Balanced Black Girl Podcast Summary

Episode: Should You Freeze Your Eggs? Everything You Need to Know About Fertility with Dr. Amanda Adeleye of CCRM [Bonus]
Release Date: February 21, 2025
Host: Balanced Black Girl
Guest: Dr. Amanda Adeleye, Reproductive Endocrinologist at CCRM

1. Introduction to Dr. Amanda Adeleye

The episode kicks off with the host warmly welcoming Dr. Amanda Adeleye, a specialist in reproductive endocrinology and infertility at CCRM. Dr. Adeleye shares her journey into reproductive health, emphasizing her passion for science and a desire to address injustices in women's health.

Dr. Adeleye [00:31]: "Obgyn as a field seemed like the best way to fix the imbalance and be fair."

She elaborates on her decision to specialize in obstetrics and gynecology to build lasting relationships with women throughout their lives, finding joy in helping them build families.

Dr. Adeleye [02:26]: "Reproductive healthcare is the one area of medicine that helps people potentially feel joy."

2. Defining Fertility vs. Infertility

The conversation delves into clarifying what constitutes fertility and infertility. Dr. Adeleye explains that:

• Fertility refers to the ability to conceive naturally when desired.
• Infertility is medically defined as the inability to conceive after a year of regular, unprotected intercourse if under 35, or after six months if over 35.

She highlights that the American Society of Reproductive Medicine (ASRM) now broadens this definition to include individuals requiring assisted reproductive technologies, encompassing LGBTQ+ communities and single parents by choice.

Dr. Adeleye [05:35]: "Anyone who needs assisted reproductive technology or assistance to get pregnant is included in the expanded definition of infertility."

3. Common Causes of Infertility

Dr. Adeleye outlines the primary factors contributing to infertility:

1. Ovarian Issues (20-25%): Includes irregular ovulation and poor egg quality.
2. Male Factors (20-25%): Low sperm count or motility.
3. Structural Issues (20-25%): Problems with the uterus or fallopian tubes, such as fibroids.
4. Unexplained Infertility (25%): When no specific cause is identified despite thorough testing.

Dr. Adeleye [06:52]: "About 20 to 25% of the time, it can be a male factor issue."

4. Specific Conditions Affecting Fertility

a. Polycystic Ovary Syndrome (PCOS):
Occurs in approximately 5-10% of women of reproductive age in the U.S., defined by irregular menstrual cycles, polycystic ovaries, and hyperandrogenism.

Dr. Adeleye [08:32]: "PCOS probably occurs in about 5 to 10% of women of reproductive age in the United States."

b. Endometriosis:
Affects around 3-5% of women, though it might be underdiagnosed due to the invasive nature of surgical confirmation and the tendency for symptoms to be dismissed.

Dr. Adeleye [11:37]: "Women with pelvic pain are often dismissed by their providers, leading to underdiagnosis of endometriosis."

c. Fibroids:
More prevalent in women of color, particularly Black women, who tend to develop fibroids at an earlier age and may accumulate more over time compared to white counterparts.

Dr. Adeleye [11:53]: "Women of color do tend to get fibroids at an earlier age and may have more significant disease burden."

5. Male Factors in Infertility

Dr. Adeleye emphasizes that male factors contribute almost as frequently to infertility as female factors, estimating that they account for 40-50% of cases when considering overlapping issues.

Dr. Adeleye [14:19]: "Men contribute to fertility issues almost just as frequently as women."

Common male-related fertility issues include low sperm count, poor sperm motility, erectile dysfunction, and inability to ejaculate.

6. Egg Quality and Aging

Egg quality diminishes with age, primarily due to chromosomal abnormalities that increase as women approach their mid-30s and beyond. This decline leads to higher rates of miscarriages and chromosomally abnormal embryos.

Dr. Adeleye [16:02]: "Egg quality refers to how many chromosomes an egg has, which decreases with age."

By age 40, only about 40% of eggs may be chromosomally normal, dropping to 5% by age 45.

7. Egg Freezing: Pros and Cons

Pros:

• Optimizing Probabilities: Freezing eggs at a younger age can preserve chromosomally normal eggs, potentially increasing the chances of a successful pregnancy later.

  Dr. Adeleye [20:49]: "Freezing eggs can improve your probability of getting pregnant and having a live birth if you need IVF in the future."

Cons:

• No Guarantee: Freezing eggs does not ensure fertility preservation. Success rates vary, especially with age.

• Financial and Emotional Costs: The process is expensive, often not covered by insurance, and can be physically and emotionally taxing.

  Host [24:20]: "It can be sold as an oversimplified layaway system without fully discussing the risks and potential outcomes."

Dr. Adeleye advises that egg freezing should be considered as part of a broader conversation about family planning rather than a simple solution.

Dr. Adeleye [24:21]: "It's about optimizing probabilities, not guaranteeing fertility."

8. The Egg Freezing Process

Steps Involved:

1. Hormonal Stimulation: Daily injections of medications to stimulate the ovaries to mature multiple eggs over 10-12 days.
2. Monitoring: Frequent pelvic ultrasounds and blood tests to monitor follicle development.
3. Egg Retrieval: A minor surgical procedure under sedation to collect mature eggs.
4. Freezing: Extracted eggs are assessed for maturity and then cryopreserved.

Considerations:

• Side Effects: Includes bloating, injection site reactions, mood changes, and in rare cases, ovarian hyperstimulation syndrome (OHSS).

  Dr. Adeleye [30:47]: "You might experience bloating, bruising, mood changes, and in some cases, OHSS."

• Success Rates: Higher success when eggs are frozen at a younger age, but there's inherent uncertainty regarding future pregnancy outcomes.

  Dr. Adeleye [35:03]: "Under the age of 35, about 70% of eggs will lead to a live birth, declining by 5% per year thereafter."

9. Impact of Political Climate on Fertility Care

The overturning of Roe v. Wade poses significant challenges for fertility care, including:

• Embryo Personhood Debates: Legal recognition of embryos could complicate the handling and disposal of frozen embryos.

  Dr. Adeleye [38:46]: "If embryos are given the rights of humans, it changes the game for fertility practices."

• Access to Fertility Services: Potential restrictions and legal hurdles may limit access to treatments like IVF, especially in certain states.

  Dr. Adeleye [41:57]: "My patients now have to consider safety and legal aspects based on their location."

Dr. Adeleye advocates for legislative advocacy to protect fertility care access.

Dr. Adeleye [42:04]: "Talk to your Congress people if this resonates with you."

10. Importance of Fertility Education

Dr. Adeleye highlights a significant gap in fertility education, particularly within Black communities. She shares her efforts to bridge this gap through:

• Community Seminars: Collaborations with organizations like Fertility for Colored Girls and Guys to conduct free educational seminars, resulting in increased knowledge and awareness.

  Dr. Adeleye [43:47]: "Education is super important because ignorance leads to suffering."

• Upcoming Documentary: A project in collaboration with Reverend Stacey Dunn to document Black experiences with infertility, aiming to further raise awareness and understanding.

  Dr. Adeleye [47:10]: "A documentary about the experience of Black people with infertility is in the works."

She underscores the myths and stigmas that exacerbate infertility challenges in marginalized communities.

Dr. Adeleye [46:21]: "There's a myth that Black people are hyper-fertile, which is absolutely not true."

11. CCRM and Dr. Adeleye’s Initiatives

Dr. Adeleye announces the upcoming opening of CCRM Fertility of Chicago in May 2025, featuring a state-of-the-art IVF lab. She encourages listeners to consult with reproductive endocrinologists to explore their fertility options.

Dr. Adeleye [47:56]: "CCRM is a network of experts and excellent fertility clinics around the country. Check out the one closest to you."

She advises individuals to advocate for themselves, seek informed conversations with their healthcare providers, and understand their fertility needs deeply.

12. Conclusion

The episode concludes with the host thanking Dr. Adeleye for her invaluable insights into fertility, infertility, and the importance of informed decision-making in reproductive health. Listeners are encouraged to subscribe, leave reviews, and stay informed about upcoming discussions and resources.

Notable Quotes

• Host [02:26]: "Reproductive healthcare is the one area of medicine that helps people potentially feel joy."
• Dr. Adeleye [05:35]: "Anyone who needs assisted reproductive technology or assistance to get pregnant is included in the expanded definition of infertility."
• Dr. Adeleye [14:19]: "Men contribute to fertility issues almost just as frequently as women."
• Dr. Adeleye [20:49]: "Freezing eggs can improve your probability of getting pregnant and having a live birth if you need IVF in the future."
• Host [24:20]: "It's sold as an oversimplified layaway system without fully discussing the risks and potential outcomes."
• Dr. Adeleye [35:03]: "Under the age of 35, about 70% of eggs will lead to a live birth, declining by 5% per year thereafter."
• Dr. Adeleye [38:46]: "If embryos are given the rights of humans, it changes the game for fertility practices."
• Dr. Adeleye [43:47]: "Education is super important because ignorance leads to suffering."
• Dr. Adeleye [47:56]: "CCRM is a network of experts and excellent fertility clinics around the country. Check out the one closest to you."

Final Thoughts

This episode of Balanced Black Girl offers a comprehensive exploration of fertility and infertility, particularly spotlighting the experiences and challenges faced by Black women. Dr. Amanda Adeleye provides expert insights into the medical, emotional, and societal facets of reproductive health, advocating for better education and access to fertility care. Listeners gain valuable knowledge to make informed decisions about their reproductive futures, emphasizing the importance of proactive conversations and self-advocacy in navigating fertility options.