June 27, 2023 – For years, reproductive epidemiologist Carmen Messerlian coached her sister Lara, who was struggling with infertility, about how to maximize her chances of getting pregnant. She’d tell her, for instance, not to burn scented candles, drink out of plastic cups, or get her nails done—all ways to avoid hormone-disrupting chemicals.
Then she had an “aha” moment: Why not turn her ongoing conversation with Lara into one that could be widely shared, so that as many people as possible could get the same kind of guidance?
That’s the idea behind a new podcast featuring Carmen and Lara having what Carmen calls “real, honest conversations between two sisters.” Called “The Fertility Sisterhood: Cleaning Up Your Lifestyle For Future Generations,” the 10-episode podcast delves into what women can do to improve their health and wellbeing to boost their fertility, focusing on topics such as toxins in the home, diet, exercise, sex and intimacy, and mental health. The first episode—“The Environment Has Everything To Do With Your Fertility”—launched June 22; subsequent episodes will air weekly over the summer.
The podcast is hosted on the website Rescripted, which focuses on fertility and women’s health. Carmen, assistant professor of environmental reproductive, perinatal, and pediatric epidemiology at Harvard T.H. Chan School of Public Health, came up with the idea for the podcast after working as a pro bono scientific adviser for Rescripted for about a year, hoping to help educate and reach a wide audience of couples and women trying to get pregnant on how to have a healthy reproductive experience.
“It’s not enough for me for my research to be stuck in some scientific index—who is that helping? How is my work having an impact? We have the evidence, we have the studies, we have the data, but what am I doing to help couples have better outcomes?” Carmen said. “My goal in life is to change the world, to impact future generations, one couple at a time. And if I can’t get my science into the hands of couples planning or trying to conceive, then I’m not really doing my job.”
Carmen brainstormed with the team at Rescripted and they initially considered a podcast with each episode devoted to a particular scientific paper. But Carmen realized that might be dry and boring. When she came up with the idea of a podcast featuring her and her sister, weaving in Lara’s real-life infertility struggles with science-based advice, the Rescripted folks gave it the thumbs-up.
A difficult journey
From the time she was in her twenties, Lara always wanted to have a baby, but she had some worrisome gynecological problems. In her mid-30s, at that point single, Lara decided to freeze her eggs as a backup. The process was physically and emotionally taxing. After multiple rounds of treatments, she only got 12 viable eggs. “It was really challenging and difficult, even having my sister by my side,” she said. “And there are a lot of women who go through similar painful struggles. I am not alone in this experience. Countless women face the exact same challenge.”
In her late 30s, worried that she was running out of time, Lara decided to begin the process of having a baby on her own, using a sperm donor. Two weeks after she and Carmen started looking into potential donors, she met her future husband.
Still, Lara wasn’t sure she could successfully carry a pregnancy. She underwent testing at an IVF (in-vitro fertilization) clinic and learned that she had several health issues that interfered with her fertility, including an MTHFR mutation, resulting in an inability to process folic acid (which is important for preventing major birth defects), and a type of prothrombin gene mutation—a blood-clotting problem that can lead to miscarriage. “With simple treatments, these are conditions with a relatively easy and affordable fix, but if you don’t have awareness of them, you could have multiple pregnancy losses, as I did,” Lara said.
During her infertility evaluation, Lara was told that she might also have endometriosis—a condition that may increase the risk of miscarriage or other complications—and it was recommended that she have surgery to confirm the diagnosis. But pre-surgery bloodwork revealed an unexpected surprise—Lara was pregnant.
“It was such an amazing surprise that it happened naturally,” Lara recalled.
Unfortunately, well into her second trimester of pregnancy, Lara learned that her baby had died in the womb. The experience was traumatic. At the doctor’s office, during an ultrasound, the baby’s image appeared on the screen but it was not moving. Lara recalls thinking, “Oh, they left a static image of another baby on the screen.” The doctor left for a moment, then returned. Lara said to the doctor, “‘The machine must be broken, because it’s showing a static image of a baby, but my baby bounces around.’ And then she told me that we had a loss.”
“It took me a minute,” Lara continued. “And I remember screaming.”
“Lara called me immediately to tell me what happened. I cried so hard in my office that day, devastated for my sister, knowing how hard her journey had been till then,” recalled Carmen. “Lara was at an advanced maternal age at the time, and as a reproductive epidemiologist, I knew the probability of another pregnancy and live birth at her age was very low.” Of Lara’s experience learning that her baby had died, Carmen said, “The doctor who left the ultrasound image up should not have been insensitive to the loss of human life for a couple. One of the gaps I am working to address is the loss of humanity in the IVF space. It’s become so medicalized, so dehumanized, so mechanical … that the experience of the couple has been shattered. How are we supporting couples through the trauma of failed cycles and pregnancy loss, which are traumatic experiences that result in neurobiological and endocrine changes that also lead to further failure? It’s now part of my mission to improve the experience for couples struggling with fertility through my work.”
Lara’s pregnancy loss occurred in 2019. In the summer of 2020, during the beginning of the pandemic, Carmen and Lara traveled together to New Brunswick, Canada to see their father John, who was then dying of cancer and in palliative care at home. Following government guidelines to minimize COVID spread, they quarantined in a tent outside their parents’ home for about a month.
“During that period of time, Lara detoxed,” said Carmen. “No makeup, no perfume, products, no unhealthy eating habits and behaviors. It was just fresh air and eating healthy foods and quiet stillness. It was all the kinds of things I had been encouraging her to free herself from all those years. And in the cycle immediately after our tent-time, she conceived again!” Lara’s pregnancy, happily, was successful; her daughter, Olympia, is now 2.
The importance of a clean lifestyle
While there’s no proof that Lara’s detox in Canada was what led to her subsequent pregnancy, Carmen emphasizes how crucial it is to detox your body and your environment to improve the chances of getting pregnant. “It doesn’t guarantee that you’ll get pregnant,” she said. “But it optimizes your opportunity for successful reproduction, pregnancy, and, most importantly, a healthier child.”
In her research conducted at the Massachusetts General Hospital Fertility Center, Carmen analyzes blood and urine samples from infertile couples, checking for chemicals such as phthalates, phenols, and PFAS. “We know that these chemicals are reproductive toxicants,” she said. “They diminish our chances of conception, they harm fertility, the embryo, the fetus, and the child after it’s born. Preconception is a window where there’s high vulnerability but it’s also a window of enormous opportunity, and that’s what the podcast is about—all the things that you can do to improve your fertility. We hope to empower people to do those things.”
The podcast episodes will cover a wide range of topics on health and fertility, including personal care products, sleep and rest, alcohol and other substances, and the role of male partners’ health in successful reproduction. The hosts will also offer practical tips on how to have a “cleaner” lifestyle.
Carmen said that observing and sharing in her sister’s personal experience with infertility has helped make her an intuitive and responsive scientist with a mission-driven purpose to support all couples experiencing fertility concerns. “Over decades, Lara has provided me with deep insights into infertility and reproductive disorders,” she said. “I lived each experience with her, not as a professional but as a sister, and it’s allowed me to gain so much perspective on the pain of the infertility journey. I am so proud of her strength and courage to share her stories with me.”
“When Carmen first approached me about the podcast, I wasn’t sure I would be able to share going through such a traumatic experience,” said Lara. “But we’ve had so much fun doing it. I’m so glad I had the opportunity to support Carmen’s mission to share her science with people at a more human level, and I hope the topics we explore will be very helpful to other women and people trying to get pregnant.”
– Photo courtesy Carmen Messerlian