IVF add-ons such as PGT-A, ERA and immunological treatments could be a great option for you, helping you to improve chances. And sometimes your problem may be that your doctor doesn't  recommend add-ons at all; perhaps the clinic doesn’t offer them due to tradition or regulation. But it also happens that (profit-driven) clinics recommend add-ons even though research doesn’t support that it will improve your chances. Most add-ons are recommended for certain patient groups, not as a standard treatment. 

When all you want is a solution, you want to try it ALL. But costs (financial and physical) may not always outweigh the potential - at least at every stage of the treatment. No matter how frustrating it is, treating infertility often is a “trial and error” process where you have to try a few things and learn along the way. 

Having said that, there’s no right or wrong decision; only you and your doctor can agree on what the next step should be. But no matter the outcome it always feels better if you’ve asked the right questions to be able to make an informed decision. So here’s a few tips on questions you can ask to have a better discussion with your doctor. Bring this check-list to your appointment...

1. Why do I need this add-on? Do you recommend it to all patients or are there certain things that make it suitable for me?

2. What will happen if I don’t add this to my treatment or if I wait a while?

3. Are there any alternatives I should know about?

4. Are there any risks or side effects involved? How likely are they to occur?

6. In your opinion - do the potential benefits outweigh the risks and costs for me?

This checklist and many other are found in Tilly's app - bring them to your doctor's appointment and tick the questions you've asked. Feeling in control can make a big difference 💪

What to ask your doctor when they suggest an IVF add-on

Checklist: Questions to ask when your doctor suggests an IVF add-on

Becoming a single mother by choice wasn't what I had in mind when I first set out to become a parent. But as life would have it, my path to motherhood took some unexpected turns, and today, I'm here to share my story of embracing single motherhood.

When I was 35, my partner and I decided it was time to start trying for a baby. Like many couples, we encountered some roadblocks along the way. After a few months with no success, we sought help from a fertility specialist and discovered that my egg reserve was low. Suddenly that straight path to parenthood was not as straight anymore. We were determined to keep moving forward, however, and decided to pursue fertility treatment.

Navigating fertility treatment and heartbreak 

My partner and I started our first IVF treatment. My road to motherhood took an unexpected turn again however, when my partner expressed hesitations about continuing treatment and our relationship, leaving me in the middle of treatment. His decision left me shattered, and of course the hormones from treatment did not help. I eventually found my way through the crisis and started to look ahead, and today I know that he is not the kind of person I would have wanted to co-parent with.

Amid all the uncertainty, I began to reassess my priorities and what I really wanted out of life. Through therapy and reflection, I came to realize that my desire to become a mother was stronger than ever, even if it meant doing it alone. The decision of pursuing single motherhood was a long process, but in hindsight, the best decision I made in my life. 

The road to single motherhood was not without its challenges. From IUIs, a miscarriage followed by IVF. But in the end it did work out.

Today I have a son that I love immensely, I have many close friends and a job that I love (and I am also fortunate enough to have a very flexible employer which is a plus as a single parent). 

I have not taken up dating yet but am confident that I can do that when my son is older. My life is filled with purpose and love, and I am very happy with the the way my life turned out in the end.

For anyone considering becoming a single parent, what is your best advice?

Lean on the support of loved ones and professionals, but ultimately trust your intuition and make decisions that align with your deepest desires. I talked to friends, family, and my therapist, but in the end the decision was mine.

Connect with communities: Seek out organizations and communities of single mothers who can offer guidance, support, and camaraderie on your journey. This helped me feel less lonely in my decision, find close friends, and form realistic expectations.

Prepare for challenges: Anticipate the challenges of single parenthood (and getting there), from logistical considerations to emotional hurdles, and cultivate a strong support network to navigate them with grace. 

Having a realistic view that it can take time, and that unfortunately (as always when trying to have a baby) there are no guarantees, is important. 

It’s also good to have thought through how you will handle everyday challenges. How you will manage work and having a child? Having a flexible employer is a plus (as for all parents). What does your “community” look like? Do you have people who can care for your child in case you get sick for example? It can be people you already know or a baby sitter agency, but I believe that having thought through what challenges life might throw at you, and how you can handle them is helpful.

Deciding on how will you become a single mother in practice. There are different roads to becoming a single mother by choice. Many of us use donor sperm, it could be from someone you know, but often it’s via a fertility clinic. In some cases, egg donation might be needed, and of course, there is also the option of adoption. Rules and regulations look different in different countries so reaching out to organisations for single mothers by choice is also a great way to be able to get guidance and decide upon your best way forward.

Do not overthink it. Despite all that I have said above I think the most important in the end is to listen to your heart. This was the right path for me, I love spending time with my son, I love being a mother, and I am very fortunate to have been able to take up this path in life.

Becoming a single mother by choice wasn't what I had planned, but it's been an incredible journey filled with love, joy, and unexpected blessings. If you're considering taking the leap yourself, know that you're not alone, and that there's a whole community of women out there cheering you on.

Raising a child on your own can be challenging - are you a single mother, or do you know someone else in need of help (e.g. financial assistance)? 

Here are a few organizations that provide support and community to single mothers in need:

Council of Single Mothers and their Children (Australia)

Femmis - Föreningen för frivilligt ensamstående föräldrar med donation (Sweden)

Mariah: My road to becoming a single mother by choice

Jenny Ann Johnson is the founder of Tilly. She’s spent a decade working on digital educational products prior to founding Tilly. After struggling with infertility and miscarriages for many years she finally found her path forward and is today blessed with four children. She is now creating the supportive and educational tools she herself was missing while going through fertility treatments.

With Mother’s Day just around the corner in the U.S. and several other countries, it’s important to acknowledge that family-centered holidays, especially ones celebrating moms and dads, can be incredibly tough for those struggling to conceive. As the big day approaches, you might notice stores and the internet flooded with advertisements, and once it arrives, your social media feed may be filled with images of blissful families honoring their parents. 

So... how do we navigate through Mother’s (or Father’s) Day without losing our sanity?

First and foremost, be gentle with yourself. It’s absolutely normal to experience a whirlwind of emotions – from grief and jealousy to anger. For anyone facing fertility challenges, triggers are a daily occurrence, but on these special occasions, they seem to intensify. Remember, whatever you’re feeling is valid. Don’t chastise yourself for it. Your emotions are a reflection of your own struggles, not a reflection of your character.

Struggling to celebrate your own mom or dad on this day? That’s perfectly okay. Express your feelings to them, even if it means sending a heartfelt text instead of a face-to-face conversation. Your parents care about your well-being above all else.

Mindfulness is key to navigating the day. Consider planning ahead how you’d like to spend your time, whether it’s engaging in activities that bring you joy or taking a break from social media altogether. Perhaps a serene walk in nature or indulging in an activity that would be challenging if you were pregnant or had children could offer solace. Remember, there’s no pressure to socialize if it doesn’t feel right for you.

Celebrate Mother’s (or Father’s) Day in a way that feels authentic to you - and include yourself or your partner in the celebration. Whether you’re a parent to an angel baby or envisioning parenthood in your dreams, your feelings are valid. Honor yourself, your partner, or your grief and dreams in whatever way resonates with your heart.

With that said, we know it can be a really tough time. Here are a few gentle activities from the Tilly app to help you navigate through Mother’s (or Father’s) Day – or any other trigger-filled day:

Take care of yourself. You’re not alone on this journey.

Mother’s Day can be emotionally draining for those struggling to conceive. In this article we share some of our top tips on how to navigate through Mother’s (or Father’s) Day without losing your sanity!

How to Cope With Mother's Day When Struggling With Infertility

This week (April 21-27) marks National Infertility Awareness Week, NIAW, in the U.S. Do you know someone who is struggling?

“It can’t be very common; I don’t know anyone who has been struggling.” 

“And if you have a fertility problem, you can just do IVF, right?” 

“Or maybe then it just wasn’t meant to happen…”

There are a lot of misunderstandings when it comes to fertility struggles, both in terms of how common it is and how it affects people.

Do you know anyone with red hair? Well, that’s 1 in 100. Do you know anyone who is left-handed? That’s 1 in 10. Infertility affects 1 in 6, according to the World Health Organization (WHO).

So, if you aren’t struggling to have a baby yourself, you probably still know someone who is. The stigma surrounding infertility makes it something that is rarely talked about in society, though, making it seem like it’s not that much of a problem.

And how about IVF being that golden ticket? Well, on average, it takes 3 IVF treatments to succeed, but that’s only the average. Some people are trying for years and years, still with no luck. Unfortunately, infertility comes with no guarantees of success. With a global average cost of $10,000+ per treatment, the stress of infertility is not only dependent on desperately wanting to have a child; the financial stress is real as well - and sometimes means that IVF is not an option at all.

Tilly was founded by two former fertility patients, and one of our main goals is to help break the stigma around fertility struggles by opening up the conversation about it and ensuring fertility patients all over the world get the support they need. With fertility patients experiencing stress levels and anxiety on par with people facing a cancer diagnosis, it’s time that we start talking about this and make it a well-known fact.

National Infertility Awareness Week (NIAW) was founded in 1989 by RESOLVE: The National Infertility Association in the U.S. Its mission is to empower you and change the conversation around infertility. This year's theme is “leave your mark.”

Well, here are three areas where Tilly would like to contribute to leaving a mark and creating lasting change when it comes to the conversation about fertility:

We urge schools to start educating students about fertility, not only how to prevent pregnancies but also that a successful pregnancy is not a given. There is so much we are not taught about fertility, conception, and especially about the female body: how it works, how common issues like PCOS and Endometriosis are, and how they can affect fertility.

 The pill is one of the greatest inventions of the 20th century, but you should at least be informed that when you are on the pill, you do not have a natural period, and that being on the pill can mask a lot of potential fertility risk factors. If you are on the pill, you do not still have a real period until you stop taking them - and without a period, no natural conception.

 The mental roller-coaster of infertility and fertility treatments is tough, so much so that the number one reason to stop treatment is the mental toll it takes. We believe it’s time to include mental and emotional support for all fertility patients. This should be the normal support - not something that a few high-end clinics offer. (And yes, of course, Tilly is here to support all of those clinics who are already taking steps to embed this into their regular care).

We also want to celebrate that even if we still have a long way to go, there are also so many beautiful initiatives within fertility health and patient care. Below are just a few of our favourites. Go, go, go, all of you who are hard at work creating a better world for preventing and solving fertility problems and also making sure those who struggle get the best care.

- RESOLVE: the U.S national association for Infertility - the founder of NIAW.

- The Institute of Reproductive Grief Care - (Psst, if you are unfortunate enough to be touched by pregnancy loss, we can recommend joining their latest research study to contribute to better care for other miscarriage patients. Read more here.)

- Ovulai is on a mission to educate and support women with PCOS.

- And of course, all of those clinics out there that every day strive to give their patients both the best medical care but also the best emotional support.

Take care everyone, Jenny Ann Johnson, founder of Tilly, and former fertility patient.

This week (April 21-27) marks National Infertility Awareness Week in the U.S. Do you know someone who is struggling?

1 in 6 is Affected by Infertility - This Week is National Infertility Awareness Week

Maya Maria Brown, M.A., is an infertility mental health expert. She has a master’s in Counseling Psychology, and has worked with individuals and couples on infertility and relationships. She also has personal experience with infertility and is currently in treatment.

Experiencing pregnancy loss is more common than we might think, yet the profound impact it has on individuals often goes unrecognized by society and even healthcare providers. The Institute of Reproductive Grief Care is addressing this gap through their dedicated efforts to bring research and education on this crucial topic to a broader audience. Today, we're shedding light on some pivotal findings from "The Trauma of Perinatal Loss: A Scoping Review", a study that one of their Healthcare Task Force Members released during one of their quarterly Research Reveals series. This study delves into the research surrounding the trauma of baby loss(*) - here are 5 key takeaways which summarizes the main findings:

1. Baby Loss as a Real and Long-Term Trauma:

It’s probably not a surprise to all who have suffered from baby loss, but the research in the review makes it clear that baby loss is a real and long-term trauma for many parents. Research indicates that up to 60% of bereaved parents undergo post-traumatic stress disorder (PTSD) following baby loss. Contrary to the belief that time heals all wounds, a study revealed that 44% of women reported PTSD up to four years after the loss, emphasizing the long-lasting impact. In fact, the effects can extend for up to 12 years, dispelling the notion that one should be "over" the loss quickly. So if you have experienced loss and are not “over it” yet - know that you are not alone.

The study also acknowledges that the trauma of baby loss is something that affects many parts of the parents' lives and that it’s not uncommon to feel stuck and unable to move forward with life. The trauma of baby loss can lead to feelings of anger, hostility, and social sensitivity. Additionally, affected individuals may experience sleep disturbances, eating disorders, dizziness, and headaches. Recognizing the holistic impact of this trauma is essential for providing comprehensive support.

The study underscores the significant influence of social support in navigating the emotional aftermath of baby loss. Friends and family play a crucial role in providing understanding and empathy, particularly during vulnerable milestones such as learning about the diagnosis, sharing the news, and the days, weeks, and months following the loss. So for anyone close to someone experiencing loss - you being there, listening and not downplaying the loss can make a huge difference for your friend. And, please remember that anyone, regardless of gender, who experiences baby loss is affected by it. The study revealed that men reported that they rarely received emotional support from their healthcare providers or their own social circle. Often the task of conveying the news of the loss also became that of the father, something that was itself.

Healthcare providers can significantly influence the intensity of parents' emotional trauma. Acknowledging the loss and normalizing emotional responses are essential steps. The study advocates for follow-up care for at least a year after the loss, recognizing the enduring nature of the trauma. It also highlights the added emotional and psychological challenges during subsequent pregnancies after a loss.

Specific moments during the journey of loss, including learning of the diagnosis, birth (if relevant), and the days, weeks, and months following the loss, are particularly vulnerable times for bereaved parents. Being aware of and providing support during these milestones can have a profound healing effect.

We extend our appreciation to the Reproductive Grief Institute for illuminating these critical findings. Understanding the trauma experienced by those affected by baby loss is vital, and the study offers valuable insights and practical advice for friends, family, and healthcare providers. By collectively embracing this knowledge, we aim to make the challenging journey of baby loss a little more manageable for those who endure it.

Note: *Perinatal loss is the academic term for a pregnancy loss sometime between conception and birth, or of the loss of an infant up to 28 days after birth - but we have chosen to use the term “baby loss” here instead.

Pregnancy loss is more common than we might think, yet its profound impact is often overlooked. The Institute of Reproductive Grief Care aims to bridge this gap by promoting research and education on the subject. In this article, we will highlight some of the finding from their recent study, "The Trauma of Perinatal Loss: A Scoping Review", which sheds light on this important topic.

Navigating the Trauma of Baby Loss: Insights from Reproductive Grief Research

Struggling to conceive is a daunting and, undeniably, stressful journey. But could stress itself be sabotaging your chances of achieving and sustaining a pregnancy? This question can intensify the emotional load for couples and individuals grappling with fertility issues. In today's article, we will delve into the research behind the relationship between stress and infertility.

The belief that stress plays a role in fertility issues goes a long way back, and unfortunately, more often than not, women and women’s minds have been blamed for it. In the 1940s, unexplained infertility was linked to psychological causes attributed to women, assuming factors like their (lacking) desires for motherhood, marital relationship troubles, or even childhood traumas as potential sources of "sterility".

Thankfully, our understanding has evolved significantly. We've acknowledged the role of men in fertility issues and have gained a more in-depth understanding of the complexity of the mind-body connection. However, the myth linking mental stress to fertility issues persists, leaving us to ask: does stress and anxiety truly affect fertility negatively?

One thing is clear: common advice like "just relax, and it'll happen" doesn't help (if something they probably do the opposite, as comments like that can create feelings of anger and hurt).

What Does Science Say About The Impact of Stress on Fertility?

Recent research does, however, suggest that stress may influence fertility, although the relationship between stress and infertility remains intricate and not fully comprehended. 

For instance, a study involving over 500 women in the United States revealed a potential link between high levels of silvery α-amylase, an enzyme released in response to stress, and a prolonged time to pregnancy and infertility. Other studies have also indicated an association between long-term elevated levels of cortisol, known as a "stress hormone," and delayed time to pregnancy. 

Another study involving 135 in vitro fertilization (IVF) patients, using hair samplings to measure cortisol levels from the preceding 3-6 months, found that heightened cortisol levels correlated with lower pregnancy rates. This led the study's authors to suggest that interventions aimed at reducing cortisol levels before fertility treatment might enhance treatment outcomes. 

Moreover, this scientific study involving stressed rats demonstrated a lower fertility rate in those, compared to their non-stressed mates. However, blocking a specific stress hormone led to equivalent pregnancy outcomes in both groups. (This potential “blocker” of the influence of stress is still a long way from being available to humans though).

5 Ways Through Which Stress Can Negatively Influence Fertility

The research delves into various factors through which stress potentially influences fertility:

1. Disruption of Hormonal Balance: Chronic stress can disrupt the normal hormonal balance, potentially affecting menstrual cycles and ovulation, complicating the conception process.

2. Negative Impact on Implantation: Mental stress during early pregnancy might hinder the endometrial lining's function, making healthy implantation more challenging to achieve.

3. Impaired Immune Response: Studies suggest stress could negatively affect the immune system response, critical for reproductive outcomes. However, the role of the immune system in pregnancy outcomes remains an area of debate.

4. Impact on Sperm Quality: Self-reported long-term stress among men has shown correlations with sperm quality. Ironically enough, certain stressful events, like leaving a semen sample, seem to also adversely affect semen quality.

5. Stress & Libido: It's widely acknowledged that stress and sex don't mesh well, and in fertility cases, it's a combination that's far from favorable, potentially affecting the time taken to achieve pregnancy.

Measuring stress accurately remains challenging, with inconclusive or unsupportive results in some studies. Nonetheless, research implies that therapeutic interventions might enhance fertility treatment outcomes, a finding that indirectly supports the idea that mental health and stress influence fertility.

Does Therapeutic Support Improve Fertility Treatment Outcomes?

Could therapeutic support decrease time to pregnancy and increase fertility treatment outcome?

Several studies suggest it might! For instance, a comprehensive 2015 analysis encompassing 39 studies and involving over 2700 women and men highlighted the potential efficacy of psychosocial interventions, particularly Cognitive Behavioral Therapy (CBT) and mind-body techniques (techniques that link the body and the mind, e.g. yoga, meditation, guided imagery). This analysis found that those using psychological strategies to manage stress were twice as likely to achieve pregnancy compared to couples who did not use such methods. While these findings are promising, researchers underscore the need for more extensive studies to establish a definitive link between therapy and fertility outcomes.

Regardless of the exact link between stress and fertility, it’s clear that working on your mental health while struggling with fertility can have a positive impact on your mental well-being and quality of life. And, that potentially it might even up your chances of success on your fertility journey!

As a former fertility patient, I absolutely don't want to add stress by sharing the above findings. I myself have wrestled with worries about how stress might affect my chances of having a baby while I was trying to have a baby. When I founded Tilly, one of my main goals was to support others through the tough journey of fertility struggles, equipping them with research-based information on mental well-being and fertility (while acknowledging ongoing debates). My intention with the above is thus not to scare you but to shed light on pressing questions you might already be pondering about how stress impacts fertility. On a brighter note, once you (hopefully) get pregnant, and if you, like I was, are freaked out during the whole pregnancy, research actually suggests that high levels of the stress hormone cortisol in the third semester might positively impact the language development of your children.

Struggling to conceive is a daunting and stressful journey. But could stress itself be sabotaging your chances of achieving and sustaining a pregnancy? This article seeks to answer this question by delving deep into the current body of evidence on the relationship between stress and infertility!

Can Stress Impact Fertility? Unraveling the Complex Link Between Mental Health and Infertility

In a recent seminar organized by the European Fertility Society, Tilly's founder, Jenny Ann Johnson, shared insights on the transformative potential of artificial intelligence (AI) to improve patient care during fertility treatment. 

In the seminar, hosted by Prof. Johnny Awwad, at Sidra Medicine & Research Center, Jenny Ann together with Cecilie Hvidberg Jakobsen, Founder and CEO of Wawa fertility and Alina Latus, Founder of the Hope App, explored the various applications of AI in fertility care, shedding light on how this technology can revolutionize the medical and emotional aspects of infertility treatment.

1. AI Optimization of Fertility Treatment

AI's ability to analyze large datasets presents a groundbreaking opportunity to optimize the medical side of fertility treatment. For a medical professional this means that instead of asking a few trusted colleagues when you come across a tricky case - you can ask thousands of colleagues. By processing patient data from thousands or even millions of patients, including medical history, genetic markers, hormonal levels, and lifestyle factors, AI can assist in accelerating new findings and personalizing treatment plans, significantly improving success rates. For instance, AI algorithms can enhance embryo selection in IVF procedures, leading to more successful outcomes. 

2. Personalized Emotional Support with AI

AI's role extends beyond medical optimization to personalized emotional support. Through analyzing user data, AI algorithms can deliver tailored content and support individuals in coping with the emotional challenges of infertility. In addition, by freeing up time for medical professionals through streamlined processes, AI enables medical professionals to focus on patient relationships, ensuring a more empathetic and personalized treatment journey. 

AI-powered chatbots offer accessible self-help options, complementing traditional therapy and providing immediate support. Studies have highlighted the beneficial impact of chatbots in therapy, making emotional and mental support available 24/7. This digital support ensures that patients feel acknowledged and supported throughout their fertility journey. 

4. AI Complements, Not Replaces, Human Connection

While AI provides personalized support, it cannot replace the human connection and expertise of medical professionals - in the end it still has to be the medical professional that makes the decisions together with the patient. AI should be viewed as a complementary resource. Prof. Johnny Awwad emphasized the importance of maintaining human connection in fertility care, with AI assisting medical providers in obtaining actionable data and spending more quality time with patients. 

5. Addressing Risks of AI in Infertility Treatment

AI's ability to provide personalized predictions introduces a potential risk of creating a false sense of certainty. Patients need to be educated about statistics and risks associated with fertility treatments. Despite high success rates, there is always a chance of failure, and patients should be informed that infertility is not their fault. Balancing hope with realism is crucial for managing expectations and providing comprehensive support. 

As AI continues to evolve in the realm of fertility care, it holds great promise for optimizing medical treatment and delivering better, more personalized emotional support. At the same time, it is essential to keep in mind some of the inherent limitations of AI, and maintain human connection to ensure patient-centred infertility care. 

For anyone interested in learning more about how AI may impact patient care during fertility treatment, the full seminar has been made available to watch here. 

In a recent seminar organized by the European Fertility Society, Tilly's founder, Jenny Ann Johnson, shared insights on the transformative potential of artificial intelligence (AI) to improve patient care during fertility treatment. Jenny Ann together with Prof. Johnny Awwad, Chair of Women's Services at Sidra Medicine & Research Center, and other FemTech entrepreneurs within the fertility healthcare sphere, explored how new AI technology can be implemented in fertility care and revolutionize the medical and emotional aspects of infertility treatment.

Revolutionizing Fertility Care: 5 Ways AI Transforms Patient Support

Checklist: Questions to ask when your doctor suggests an IVF add-on

This checklist and many other are found in Tilly's app - bring them to your doctor's appointment and tick the questions you've asked. Feeling in control can make a big difference 💪

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