Getting pregnant was harder for me than battling breast cancer
When I was 23, I was diagnosed with breast cancer. Little did I know how simple cancer treatment would be compared to the unknowns I struggled to understand over the next eight years, namely my fertility.
Since completing treatment (a relatively standard protocol of a double mastectomy followed by three months of chemotherapy and a month of radiation), perhaps unsurprisingly, I have become unequivocally obsessed with my health. When you realize how fragile something is coupled with a Type A personality, you want to do everything in your power to be proactive and get ahead. Unfortunately, this is where the healthcare system, designed to be reactionary, fails us. None of my doctors bothered to start a conversation about my reproductive future. It was up to me to figure out how to optimize, run, and in some cases totally recalibrate.
And this is where things can get dangerous. As a motivated patient wanting to get pregnant, I turned to the internet and the wider wellness industry to supplement what I wanted my doctors to tell me. I ended up experimenting myself based on what I heard that worked for others (intermittent fasting, keto, IV therapy, HRT…the list goes on), who don’t share necessarily the same medical history, risks or even goals. And then I held my breath, waiting for the desired result, hoping that I wouldn’t harm myself or my body in the process.
I followed the advice I received through podcasts, blogs and Dr. Google. I became so restrictive about what I should and could not eat, and when I should eat, that I plunged myself into a state of chronic stress. In other words, my body shut down.
Given the state of the wellness boom and the prevalence of women as consumers of wellness services, it is surprising how little we are aware of our own bodies. With the conversation now shifting to maximizing longevity and slowing the aging process, it’s no surprise that women are consistently cutting fat, limiting calories, doing HIIT workouts, and more. Unbeknownst to me, the research around these modalities has mostly been done on men, and their constitutions and hormones are drastically different from mine. According to a 2010 study by National Institute of Health, “Underrepresentation of females in animal models of disease is commonplace, and our understanding of female biology is compromised by these shortcomings.” In fact, it’s mostly the opposite advice that anyone trying to get pregnant should follow. “Well-being” is not created equally, nor a “time” for all.
Ultimately, that’s where I was wrong. I tried to optimize without any guidance and ended up hurting myself – and my fertility – along the way. Eight years into remission, and my pregnancy journey ended up being far more complex than my cancer journey. I had a hard time understanding why I was no longer ovulating or producing periods. I went through several rounds of IVF and IUI, but ignored the big elephant in the room: my weight. I was too skinny (my BMI was hovering around 16.4) and stressed, and each step in the process made it worse in some way. After several failed IVF attempts, I pursued surrogacy. I feel extremely lucky to have been able to choose this path, but if I could do it all over again, I would tell myself to pick up five to 10 pounds and do my best to relax.
The thing is, I should have received a more comprehensive approach to my fertility. I went to see the best reproductive endocrinologist in New York. He looked at my hormone levels and was confident that my deficiencies would be resolved only through IVF. As long as I took the necessary medications, he said, I should have no problem getting pregnant. Two miscarriages later, I realized it was time for a second opinion.
What I learned later is that yes, I could getting pregnant, but I couldn’t have a healthy pregnancy until I repaired the damage I had done to my thyroid and hormonal health. To this day, it’s hard to say why my doctor felt the way he did. But what I understand now is that intermittent fasting coupled with overly restrictive dieting, overworking and overexercising is not the way to support fertility at all. According to a 2022 study using data from the National Health and Nutrition Survey, “there is [is] a non-linear relationship between BMI and infertility, each unit increase in BMI reducing the risk of infertility by 33% when BMI was
I can’t say that I look back on my cancer or infertility experience with emotion, but I’m grateful for the insights I gathered, as it led me to start The Lanby, a club of members of the health. Wellness, like medicine, must be personalized. Health care requires an integrative approach, and we cannot rely exclusively on physicians to bear this burden. I wish I could have partnered with a dietitian (or in our case, a designated wellness advisor), who could have guided me towards a healthier lifestyle based on my needs and goals at the time. Equally important, wellness modalities should be monitored and monitored by a healthcare professional to ensure patients are optimizing safely and effectively.
As a “professional” patient, it is easy to see what needs to be done to circumvent the archaic, incomplete and quasi-factory experience of traditional primary care, in favor of a health system that considers our future as well as all what hurts us. in the present.
Chloe Harrouche is the co-founder of The Lanby, a New York-based primary care club that puts a patient’s needs first from all angles of healthcare.