so I think your perspective that you came at it from a patient perspective so you know first hand what makes this such a valuable resource. You know, you've been there and Dara and I often talk a lot about feeling really lucky that a lot of the women we find in this space who have gone on to either write books or create companies or whatever it's because they were a patient, they had the personal experience and then they felt there was something lacking in the space. And so they work to make it better. And I think, you know, it sounds like that's exactly what you're doing with your book.
Amy: Yeah. So, I mean, it's, you know, the doctors are changing the science and the research, but it's up to, I think a lot of that time it’s up to the patients to fix the patient experience.
Rena: Yeah. I mean I’m a big believer in patient advocacy and speaking up for yourself and not being afraid to ask questions. I think a lot of times you'll come at it with sort of a, an antiquated approach that, you know, we have to just sort of smile and nod at everything the doctor says, and it's not like that anymore. I think it, if anything, now we're much more in the driver's seat as patients, you know, it's our right to ask questions, doctors like it. The doctors I work with, we work in a collaborative, integrative approach Dara and I, and so we are a team and I think they, they like that, they're open to it. But I think a lot of times patients are afraid to do that or schedule a call or they think they're not allowed to. And I think, you know, I always advocate for that. And for being, you know, an advocate for yourself, because this is such a personal important experience, and you want to make sure that you understand what's happening and you're choosing a path that's right for you. And obviously it's confusing. And as you said, you know, groups are great, but they can often be overwhelming and you don't want to take advice from someone that's not a medical professional. You know, you need to trust your doctor. And so I would say at least, you know, from our end, it's definitely welcomed, you know, this collaboration between doctor and patient.
Amy: Especially now, you know, you get your doctor on a tele-health call, maybe, maybe they have a little more time to answer all your questions.
Rena: Sure. And look, I know, certainly it's not like that everywhere. You know, I think Dara and I are lucky. We work in a place where it, it is like that. The doctors I work with, they want that, they welcome it. But of course, you know, I work with patients from, from other clinics as well in my own practice and so I know that it's not like that at every clinic. You know, I wish that it was, I wish that there wasn't still patients being made to feel like that it's not their right to ask questions or they're being annoying for doing that because no one should feel that way.
Amy: For sure. And I, I mean, it's definitely not necessarily only, but I think a lot of younger doctors are assuming we have more information. But I think that all the younger doctors coming through the system right now understands it's a different feel of people who are more informed and want to be more part of the process.
Rena: Absolutely. I couldn't agree more. And I think, you know I mean, look at you, look at your voice. You're such a powerful voice. I know my patients are all, they're extremely smart, capable women. And I admire, and men, that I admire so much in all sorts of different areas of life. And I think that as you said, the younger doctors especially see more. That's what people they're questioning their care, they're asking questions. And so doctors, they have to be aware of that. My patients keep me on my toes all the time and right before this and that totally threw me. And I was like, that's why I love my work though, because it's so challenging and people really, I mean, they keep you on your toes. And so I think that's a great part of the work, but you know, again.
Amy: I think also people, even though we've all been through this, sometimes it's hard to remember every single thing that produces so much anxiety and so much questioning. Oh, the clinic didn't call me. I accidentally missed my med at nine o'clock it's eight o'clock 10 o'clock what should I do? Skip my med? There's so many ways to cause anxiety.
Rena: Oh gosh. Yeah. Well, and then I guess that's where my job comes in as a mental health professional to help people manage that for sure. And I guess that goes to sort of a bigger conversation, which is why I love someone like you getting your voice out there with your book and the columns you write is that you're helping change the dialogue. And that's the thing we talk about a lot on here is that one of my macro goals in being in this field is to change the stigma and really change the dialogue surrounding this. I think there's still, when I went through this, certainly I guess I started, my daughter's four now, so I started about six years ago. You know, there's so much shame and stigma surrounding it. I suffered in silence for the first year. And then I realized after a year I was, you know, trying to create a life, but I was no longer living one. So then I got involved with Resolve and that kind of flipped the switch for me. But I think there is still shame and stigma surrounding this and people don't know how to respond to it. They don't know how to help. They don't know how to go through it. 20, 30 years ago, cancer was still the C-word, you know, people whispered about it. It wasn't talked about. Now everyone understands cancer. Right? We understand how stressful it is. We understand how difficult it is. And you know, I so hope the same thing for fertility that it becomes, people understand, Oh, you're going through infertility? That's so stressful. What can I do to help? And that the general population understands how traumatic this can be, you know? And I don't think we're there yet, which is why I so admire you. And again, I'm so appreciative for someone like you getting your voice out there, working to put this out in the public, you know, using the platform like the New York Times, you know, your book. Let's educate the general population so that people understand it and then people do not suffer in silence anymore.
Amy: Yeah, for sure. I'm glad that people have many more ways to join on Facebook or Instagram and to see other people's stories, that's one and, you know, celebrities and even like the princess writing about it, their miscarriage, their losses and infertility. So important.
Rena: Yeah. I thought that was so powerful in getting that out there for sure. Did you find that for you, just from a patient perspective and your own experience that writing the book or any of the things you've written in your columns or anything you’ve written was therapeutic for you in some way?
Amy: It was definitely, I mean, I couldn't think about anything else. You know, I think I was working on another book that I don’t even remember what it was, but this takes over your whole life. And I did have some, a few different jobs, editing jobs at different magazines at times, but it really takes over everything that you're thinking about. And that's why I had to write about it. So it was definitely helpful for me to write down all the details and everything that happened. It helped me process it. Obviously I didn’t publish everything I wrote right away, but it was definitely very helpful.
Rena: And how long did it take you to write the book from start to finish?
Amy: I’d say between a year and a half, a year and a half I’d say. But I had, you know, not only did I have my New York Times column, but I have like I was working on another memoir before I decided to change it to a self-help book. So, you know, from a therapy point of view, like I'm not a therapist, I'm a writer, but I always find that it's very helpful to journal something while you're going through it. If you put it down in a journal, but that's not like the final, like you journal because when you journal something, you get all those like really juicy details to know like something, if you ask me that today, I wouldn't remember like, Oh my God, that time that my husband told me, like there were all different types of ethnic porn in the collection room. I wouldn't remember that so many years later but because like I journaled it as it was happening. So, you know, you write down a lot of the details and your feelings and it's very raw and that's not what you publish. And if you just want to, from a therapy-point of view, it's so helpful to journal. But if you want to write about it later on, I find that the best writing process is always like a two-prong, you journal about it now, and then you kind of edit it and take these points later. If I was going to write all about it now there's so many things I would not remember like good juicy writer detail.
Rena: I mean, of course I'm a big advocate for journaling. And I think as you said, you know, it's very different when you're in the moment. It's so raw, but it's such a great outlet. And then, you know, later it's a great thing to have to look back on or, you know, use for something else. But in the moment it really helps you process and record feelings. So, so important. And I guess, do you have any sort of, what are your kind of goals or maybe projects you're working on after this, in terms of the fertility community?
Amy: So I still write a lot about fertility and what's going on in science because it's changing every day and there's so many new companies and merging with new products to make things better. So that's super interesting. I'm working on my next book. It's less self-help, it's more narrative nonfiction. It's about third party reproduction about egg donors, sperm donors, embryo donation, where the kids end up and what it means for society, which, less of a self-help book and more just like for the general reader to understand what's happening in the world.
Dara: That's exciting. That's something to look forward to.
Rena: Definitely. We need more resources for that for sure.
Dara: And it sounds like it's never-ending for you, Amy. You're continuing to work and that's great. And give back to the fertility community.
Amy: Yeah. I mean, you know, it's so interesting, the science was very different back when I was doing it, there were like three or four different questions, different science maybe, but it's, you know, the journey like the emotional journey is still stays the same, if that makes sense. And I'm sure you guys see that too all the time. It's like maybe the technical questions are different. Maybe one day we'll all have insurance coverage and it will be free and the financial questions will go away. But it's still that, I mean, that initial shock, I mean the worst shock of all this is like, you're going to have to go through this. You know, that shock is like, not only do you have to go through it, but you have to figure out what the hell like you thought getting pregnant was going to be the easy part. And then all of a sudden you have to get like this PhD and your body, your cervical mucus, things you never thought you'd have to think about. So that part is super shocking. That first initial part. And then after that you have lots of little earthquakes along the way.
Rena: I think that's such a great point because people often think that the journey kind of stops when they get the positive pregnancy test and then they quickly realize, no that's just mile 18 of the marathon. You know? You still have a ways to go. And I think that's why ongoing continuous care is really important, too. But I think, you know, I always encourage people to work in the micro and take it one thing at a time, but it's definitely a marathon, not a sprint and it takes a village. And so I'm so happy to hear, you know, what you have on the horizon as well to keep expanding on what you've put out there, because I think you're such a powerful voice and your information so well researched. So pertinent. And then to add in that you had your own personal experience, I think makes it all the more powerful and really help other people relate to it.
Amy: Thank you. I mean, like, I just think about people who, of course, you know, when I was going through it, I thought my story was the worst. And then of course, when I did research, I just learned that it was not the worst. Not that it's a pain Olympics and not that I'm comparing obviously, but then, you know, you just hear these other stories and you’re like thank god I didn’t go through that. And then these days, I'm just thinking about all the people who have fertility treatments put on hold because of COVID. And I just think, Oh my God, if this had happened to me, my heart just bleeds for people because if this had happened to me, you know, like when you're going through infertility, sometimes you have this like, feeling like the universe or God or whatever is out to get me. But then if I had to stop my treatment for three months, I would have really felt I would have felt down and depressed. So I, my heart goes out to people. Thankfully, most clinics are opening up again, but it's still, still very anxiety producing to go through fertility treatments during COVID. And also, you know, people have questions about pregnancy during COVID and people who need surrogates. That's a whole other nightmare right now, and even egg and sperm donors, like just the whole, you know, and nobody, the news is so horrific sometimes that we don't have time always to think about that there are people who still don't have the babies or the families that they want because people are dying and that's terrible too, but people have their regular lives as well. And it's hard to take time out to think about the people who are suffering from infertility.
Rena: Sure. But I think, you know, everyone's experience is their own. And I always tell someone, regardless of you're at one IUI or you're taking a Clomid or you've had five rounds of IVF, you know, and three miscarriages your experience as yours, and it's hard. It wasn't what you pictured. And so you need to validate that and honor that. I think there's a lot of intangible loss that goes into this, regardless of where you're at. And again, you know, as you said, of course now it's definitely multifaceted and complex because you add in the fact that we're in a global pandemic and how do you kind of add that impact onto the stress that fertility treatment is in general? What comes with that? So I think, you know, as you said, this is a time to be as compassionate as we can and really be kind. I think kindness is so important. You know, you never know what journey somebody else is walking. And I think if anything, you know, this is a time to be extra compassionate and be extra kind. And to offer that energy out to the universe because life is hard and this is hard, right?
Amy: For sure. And I have a couple of chapters on the emotional journey in my book about regret, the regret that you have before you start fertility treatment. The things you not only regret but also like baby envy and how you feel and especially now being stuck online, watching people complain about their kids orpost their surprise pregnancy. It’s totally true. It's like we should all give, we should be kind to ourselves, but also like create your own bubbles. You know, like if someone is posting their...I actually have someone right now who keeps posting her ultrasound. It's fine. But like, why do you have to keep posting the picture? You know what I mean? I'm not even trying to get pregnant right now and sometimes I’m just like, woah! It's a little too much. But I am judging myself. I could think mean thoughts and not say anything. So yes, you should be kind, but you should also use a bubble to protect yourself until this is over.
Dara: I know also, Ren and I always say, it's also okay to say no, if something bothers you get off that group or mention it. But I do think I liked how you said to be kind to yourself because I think that's where it all, it's great to be kind to others, but if you can be kind to yourself, I don't think that's the best. So I think it's great that you have not only been kind to yourself by journaling and sharing with us your story, but also giving back kindness, showing kindness by really giving back to others and being part of this community. We're so lucky.
Rena: Thank you so much for coming on and sharing and offering this as a resource to the community, you know, as Dara said, I think you're a wonderful voice in the community. You're such an inspiration. So they're going to be more thrilled to have you on and share this with our listeners. And you know, we're so excited to keep them updated on what you're working on next, what you come out with. I think it's fantastic.
Amy: I also want to just say one thing that I also worked with Hadassah, an organization. They just started getting into the fertility field. They have an initiative called Reconceiving infertility, which is to fight the stigma against infertility and to advocate for change. And they have a website and I'm working with them because I think it's so important that they're in the field right now.
Rena: Okay. Oh yeah. And I guess offline, I'd love to talk with you more about it and learn more, because that sounds exactly like I want to get behind and help them grow. That's great. I'm so happy you brought that up.
Amy: Yeah. I'm really happy that, you know, organizations, big organizations like Hadasah, powerful women's organizations are understanding that this is really something that's affecting a big swath of the community.
Rena: Yeah. Oh, that's great. That made me so happy. Thank you, sir. That gave me such a spark today. Thank you for sharing. Yeah to know that you know, someone else and it's such a powerful organization, really recognizes it and behind it. And you know, you're involved. That makes, that gives me energy to move forward and keep doing the work I'm doing. Because sometimes it's hard when you're in it to see, you know, you feel like, well, am I actually doing anything that makes a difference when?
Amy: You're doing something! Yes, you are doing something that makes a difference.
Rena: I love that they're doing it and our work is growing. Thank you for sharing that. Hopefully we can have them on and talk to our listeners more and we’ll definitely look into that.
Dara: Amy, where, where can we buy your book? Or where's the best place to buy your book?
Amy: Well, if you like the sound in my voice, then you can listen to the book on audible. But if you don't like the sound of my voice just by the written version, any independent bookstore, Amazon, I think it's having a sale, but you know Barnes and Noble or any independent bookstore. My website, if you want to see there's some excerpts in the website, it's the tryinggamebook.com.
Dara: I'm all about audible so I'm thrilled. I love your voice. And I love listening to books on the way to work or when running errands. So I think that's great that you have more than one way of getting in some of that great content.
Amy: You know, I say my life saving is getting the New Yorker on the iPad because I can just skip around to the next article.
Rena: Well I have your book in print and Kindle. Fantastic! Big fan. So thank you so much. We like to always end our episodes on a positive note and say something we're grateful for and a gratitude. So I would love for you to share with our listeners something you're grateful for.
Amy: I am grateful for my health. And I'm grateful that the world is looking 2021 is looking much better and I just wish it were here already.
Dara: A-woman to that.
Rena: Dara, what about you?
Dara: I am grateful for new traditions, especially because we just finished Thanksgiving long weekend and definitely created new traditions of our own with my family. And also the idea that like, we are much more adaptable than we give ourselves credit for. So human adaptability is what I'm grateful for today. Rena?
Rena: I love that. I actually, I read an article in the New York Times this weekend about adapting to the pandemic, which is great, but I won't digress. I guess I am, I am so grateful for, I guess I'll go with, I have a little surprise visitor who's been on my lap - very good and quiet the whole time - my daughter who’s 4. It has been a take your daughter to recording day and she's been so good and I'm so grateful for her. She's a blessing to me. She changed me personally and professionally. She's the light of my life and why I do what I do every day. Do you want to say something? Do you want to say something you are grateful for? Because we always talk about an attitude of gratitude? No? Okay. She's feeling shy. So 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 @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.

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