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Deborah Howell (Host): Over the last few months, we've spoken in general about couples and their fertility journeys. But today we'd like to share some valuable insights that can help women and couples in the black community, on their fertility journey.

In this episode, we'll find out some valuable fertility facts for black women and couples, get some tips for finding a doctor you can trust and learn how to improve your chances of conceiving. Joining us today is Dr. Channing Burks Chatmon, a Reproductive Endocrinologist, and Infertility Specialist at Fertility Centers of Illinois.

This is The Time to Talk Fertility podcast. I'm your host, Deborah Howell. Welcome Dr. Burks Chatmon.

Channing Burks Chatmon, MD: Thank you so much, Deborah. And thanks for having me. I'm really excited to have this opportunity to speak with you today.

Host: We're really excited that you're here for us. Now let's kick off right at the top with what you think it's important to discuss about fertility for black women and couples.

Dr. Burks Chatmon: So, I just think overall, from my own personal experiences and experiences of my families and friends and my patients, I think that often fertility in general or struggles with fertility is not something that's openly discussed, in the black community often. And I think that, unfortunately is a shame and I am just hoping to kind of bring awareness, promote fertility awareness and to just to let people know that they are not alone. One in eight couples in America struggle with infertility. And so it is common. You're not alone. And I want people to feel open to talk about it.

Host: Wonderful. So what causes of infertility are most common among black women?

Dr. Burks Chatmon: So honestly the causes don't really differ that much among different ethnicities and race. But in general, one-third of the time we find a factor that is specifically related to the female partner. One-third of the time we find a factor that's related to male. So male factor, which generally means that there's low sperm parameter. And then a third of the time, it is either something in both partners or what's called unexplained infertility, meaning yes, you're struggling. You have infertility, but all your testing came back normal, which just shows in our world of fertility, we are still learning.

Host: Sure. What questions then should you ask your doctor if you suspect you may be struggling with infertility?

Dr. Burks Chatmon: So I think, one of the most important things to keep in mind is how long you've been trying. So, anyone less than 35, we would recommend trying for no more than 12 months, really before seeking further help or instruction from either your OBGYN or fertility specialist so that you can have testing and an evaluation started. If the female partner is greater than 35, then we typically recommend only waiting six months before starting that evaluation. And that's just because as we age, and get into our later thirties and forties, it becomes harder to become pregnant.

Host: Right. The clock is ticking. So what steps can women take to find a doctor they feel compatible with and trust?

Dr. Burks Chatmon: I think one of the best places to start, especially if you have a good working relationship and trust with your OBGYN, is to ask them who they recommend. So, who have their patients had success with, who have their patients liked. You also can try to start conversations with some of your friends.

Hi, we're struggling to have a baby. Have you guys had any similar experiences? Have you ever used a fertility doctor? A lot of times you'll be surprised how many of your friends have actually seeked care and fertility. And then also of course you can use social media or the web, but I think you just have to be careful when using those avenues, because you don't necessarily know the individual success of the doctor or the practice just from looking at a website.

Host: Sure. Now I've heard that black women have a higher prevalence of fibroids. So first of all, what are fibroids and how to fibroids affect fertility?

Dr. Burks Chatmon: Deborah you're right. So, in general, black women are two to three times more likely to have fibroids than Caucasian women, Asian women, or Hispanic women. Fibroids are a benign, so non-cancerous tumor. They arise from the muscular layer of your uterus. And they can obviously grow. You can have one fibroids, you can have multiple fibroids. The location and the size of the fibroids is what really can impact your fertility. The way it can negatively impact your fertility is if the fibroids are in a location where they're causing what's called mechanical obstruction. So, it means that the way egg and the sperm are unable to meet because somehow the fibroid is in the way.

Or it can cause distortion of the uterine cavity. So, let's say you're actually able to get pregnant, but when it comes time for the embryo to find a safe place to land in the uterus, it's unable to do so. And then also it does have repercussions as far as miscarriage, and can also put you at increased risk for things in your pregnancy. So, it is important for you to be monitored closely if you do have fibroids.

Host: Right. And what are some of the fibroid symptoms to watch out for?

Dr. Burks Chatmon: So, some women have no symptoms and that's just because their fibroids are small or because of the location, but often women will have either irregular bleeding, or heavy menstrual bleeding, really heavy periods. And that can also even result in what's called anemia. So, because of the increased blood loss with your period, your blood count actually starts to decrease.

You can also have pelvic pain and pressure, pain during intercourse. The fibroids could potentially put pressure on your bladder. So you're going to the bathroom a lot, or it could also cause increased constipation. So, those are kind of the main symptoms to watch out for.

Host: Got it. How does a woman know whether or not she has fibroids?

Dr. Burks Chatmon: 40% of women by the time you get to age 40, will have a fibroid. That's just, they're very common. So, if you're not having any symptoms, there's not really any reason to just look for fibroids. But if you're having some of the symptoms that I noted, so the pain, irregular bleeding, heavy bleeding, pain with intercourse, constipation, or you have been struggling with trying to get pregnant; then that would be a reason to have an evaluation. And typically your doctor's going to start just with an ultrasound, just to actually look at the uterus and see if there are any fibroids present, and also where they're located in the uterus.

Host: That makes sense. So, what's the connection between weight and fertility and how does one impact the other?

Dr. Burks Chatmon: So, we do see when women cross a certain threshold, and enter into what's called obesity. It's based off of BMI, which is based on your own height and weight. Women who have a BMI greater than 30 are considered to be obese. And once those numbers start to go up, we do see a decrease in likelihood to get pregnant. We also see that women that are obese can have an increased risk of miscarriage as well, and also other complications when it comes to delivery. So, those are kind of the main things how weight can impact fertility.

Host: Got it. Now I am a person that does better with goals. Maybe you are too. So what should women strive for in terms of weight?

Dr. Burks Chatmon: Typically anytime you go see your ,primary care doctor or your OBGYN, they're going to weigh you and they should already probably have your height. So, they're going to tell you what your BMI is. So goal is for you to be under that obesity line. So less than 30. Obesity also puts you at increased risk for other lifelong health problems. So hypertension, diabetes, high cholesterol. So just from a general lifelong health perspective, it's always better if we can try to get you to lose weight. I think it's important for women to try to strive to hit realistic goals. So don't just say, okay, I'm going to go on a fad diet and try to lose a hundred pounds in six months. That's probably not realistic and also probably not safe. So, I think just instead of focusing on fad diets, it's better to just make overall better, healthier choices in what you're eating and to make goals, to try to slowly start to increase your physical activity, whatever starting point you're at and then you'll start to see a change. And as you start to see changes, I think women become more motivated to further increase their physical activity and even maintain their healthy diet.

Host: Got it. Now, there are people on the other side of the BMI scale that are under their BMI weight. What about those women?

Dr. Burks Chatmon: It goes both ways. So, women that have a BMI less than 20 also can struggle with fertility. So, there's a certain percentage of body fat that we think is positive for you as far as fertility rates. So, if your BMI is less than 20, your doctor also might advise you, obviously, I'm not going to tell you to gain a hundred pounds, but that it might be good in regards to your fertility to maybe cut back on exercise a little, or to put a little bit more fat, especially into your diet, avocado, things like that.

Host: Got it. Now, when it comes to diet, since you spoke of avocados, which are one of my favorites, what foods should women choose and stay away?

Dr. Burks Chatmon: So overall healthy diet, a lot of proteins, lean protein, especially. So things like fish, salmon, shrimp, lean chicken, even like lean sirloin or beef, if that's what you're going to be choosing to eat. But chicken and fish, try to do more of those than red meat. Also a lot of fruit and vegetables. Those have a lot of nutrients. They have a lot of what we would call good carbs or healthy carbs. And then for carbohydrates specifically, if you're going to have a pasta, it's always going to be better if you have whole grain pasta, or whole grain bread, as opposed to white pasta or white bread.

And then I did mention avocado already. So as fat goes, trying to look at unsaturated fat versus saturated fat. So, I think one easy thing to start off with is sugar. So, how much sugar do you have in your diet? Do drink a lot of sugary lattes. That's one of my favorites. Do you drink a lot of sugary drinks, pop, soda? Do you use have a lot of sweets, I think starting there, trying to decrease your sugar content. And I think making one change at a time, is going to set you up for success. Once you have that change down, say, you drink a lot of pop. Now you've eliminated that from your diet. Now you can work on the next thing.

Now I'm going to try to eat only whole grains. So wheat bread, wheat pasta instead of white pasta. And then now I'm going to focus on my proteins. I think, it's one step at a time it's not as overwhelming as trying to change your whole diet overnight.

Host: Yeah. And plus you'll probably start feeling so much better, you'll be motivated to continue to make those changes.

Dr. Burks Chatmon: Yes. I think people realize they see how much their energy level changes. They don't feel so tired. They're less bloated as you start to eat more leafy greens whisch has fiber wich helps decrease constipation. So, you're right. People just start feeling better and that in and of itself serves as motivation to continue to eat better.

Host: Great. Now let's talk about a good workout. When it comes to exercise, what's a good goal. And what exercise is fertility friendly?

Dr. Burks Chatmon: So actually February is not in addition to Black History Month, it's also Heart Health Month. And so good goal is at least 30 minutes cardiac activity. So meaning getting your heart rate above base for, generally 90 to 150 minutes. The goal is 150, but if you're starting at zero, I think it's best to aim for three times a week for 30 minutes, then you can slowly start to increase to the goal of 150 minutes.

When it comes to exercise, you have to find something that you enjoy, otherwise you're not going to continue to do it. So if you are not a runner, I think it's unrealistic for you to think, oh, I'm going to get prepared to run a marathon. That's probably not going to be something you're going to keep doing.

So, I think most important, find something you actually enjoy. Things that are fertility friendly if you're not undergoing fertility treatments, you can really be doing anything. The only time we will ask you to kind of restrict like vigorous activity, so maybe no running, no HIT or high intensity interval classes would be, if you're undergoing a fertility treatment or an IVF or in vitro fertilization cycle, we would like for you during that time, keep it more minimal. So walking, elliptical, things like that, but in general, you can really do whatever you want.

Host: And I just have a couple more questions for you. What should women keep in mind with their weight goals?

Dr. Burks Chatmon: I think that you just in general, want to strive to be the best version of yourself and to be healthy. So, I think if you are trying to lose more than one pound a week, that often is not safe. It can also be not sustainable. So, I think to have realistic goals and to aim to really lose a half pound to a pound a week, if you are trying to lose weight. I think that is something that is sustainable.

Host: Got it. So, what else should women know about fertility that maybe we haven't covered yet?

Dr. Burks Chatmon: So, I think it's important for women to know that unfortunately, fertility does decrease with age. As women, we are born with a certain number of eggs. It's the only number of eggs we're ever going to have. And once we enter puberty, we start to lose those group of eggs each month. There's nothing that you can do to speed it up or to slow it down. So, if you are struggling with fertility, you're trying to have a baby; I would recommend and encourage you to reach out for help if you have been trying for 12 months or more, and you're less than 35 or six months or more, and you are over the age of 35, please come to see us so we can help.

Host: Wonderful. Now, can you share some words of hope or maybe some encouragement with our listeners?

Dr. Burks Chatmon: Of course. So, infertility is common. One in eight couples will struggle to conceive, but if you come to FCI, we're well known for our success rates. We have a very talented lab and over the past 30 years, we have helped over 4,000 couples have had babies. So have hope in that and, please come see us so that we can help you.

Host: Well, thank you so much, Dr. Burks Chatmon for all this great information today and for the positivity and for bringing us a full perspective on infertility in the black community. We've loved having you on the podcast. Want to wish you a very, very happy Black History month as well.

Dr. Burks Chatmon: Thank you so much, Deborah for having me. It's really been a pleasure just to take the time to talk with you today.

Host: That was Dr. Channing Burks Chatmon, a Reproductive Endocrinologist and Infertility Specialist at Fertility Centers of Illinois. Find out more about the services FCI provides for patients by calling 877-324-4483, or head on over to FCIonline.com to schedule an appointment, to talk to a fertility specialist.

And if you enjoyed this podcast, you can find more like it in our podcast library. Be sure to give us a like, and a follow if you do. This has been The Time to Talk Fertility podcast. I'm your host, Deborah Howell. Have yourself a terrific day.