In this exclusive interview with Krystle Ng-A-Mann (a.k.a: @dineandfash), the successful lawyer/blogger let Digital Editor Anastasia Barbuzzi in on the trials of her fertility journey and how she’s raising awareness about the challenges of family planning for women through her immutable platform.
A: About a year ago, you had an ectopic pregnancy which resulted in you and your husband losing your baby. Since then, you’ve been very open about your fertility journey. Tell us: How did it feel to discover that after months of planning and excitement, you had lost your child?
K: The ectopic pregnancy was particularly gut-wrenching for us because we very intentionally had waited to start trying to have a baby until we both felt emotionally and financially ready. I was 37 at the time and my husband was 34. So, when we learned that I had become pregnant, we were obviously very thrilled!
To our knowledge, we had no issues with fertility. The beginning of our pregnancy was filled with joy and we had started planning, were discussing names etc. I had even started planning the pregnancy announcement, had a midwife appointment booked, and our first ultrasound booked. But the pregnancy was short-lived because the ectopic happened fairly early on.
That being said, it was no less devastating. One day, I began spotting, and the next day, I needed to go to the emergency room. And when I entered the ER, I never ended up leaving until the following day, after my salpingostomy. Despite the hours in the hospital waiting room, it all happened so fast and was really shocking. I shared the full story in this post.
A: You’ve said that you feel compelled to share your fertility story because stories like yours aren’t shared enough. Amidst all the tales of success on Instagram, there are the stories of women who are trying to conceive, which remain in the dark. Why do you think they’re so overshadowed?
K: Although infertility is such a common issue (it affects one in six couples in Canada and one in eight couples in the U.S.), for a very long time, it hasn’t been spoken about. The topic unfortunately has been shrouded in stigma, shame, and guilt, and for this reason, women don’t feel comfortable opening up. There’s a real lack of education on reproductive health, in general; and if most women were informed about some of the most basic issues in fertility or even knew just how common infertility is, I think it would go a long way to destigmatize it.
A: You’ve also said that you used to think fertility treatment wouldn’t be for you and your husband. Back then, a part of you doubted that you’d ever have reproductive challenges. Do you think you, along with many other women, fear infertility, so you choose not to believe it?
K: I definitely didn’t know enough about infertility – particularly the fact that it’s so common and has so many layers. The technical definition of infertility is an inability to conceive for 12 months for women 35 and under, and for six months for women older than 35. Looking at it this way makes it seem so much more objective and less ‘scary’ than what I previously thought. I also used to think (maybe due to portrayals in the movies and on TV) that it was black or white – that you either could have kids or couldn’t. But there are so many grey areas and complexities to infertility, and more importantly, so many options available to couples.
A few years ago, part of the reason why both my husband and I thought that fertility treatment wouldn’t be for us was because we had a misconception about it being very invasive, and quite frankly, we didn’t think we’d ever need to do IVF or seek fertility treatment. We also understood that it was very emotional, difficult, and expensive. While these things are certainly true, when you’re faced with the prospects of not being able to conceive without assistance, you’d be surprised at the emotional and financial challenges you’re willing to take on. We’ve become much stronger individuals as a result of going through this process, and I want to share with couples widely that you can definitely get through it too.
A: With all the blood tests, ultrasounds, clinic waits and acupuncture appointments, you’ve admitted that IVF is an all-consuming process. Since so much mental and physical energy is focused on it, what would you recommend to friends and family who are looking to support someone who is trying to conceive, after they’ve been drained on every level?
K: I’ve found that the best kind of support comes in the form of listening. While there are many days that I don’t feel like talking about fertility, there are lots and lots of days when I just need someone to vent to, get advice from, or talk through an issue with. Talking, for me, can be quite cathartic. Going through fertility treatment has also enabled me to educate other people about it.
Since fertility treatment is a very complicated process, it’s been really helpful for me to have family members and friends who are understanding and know enough about our journey to be able to lend support and give their guidance (even though many haven’t been through it). In short, just asking someone how they’re doing or what you can do for them goes a long way. It’s also important to check in with the male partners too, because they often internalize their feelings.
A: We’re lucky to live in a province that has government-funded IVF. Though there are clinics that can provide excellent care and direct access to funding, the system does not guarantee equal access for all. Can you expand on what this divide looks like, socially and economically?
K: This is definitely one of those things that ‘they don’t tell you’. A significant portion of women seeking fertility treatment in Ontario do not know that there is unequal access to funding – even from clinic to clinic in downtown Toronto. While we are fortunate to live in a province that offers government-funded IVF (if you meet the criteria), some women are able to access this funding immediately, while others have to be on waiting lists for anywhere between one to three years. Funding goes according to the size/volume of a clinic and other factors. So, funding for a large clinic in downtown Toronto will be very different than for a small clinic in a smaller town.
As far as I know, there is only one clinic that has direct access to government funding – meaning its patients don’t have to go on a waitlist to access funding for IVF. Funding at that clinic is allocated on a first come, first serve basis until it runs out and renews the following year. So, in my case, I didn’t have to wait for my round of government-funded IVF, while friends and people I know at other clinics are/were on a waitlist for a minimum of 12 months. That this is not a widely known fact is shocking. The ability to access government funding could be a make or break for a lot of couples.
A: What do you believe needs to change so that the system is more equitable?
K: More financial assistance from the government. Better and more equal access to funding for fertility treatment. More support from employers, including leave and accommodations for fertility treatment and pregnancy loss. The current leave for miscarriages and stillbirths at 17 weeks or less before a woman’s due date is kind of a joke. Miscarriage and pregnancy loss at any stage should be afforded the same benefit. More comprehensive reproductive health education in schools is definitely needed (family planning should not just be centered around the use of birth control). I also think basic fertility workups (including testing AMH, FSH, thyroid, bloodwork, and ultrasound) should be offered for free in Ontario every couple years from primary care physicians or referrals from their offices.
A: You’ve said that women’s family planning decisions are not always informed, and that sometimes, they’re actually made for us. Can you explain?
K: While we’re encouraged on the one hand to delay family planning in favour of education and career (both great things!), we’re not, on the other hand, being informed adequately or provided with the resources we need to make those decisions. Due to a lack of reproductive health education and support from our government and employers, professional women seem to be presented with only one part of the equation. In many states in the U.S., employers are far more progressive and offer benefits for fertility preservation. I’d love to see that in Canada. Also, there is no government funding for fertility preservation (egg or sperm freezing) unless you have a medical reason, and I believe that should change.
A: You’ve pointed out so many truths when it comes to the stereotypes surrounding family planning. For example, the discussion is always centered around women taking birth control, but why do we never consider the flip side: 40 to 50 per cent of all infertility is a male factor. Why do you think these gendered assumptions are so much a part of the conversation, and how do they negatively affect it?
K: Short answer is that I think we have to consider and question who mainly made the rules and wrote the textbooks (hint: the answer is the men)!
A: Since finding out about your ectopic pregnancy and starting your IVF journey, you’ve had to become your own health advocate. What are some of the biggest lessons you’ve learned?
K: Don’t be afraid to ask questions! Ask questions to your fertility doctor. Ask questions to the nurses. Ask questions to the ultrasound techs (even though they’re not technically supposed to give you information). Do your own research and trust your intuition. So, if something doesn’t feel right, speak up about it. Also, understand the approach and limitations to traditional western medicine, and be open to alternative forms of medicine, like naturopathy and Chinese medicine (acupuncture). Health, in general, and reproductive health, specifically, should be viewed holistically.
Also, don’t bottle things up inside. Infertility can be an incredibly isolating process and it really doesn’t have to be. If you have a good support system, lean on them. And if you don’t, there are so many resources online – forums, countless infertility accounts on Instagram, Clubhouse etc., where you can start to build a support system for yourself. No one should ever feel like they’re going through infertility alone.
A: There are so many common responses people have to fertility troubles, some of the silliest being ‘put your legs up the wall after sex’ and ‘relax’. These suggestions are mostly unwelcomed to anyone who’s going through an exhausting process like IVF. What constructive advice could we replace these things with instead?
K: I think the reason for a lot of this unsolicited advice and uneducated guidance comes from the fact that people: (a) don’t like to feel uncomfortable in situations; and (b) think they need to help solve the ‘problem’. For someone who doesn’t really know anything about infertility, I think a woman opening up about her infertility can be a great opportunity to listen and learn. When in doubt, don’t try to offer advice (particularly about a topic you have no experience with), but instead, ask how you can provide support.
A: You recently soldiered through your first self‐administered IVF injection. Why are the ‘small wins’ so important to celebrate throughout this process?
K: Simply put, because it’s so. damn. hard! It’s an emotional rollercoaster and involves a lot of waiting, overthinking, obsessing, over-researching, needles, ultrasounds, and other procedures. Infertility can also lead to a lot of negative thinking, feelings of hopelessness, blaming oneself, etc. So, I truly believe women need to celebrate the small wins and give themselves a lot of grace. To even seek fertility treatment is courageous, so to go through the IVF process makes everyone woman I know a champ.