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Kim Clijsters talks WTA’s New Fertility Rule & Maternity Support for Players | LOVE ALL
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- [00:00]
Kim Clijsters
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- [00:23]
Kim Clijsters
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Kim Clijsters
I was, I think, the only mother on tour. There wasn't much support. I feel like tennis is always kind of the frontrunner when it comes to women's sports.
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Dr. Megan Gornett
These young women, there's so much pressure on them.
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Kim Clijsters
The responsibility to your sponsors, your ranking.
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Kathleen Stroya
Your points, we work every day to continue to work toward their dream.
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Kim Clijsters
Here we go. Hi everybody. Welcome to Love All. I'm Kim Kleisters, and some of you might or may not remember that back in 2009, I won the US Open. And what made that tournament so special to me was that I was able to have Jada, my daughter, there to see it in person. She was 17 months old at the time. She is now 17 years old and is a basketball player herself. And it's really, really crazy how time flies. So in 2009, I was the only mother on tour, but a lot of things have changed since then. I think there's about 25 mothers on the WTA Tour right now. And in fact, at the halfway point of this season, we've seen two moms win titles. So we had Tatiana Maria, who just won at Queens a couple of weeks ago, and then we had our former guest of the show, Belinda Bencic, that won in Abu Dhabi. So in this episode, we're going to dive into the evolution of the WTA support for players when it comes to motherhood and fertility from the of the PIF WTA Maternity Fund a few months ago back in March. I think that was to the brand new fertility ranking rule. Players no longer have to choose between tennis and motherhood and there is room for both. So I have two awesome guests coming on the show today, Kathleen Stroya and Dr. Megan Gornett. Kathleen is the Head of Performance Health at the WTA and she's been with the tour for 35 years. I've known Kathleen since I was a little girl, since I started playing on the pro tour as a 16 year old. And Dr. Garnett is an Assistant professor at Washington University, a fertility expert and is working with the WTA on this topic. So we have a lot of things to get into. So let's get started.
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Kim Clijsters
Hi Kathleen and Megan. I am very very excited about this conversation. Kathleen, let me start with you because you and I think we've known each other the longest and I've had many great conversations in the past and in the physio room. So hopefully we can kind recreate that here a little bit. But thank you so much for taking the time to have this conversation with me.
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Kathleen Stroya
Thank you Kim. It's a pleasure to be here. Greatly appreciate you inviting us.
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Kim Clijsters
So I'm just going to go straight to it. My thought process about this episode was me thinking back in 2009 when I played the US Open and there wasn't much support for a mom. I was I think the only mother on tour at the time. I know Lindsay had just retired because she came back after she had Jagger. She had just retired So I think I was probably the only mother on tour at the time. And then fast forward, I think about 16 years later where we are at now, we have about, I think 25 mothers on tour. So very proud to see that. We saw I think Belinda Bensich win in Abu Dhabi. We saw Tatiana Maria win. So for me, kind of the thought process is when did the WTA really start to put a focus on, okay, let's make changes for mothers that are coming back. Mothers to be right. Women players that want to become a mother while still thinking about their career after having a baby.
- [05:50]
Kathleen Stroya
I think for many years it's been on our vision board working with female athletes and women athletes and just wanting to understand more about women's health. Hologic, when they joined us in 2023, really made that happen to come to another level for us. And Megan is a part of it. Dr. Gornett, who the Women's Health Task Force, which is comprised of 19 specialists from around the world with different disciplines of women's health, working with our athletes, advising us. And so that was a real focus for us. But going back to that is particularly from the origin of the tour, it's always been player led. And if I could just take a moment about the history of the tour that from the original nine on, from the very beginning, they hired the first athletic, female athletic trainer in professional sports. And this was their vision for us to continue to develop this. And so from the, from the beginning they were trailblazers and even, even the sports medicine side or the, or the athlete health. And in 2019, Serena Williams and Victoria Azarenko were very instrumental in asking us to revisit the maternity leave, the special ranking maternity leave. And that was this time when we looked at it and it was really an expansion of how much time an athlete really needed for postpartum return to an elite level sport. And we were able to revisit that. So that was after when you came back and able to revisit that and really apply this time some of the science and what we learned in the field to the rule itself. And so giving the amount of time that an athlete needed to come back and fully return to player to participation at this highest level. So, you know, it was really driven by our, by our athletes and understanding the demands of the sport and their needs and what we needed to look at and really looking at the holistic person, not just the athlete, but the entire person and taking that holistic approach. And that's really been a driver for us.
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Kim Clijsters
Amazing. I remember when I came back in 2009, and I think one of my first or second week back playing in the States, one of the players, she was in her mid-30s, and she told me, she's like, I can't believe you just did this without making it look so easy. I've been thinking about it for so long, and I'm scared to kind of give up my career that I've worked towards for so many years. And I never really looked at it that way. Right. Like, for me, it was more like I feel like I wanted to become a mom. And I know that I was fortunate enough that I had made enough money so that I didn't have to worry about taking a break or coming back. We were able to take a nanny. Yeah. It just made things a lot easier. But over time, you realize not everybody has that luxury on tour. And it's sometimes the choice between, okay, do I pick a trainer, do I pick a coach, do I take my physio with me, or can I take an extra nanny? So just seeing all the changes that have happened and we've seen, I think in March, the PIF WTA Maternity Fund was launched. We saw the fertility rule that just came into place a few weeks ago. So a lot is happening. And I feel like tennis is always kind of the front runner when it comes to women's sports and how they support their athletes. So I'm really, really proud to see all that. It's just. Yeah, I always am very curious to figure out, so what is the rule about which players are able to. To use it, which aren't. So if you can maybe give me a little bit more kind of an explanation or an example of what could happen.
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Kathleen Stroya
I think what's really exciting that you indicated is that there's now a fund for the players from maternity leave and the fertility protection process as well. So that was recently introduced, and that was with our partner pif, and that. And that applies to several athletes on the tour. For several hundred players on the tour, from the maternity leave fund to the top 750 singles and doubles players for the fertility protection. So giving them those opportunities, like you said, this is, again, it was driven by the players. And with our partner with pif, we were able to make this happen. In addition to. And our tremendous leadership, and then taking it a step further, which was players speaking out about egg freezing and fertility. Sloan Stevens was very much an advocate of that. And so us taking a look at it and working with our specialist who's on the call with us today, Dr. Garnett. And helped us to write the fertility rule because this is such a high level specialty and the considerations that needed to. To be in place. So, Megan, maybe you can talk a little bit more to that, please.
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Dr. Megan Gornett
Yeah, yeah, absolutely. You know, when I was first approached about this about a year ago, I was just so impressed with what, you know, Kathleen, you all with the WTA and the hologic women's task force were doing. We have a saying in medicine that, you know, you want to treat the patient and not the disease. And I think, you know, the WTA is taking that as you want to treat the player. Right. And not just the tennis aspect of it. And so in this circumstance, with this fertility rule, especially this special protection for players to preserve their fertility through egg freezing or embryo freezing, it's exactly that, right? It's looking at the whole player and what benefits them as an individual and not just the tennis part and the athlete part. And I have had so many patients, you know, outside of just being an athlete, that these young women, there's so much pressure on them, right. In regards to their fertil and being scared about, you know, their own biological clock, which is a reality for us as women. Right. And just the ability to have this investment in themselves and preserve this fertility takes a huge mental weight off of them. And, you know, obviously we don't, we don't know yet. Obviously Sloan, as you mentioned, has been vocal about this, but I'll be curious to see how this helps them on an individual level, on a mental level, and then changes ultimately performance. And obviously the goal being longevity for our players.
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Kim Clijsters
Yeah, that's the thing that I love about it is like our sport has grown. I feel like the age of women being at their best level in our sport, I feel like it's also gotten older over the years. And so it just takes away an added pressure, like you said, right. Like my girlfriends who don't play sports, but for them it's already like such a big relief if you don't have a partner, not sure about what direction to go. Like, it's such a relief. And then for tennis players, like, we worry about so many things, right? It's about the responsibility to your sponsors, your. Your ranking, your points. Like, there's. There's so many things that we are focused on that just add more pressure to the ball that like a player carries with them and it's not just hitting a tennis ball. And Yeah, I just for me, kind of, you know, when I think back about, I think Kathleen, my first year on tour, I was 16, right? And to be, you know, sitting here and having these conversations, it's like knowing that we were going to have this conversation just thinking about like all these years and the connections and I've always loved that kind of the atmosphere in the locker room where I get to go into the locker room where the physios are and it's always women. Like my team was mostly men, right. So just to be in the locker room and talk to women and when I was young, right when I was, you know, young girl with acne in my face and like didn't know how to handle that and like they would, you know, give me advice and then to being a first time mom and my daughter or Jada being sick and not knowing what to do and it would just the strength of the locker room, the physios in the, in the training room is I feel like so valuable and it was so much more meaningful than maybe I took it during the time. Right. So yeah, I'm very, very excited that we have that everything in place now where mothers feel helped and feel like they have a voice that they can share their struggles because it's not easy, right? Being a first time mom is not easy in day to day life. But then trying to do that on the road, it just makes things a lot more complicated. So maybe Kathleen, can you explain to me a little bit also about like the physios, like how they've changed kind of also or how you've added different post. Yeah, Postpartum, you know, kind of tools to help new moms on tour. Because there's a lot of players that I took, I feel like I took my time. But there's a lot of players now these days that come back really early and really quickly. So how have you taken on that approach or what have you added onto the team in the physio room?
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Kathleen Stroya
I think they're. There's several. As we've evolved, we have had the opportunity to also grow our services. And we have our primary healthcare providers who are physical therapists and athletic trainers and then our massage therapy team. We have mental health care providers at every tournament now. And so it's treating the total athletes. Sometimes we have acupuncturists and then of course we have our tournament physicians and our medical advisors. And so our focus has shifted over the years as we've evolved. It's still on sports medicine, very much sports medicine and bringing advancements in the field to the training room and then tennis medicine. And now the female athlete or women's health is the latest Aspect where some of our clinicians have actually gone on to study and get their. Their certification in women's health specialty subspecialties of women's health. So we've added pelvic floor. Taking a look at the pelvic floor and pelvic floor assessments and pelvic floor care. Also bra fitting. It's a piece of equipment. And so really looking at that and providing the assessment and then the advice to the athletes on how to, you know, what the best support is. And so really evolving to, again, it's the life cycle of a female and really studying that and applying that and working with the athletes at each stage of their career, whether it's when you started at 16 or became a mom, you know, which was, you know, which a lot of other athletes paid attention to because, you know, you came back at the very highest level winning a Grand Slam and so showcasing that can be done and then wanting to learn more about that and the journey. And Kim, I think I've shared this with you over the years, but it's so greatly appreciated so that the players take the time to tell us what it took for them to get there and what they need from us to stay there. And that is so highly valued, and it's so appreciated because it allows us to continue to understand and to continue to grow.
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Kim Clijsters
Yeah. And that's the mindset that you really feel. It's like you have the ability to find the right people with the passion, with the care, with the professionalism, the knowledge. Right. Like, I think I've traveled to different sporting events and I've been, you know, around, and it makes me realize, like, how well organized the tour is and how well organized, especially the physio and the medical field on. On our tour is. And so, yeah, maybe it's part of getting older, but you. I really start to appreciate it more and more and realize, like, how much more the WTA is. Yeah. Just takes care of their athletes so well. Maggot, can I ask you, are you directly in touch with athletes or is it. Are you.
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Dr. Megan Gornett
Yeah, yeah. Great question. As a. As a part of the task force, I've had a couple of individual athletes reach out to me about, you know, certain questions about the logistics and things like that.
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Kim Clijsters
Since the news came out.
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Dr. Megan Gornett
Since the news came out. Yeah. Yeah, it's good. It's. I. I enjoy being a resource for them, so it works well for all of us.
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Kim Clijsters
And will. Will you also travel to some tournaments or are you based from home?
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Dr. Megan Gornett
Yeah, I'm based at home, but you Know, I. I will go where the WTA needs me. You know, I. I had the opportunity to sit in on some of the players council meetings, especially as this role was being kind of deliber. And, you know, I think that I'm viewed as a voice that can be helpful to them in terms of should I or shouldn't I in terms of these procedures. But, yeah, happy to be a resource in this way for the WTA.
- [19:35]
Kim Clijsters
I'm very excited to kind of see this evolve, because our sport, we travel around the world, we have athletes from different backgrounds, different cultures. So to see. I can't wait to see a new mom hold a trophy, a grand slam trophy. Like, I'm so excited to see that happen. I'm excited to see a player use the paid leave program, the fertility program. So, yeah, I'm very proud that this is where we've gotten. Kathleen, I feel like you've been on my top five list of people that I would love to interview or interview, have a conversation with. And there's so many topics that are going through my head that we talked about in the past, and it's always been kind of with, okay, where can the tour go, right? Like, how can we still improve? And what do you feel like at this stage? Where can the. Or if you have your dreams or your passion, like, where do you see yourself and the tour? Where do you see things added in this field? Where else can. Can the tour improve?
- [20:42]
Kathleen Stroya
I think a big part of it is a little bit broader in women's health, specifically, this is not in general, because there are women and men's studies that are done, but solely women's studies that are done. It's only 6% of the research that is published. And so us continuing to be a part of that, to gain knowledge and to continue to share that out is really important because we all learn together. So I think as we evolve and continue to learn and contribute to what we learn about female athletes, and working with our athletes and engaging with them is a real direction, and then providing them with the resources they need and expanding in this area. We're only at the beginning, truly. We talked about when we set up and developed the fertility rule. We. We also talked about what do we really know about and how do we begin to plan. Like, you asked the question about return to play protocols. And so we have some of the general information, but for us to get specific to our environment and engage with athletes who have gone through it will be a next step. And that's what we continue to evolve with, and then Advancements in the sport, in sports medicine, bringing it to the field, continuing to stay on top of our sports medicine advancements and impacting manufacturers. That's a really big one because we've had, over the years, we've been able to work with some shoe manufacturers and work with them on creating a shoe that is made from a women's last and not just a men's last cut down. But there's so many more areas in manufacturing where we can definitely get more female athlete or women's health specific. So those are some of the, I think, the future as we continue to grow in this area.
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Kim Clijsters
Yeah, great, Megan. And what.
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Dr. Megan Gornett
Oh, yeah, sorry. I was just going to say if I might chime in, you know, in the creation of this fertility rule, one of the things that was actually surprising to me initially was that there is so little data about recovery and return to sport when it comes to something other than an orthopedic injury and even that. I mean, there is good data, especially, you know, how potentially menstrual cycles and progesterone and all of these things can affect that, but honestly, not that much. And so it was kind of tricky to come up with, you know, the appropriate amount of recovery time from this type of procedure based on, you know, really not much information. And so to touch on what Kathleen was saying, I think a big goal of all of this is to g information about high performance athletes, how, how we recover, how, you know, how they recover from these types of procedures and, you know, set an example for other women's professional sports. Right. And how players can return after these types of procedures.
- [23:55]
Kim Clijsters
And are you, are you allowed to kind of go a little bit into detail about, like, recovery for sure is like, I'm sure there's a big difference in, you know, a woman that has a baby or goes through the fertility program. Like, when I came, you know, it took me about nine months to really be where I felt like, you know, no, it took me longer. I started training about nine months, but I had Jada about 17 months prior to. So I really took my time to let my body heal and mentally as well, to just focus on just being a mom and enjoying it to the fullest. But like, in the fertility process, like, how does that, like, translate to recovery? Like, do you know more information about that or not yet?
- [24:38]
Dr. Megan Gornett
I can certainly answer the question. Question. But the answer is we don't know. Right. And that's again, kind of the crazy thing, you know, in the course of the egg freezing process, which, you know, just to be Clear. Is the same process that a woman or a couple going through IVF does. Right. So they're taking about two weeks of injection medications that really drive up their hormones and get to really, really high levels. And, you know, but we don't know what the impact is on the immediate level of all of those things. You know, ob. To your point, those high levels of all of those hormones and the changes in the pregnant body does have an impact for the postpartum athlete, but specifically in this very small window of time that we have for this fertility protection, we don't necessarily know that, and it was pretty much just based on expert opinion. One of the biggest things is that the ovaries get huge. They get to be about even 10, 20 times the size as they normally are. It's crazy. Basically, like. Like, almost like grapefruit in your pelvis sometimes.
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Kim Clijsters
Oh, no way.
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Dr. Megan Gornett
Yeah, yeah. And so part of these guidelines for the 10 weeks was trying to build in time for the ovaries to decrease back to their normal size to account for an athlete who maybe they didn't get many eggs or embryos the first time around. Are they going to have to do it again? And then again, accounting for that decrease in ovary size, getting back to your hormonal baseline, all of those things were definitely taken into consideration. But admittedly, in a knowledge gap.
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Kim Clijsters
Right. So players aren't. They're not, let's say. I don't know, some players might react differently to it. Are players allowed to play while they're on the fertility program or no?
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Dr. Megan Gornett
Great question. Yeah. So we came up with, again, these kind of guidelines. Not recommended to play when you're doing the actual treatment. The recommendation was starting about two weeks after the egg retrieval procedure. You can start taking a more graduated approach into introducing exercise. Low intensity is okay during some of the stimulation, but again, the worry is that those ovaries are so big that they can actually twist on themselves and actually be in emergency. So very specific guidelines that we tried to create to promote activity, not get too deconditioned, but at the same time trying to be safe.
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Kim Clijsters
And is this something they do from home or do they have to go into a local clinic or work with.
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Dr. Megan Gornett
Yeah, yeah.
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Kim Clijsters
Their doctor or. How does that work?
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Dr. Megan Gornett
Yeah, great question. So, you know, for the egg freezing process, Is that what you're referring to, Kim? Yeah, yeah, yeah. So starts with an initial consultation with a fertility specialist, a reproductive endocrinologist, someone like me, where you do, you know, an initial consult, because there's so many different things that Go into, is a player going to respond well to medications or are they not respond well? So some of that initial testing is really helpful and actually those are some of the questions that players have asked me in terms of do they think they're going to get a good response or not, though none of us have a crystal ball. But anyway, yeah, about a two week process of injecting medications, about four to five ultrasound blood work visits on average. So very time intensive where they're having to go in to the clinic for those types of studies. So. Yeah.
- [28:12]
Kim Clijsters
Kathleen, have you noticed, because I think you've been on tour for what, 35 years. Have you noticed that the lifestyle of a female tennis player, the intense travel, the pressure. Have you noticed with players that retired that there were more fertility issues because of the intense lifestyle or was it not really any change?
- [28:36]
Kathleen Stroya
I don't think we have that information. I don't know.
- [28:39]
Dr. Megan Gornett
Yeah, yeah.
- [28:40]
Kim Clijsters
I was just curious to see what like, you know.
- [28:44]
Kathleen Stroya
Yeah.
- [28:44]
Kim Clijsters
Jet lag and all that stuff does on the, on the female kind of reproductive organs.
- [28:50]
Dr. Megan Gornett
We do know that some of that can impact. Yeah, yeah, okay. Yeah. Circadian rhythm issues.
- [28:56]
Kathleen Stroya
And so we look at that as part of the, you know, our travel, our sleep protocols. We, you know, it's the life cycle of a female that is also incorporated into that all the way through, through perimenopausal. So it's just because we, you know, with our age eligibility and player development, we now have longevity on our tour and some, some of our players are playing into their 40s, so it's, it really.
- [29:19]
Kim Clijsters
So we can start talking about perimenopause as well.
- [29:23]
Dr. Megan Gornett
Yay.
- [29:28]
Kim Clijsters
Yeah. But it's, it's, it's really exciting. I mean. Yeah. And to have the support and.
- [29:34]
Kathleen Stroya
Yeah. And, and as part of the building of the, of the rule, the, the fertility protection process that we put in place, we interviewed athletes that had gone through that process. They, again, they took the time and shared their experiences and their timelines and what they felt was, you know, what their experience was, how long they felt was needed to really have that return to play, safe return to play, and ample time that they needed in order to come back to play the elite level. And so that was, with their input was a tremendous part of also the shaping of the rule.
- [30:15]
Kim Clijsters
Right. That's something like when you watch a player on tv. And now me as a fan, I know what female players go through. Right. Like when you see somebody maybe a little more annoyed on court or frustrated or cranky. Yeah. There's so Many things that, you know, with our hormones that have an effect and you just try to make the best of it. But yeah, it's not that easy. And then add jet lag and different, you know, all the different changes that we go through all the time. I just know that me getting older and traveling with Jada, it's a lot harder for me to sleep, you know, go through time, change, sleep in different hotel rooms and have different pillows. And back in the day it never used to bother me, but I feel like now it's just getting harder and. But it's great to have the support and to see all the work that the WTA keeps doing and to improve the players health. And I love that quote that you mentioned. I've heard you say it before and it gave me goosebumps then and I had it earlier. It's that the players came to you to say this is what we did to get here. And it's the job of the WTA, the staff, to have them there for as long as possible. And I absolutely love that. And I felt that when I was playing and I feel it now probably more than ever when as a tennis fan and going to these tournaments, how well that message comes across in not the words but in the actions. And I think that's the most important thing. And I hope the players these days know that as well and are grateful for it because once you stop playing, there's nothing that I miss more than is the treatments and the taking care of your body and putting that first. And so, yeah, I'm grateful that you took the time for this conversation. Kathleen, thank you. Megan, thank you so much. I'm excited to see you around on tour. And yeah, I guess we're all excited to see the first player come out and kind of use the maternity leave program and also the fertility program. So thank you so much for this.
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Dr. Megan Gornett
Well, thanks for your time.
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Kathleen Stroya
And as you always talk about, this is the training room environment which we call the kitchen of the tour. And so. And where all the good conversations take place.
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Kim Clijsters
Right. That's where it all. We can all relax in the physio room. It's fun. I always say like, you know, I think like LeBron James has that or he had like a talk show where they were all sitting in barber chairs. And I feel like Artur can do something like that where you sit in the physio room and have players, you know, getting treated or massage or having ankles taped. Absolutely. The conversations, we would have some good laughs too.
- [32:57]
Kathleen Stroya
The athletic care was the vision of the original nine. And so we work every day to continue to work toward their dream.
- [33:05]
Kim Clijsters
Yep. They were trendsetters years ago and it's amazing to see it all kind of fall into place and still get better year by year. Yeah. Thank you both very much.
- [33:18]
Dr. Megan Gornett
Thank you so much.
- [33:20]
Kim Clijsters
Look forward to seeing more about it all. Yeah.
- [33:24]
Dr. Megan Gornett
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- [33:31]
GMC
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- [33:40]
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- [34:08]
Kim Clijsters
Thank you, Kathleen and Megan. I really enjoyed the conversation. I feel like I learned a lot. What I probably love the most about this conversation or what stood out to me the most is that I loved hearing that players like Serena and Vika and Sloan were so involved in creating this program and sharing their information and their experiences, which will really help the next generation of mothers playing on tour or people players starting the fertility process and really learning and and sharing the experience that they gave them. So very, very exciting. It's great to see that this is happening on the tour and I hope that this becomes a standard across other women's sports as well. So a big thank you to Kathleen and to Megan for sharing their wisdom. Thank you everybody for listening and for watching. Be sure to rate to comment, ask questions and subscribe. Subscribe to the podcast. So I'll see you next time on Love All.