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A Mediaplanet Guide to Every Step of the Family Planning Journey Family Planning SEPTEMBER 2022 | FUTUREOFPERSONALHEALTH.COM Learn about the company providing end-to-end solutions for families struggling with infertility04 What new guidance reveals about choosing the most e�fective home ovulation test02 An Independent Supplement by Mediaplanet to USA Today The Fertility Mama talks about overcoming stigma to help others through IVF Ceire Nevins

At least a fifth of Americans take biotin, either as a beauty supplement, as part of an over-the-counter multivi

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Home urine ovulation tests are highly accurate and reliable Doctor’s offices typically use a combination of ultrasound and blood tests to predict

As rising infertility rates drive these tests’ popularity, a group of clinical labora tory testing experts from the American Association of Clinical Chemistry (AACC) recently released updated information to help guide theirHereuse.are three essential things from this guidance that consumers should know:

But if you’re taking a high dose of biotin and the con trol line fails to form after repeated testing attempts,

But the verdict isn’t in yet on other home ovulation tests Recently, home saliva ovulation tests and bio sensor-based basal body temperature (BBT) monitors have emerged as potential alternatives to urine LH tests.

A group of clinical laboratory testing experts from AACC has released updated information to help guide the use of home ovulation and pregnancy tests.

Dr.HaymondShannon President, ClinicalAssociationAmericanofChemistry

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The great news is that, yes, it does.Studies show that overthe-counter urinary tests for luteinizing hormone (LH) are excellent at predicting ovulation, to the point that these tests can be used to time intrauterine insemina tion cycles. Among healthy fertile women trying to get pregnant, studies also show higher conception rates among women who used home urine ovulation tests versus those who didn’t.

tamin, or as a treatment for medical conditions like mul tipleDespitesclerosis.this vitamin’s benefits, at high enough concentrations, it can inter fere with numerous clinical laboratory tests — including urine pregnancy tests.

Home ovulation and preg nancy tests — also known as point-of-care tests — have revolutionized reproductive medicine by making testing more convenient and acces sible for patients.

Publisher Charlotte Avery Business Developer Joelle Hernandez Managing Director Jordan Hernandez Lead Designer Kayla Mendez Designer Daniel Vega Lead Editor Dustin Brennan Copy Editor Griffin Cronk Director of Content and Production Joelle Hernandez Cover Photo Sarah Driscoll All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

All urine pregnancy tests have a control line that shows the test is working properly, and a test line that tells you your actual result. Typically, if the control line fails to show up, that means your test has failed and any result is invalid.

then it’s likely the biotin is interfering with the tests and causing the failures. In this case, we recom mend that you consult with your healthcare provider on what the most appropriate next steps are. n

Essential Things You Should Know About Home Ovulation and Pregnancy Tests

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ovulation, an approach that is considered the gold stan dard for identifying this crucial part of the menstrual cycle.Does peeing on a stick or strip of paper really match this in terms of accuracy?

The popular supplement biotin can interfere with home pregnancy tests

However, consumers should approach these newer tests with Thoughcaution.saliva tests are simple and reusable, they unfortunately have demon strated subpar reliability. Biosensor-based BBT tests show more promise — and their manufacturers claim they are highly accurate — but further performance studies are still needed to confirm this assertion.

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Instead, I felt seen, heard,

How I Learned to Embrace My IVF Journey

But I was not only lying to the people in my life; I was lying to myself. The guilt and shame of keeping IVF a secret continued to take root within me.

In this infertility commu nity, we are all twin flames, supporting and guiding each other through our journeys. So, if you are struggling with infertility, secondary infertility, or pregnancy loss, remember that you are not broken, this is not your fault, and, most of all, you are not alone. n

Ceire Nevins is a proud IVF mama to twin girls and her son (naturally). She received her infertility coaching certificate through the Institute of Integrative Nutrition and lives in Boston.

No one knew our twin girls were born through IVF.

Then, two years later, I met Jess, a neighbor who also had twins through IVF. She spoke so openly about her experi ence.Ifinally had someone I could talk about this with and relate to the emotional roller coaster of IVF and infertility. I no longer felt alone, ashamed, and broken.

lied about doing in vitro fertilization (IVF) for over two years because I was ashamed.So,through years of strug gling in silence, I hid my fer tility treatments from family, friends, and co-workers.

Opening up to a new friend

Then, only a few months after the birth of our twins, we were shocked to learn we were pregnant with our son.

Ceire Nevins

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My story that I once hid from has become my pur pose and passion for helping other women as their fertil ity coach. I learned the vital importance of connection, community, and living life with integrity. Infertility is a disease that affects 1 in 8 couples.Bysharing our stories, we can end the stigma and help spread awareness.

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Jess quickly became one of my best friends and is my “twin flame,” someone who mirrors you, showing you your deepest insecurities and fears while helping you overcome them. My twin flame taught me that I was not alone and had nothing to be ashamed of.

and valued. Through her con fidence, I gained the courage and strength to open up and share my story.

Consequently, our son’s natural birth helped me fur ther conceal my fertility strug gles. I had “gotten away” with doing IVF, and no one would have the choice to judge my decisions or my body.

Call your healthcare provider if you have any questions or concerns (see “When should I call my healthcare provider?”). Otherwise you should return to your healthcare provider for a follow-up visit after your first menses after Paragard is placed to make sure that Paragard is in the right position.

How does Paragard work?

• have Wilson’s disease (a disorder in how the body handles copper)

• are allergic to copper, polyethylene, or barium sulfate

Brief Summary

• recently had a baby or if you are breastfeeding

How will Paragard change my periods? Your period may become heavier and longer. You may also have frequent spotting between periods.

• slow heart beat (bradycardia)

• think you are pregnant

• might be exposed to sexually transmitted infections (STIs)

Should I check that Paragard is in place?

Before having Paragard placed, tell your healthcare provider if you have:

• are concerned that Paragard may have been expelled (came out)

• have pelvic pain or pain during sex

To learn more, talk about Paragard with your healthcare provider and see the FDA-approved Full Prescribing Information found on paragard.com or call CooperSurgical, Inc. at 1-877-PARAGARD (727-2427).

Call your healthcare provider if you have any concerns about Paragard. Be sure to call if you:

Ectopic pregnancy is a medical emergency that often requires surgery. Ectopic pregnancy can cause internal bleeding, infertility and even death.

• become HIV positive or your partner becomes HIV positive

• want birth control that is reversible

• prolonged periods • vaginal discharge

What if I become pregnant while using Paragard?

There are also risks if you get pregnant while using Paragard and the pregnancy is in the uterus. Severe infection, miscarriage, premature delivery, and even death can occur with pregnancies that continue with an intrauterine system (IUS). Because of this, your healthcare provider may try to remove Paragard, even though removing it may cause a miscarriage. If Paragard cannot be removed, talk with your healthcare provider about the benefits and risks of continuing the pregnancy.

Paragard ('par-uh-gahrd) (intrauterine copper contraceptive)

You can keep Paragard in your uterus for up to 10 years. After 10 years, you should have Paragard removed by your healthcare provider. If you wish and if it is still right for you, you may get a new Paragard during the same visit.

• anemia (low red • expulsion (complete or partial) blood cell count) • spotting

with antibiotics. More serious cases of PID or endometritis may require surgery. A hysterectomy (removal of the uterus) is sometimes needed. In rare cases, infections that start as PID can even cause death. Tell your healthcare provider right away if you have any of these signs of PID or endometritis: low abdominal (stomach area) or pelvic pain, pelvic tenderness, painful sex, unusual or bad smelling vaginal discharge, chills, long-lasting or heavy bleeding, fever, genital lesions or sores.

• have problems with your immune system

• Paragard can be removed by your healthcare provider at any time.

• Paragard does not contain any hormones.

• embedment: Paragard may become attached to (embedded) the wall of the uterus. This may make it hard to remove Paragard. Surgery may sometimes be needed to remove Paragard.

• can feel any other part of the Paragard besides the threads

• Paragard is a copper-releasing system that is placed in your uterus by your healthcare provider to prevent pregnancy for up to 10 years.

• perforation: Paragard may go through the wall of the uterus. This is called perforation. If this occurs, Paragard may no longer prevent pregnancy. If perforation occurs, Paragard may move outside the uterus and cause internal scarring, infection, damage to other organs, pain, or infertility and you may need surgery to have Paragard removed. Excessive pain or vaginal bleeding during placement of Paragard, pain or bleeding that gets worse after placement, or not being able to feel the threads may happen with perforation. You are not protected from pregnancy if Paragard moves outside the wall of the uterus. The risk of perforation is increased in breastfeeding women.

• want birth control that works continuously for up to 10 years

This information is not comprehensive. Please see the full prescribing information at paragard.com for additional information.

• want a birth control method that you do not need to take daily

Is it safe to breastfeed while using Paragard? You may use Paragard when you are breastfeeding. The risk of Paragard becoming attached to (embedded) or going through the wall of the uterus is increased if Paragard is placed while you are breastfeeding. Will Paragard interfere with sexual intercourse?

• have had an infection in your uterus after a pregnancy or abortion in the past 3 months

• want long-term birth control that provides a low chance of getting pregnant (less than 1 in 100)

• have an intrauterine system in your uterus already

How soon after placement of Paragard should I return to my healthcare provider?

• have or suspect you might have cancer of the uterus or cervix

• want birth control that does not contain hormones

Do not use Paragard if you:

What is Paragard?

• have severe bleeding that lasts a long time, or bleeding that concerns you

Call your healthcare provider right away if you think you may be pregnant. If you get pregnant while using Paragard, you may have an ectopic pregnancy. This means the pregnancy is not in your uterus. Unusual vaginal bleeding or abdominal pain especially with missed periods may be a sign of ectopic pregnancy.

• life-threatening infection: Life-threatening infection can occur within the first few days after Paragard is placed. Call your healthcare provider immediately if you develop severe pain or fever shortly after Paragard is placed.

• changes in bleeding: You may have heavier and longer periods with spotting in between. Sometimes the bleeding is heavier than usual at first. Call your healthcare provider if the bleeding remains heavier or longer and spotting continues.

• pain during sex • painful periods

Paragard® is a registered trademark of CooperSurgical, Inc. The other brands listed are trademarks of their respective US-PAR-1900199Trumbull,CooperSurgical,Manufacturedowners.by:Inc.CT06611(1)US-PAR-1900199(1)

• Paragard can be used whether or not you have given birth to a child.

Paragard is placed in your uterus during an in-office visit. First, your healthcare provider will examine your pelvis to find the exact position of your uterus. Your healthcare provider will then cleanse your vagina and cervix with an antiseptic solution and then, measure your uterus. Your healthcare provider will then slide a plastic tube containing Paragard into your uterus. The tube is removed, leaving Paragard inside your uterus. Two white threads will extend into your vagina. The threads are trimmed so they are just long enough for you to feel with your fingers when doing a self-check. As Paragard goes in, you may feel cramping or pinching. You may have some bleeding. Some women feel faint, nauseated, or dizzy for a few minutes afterwards. Your healthcare provider may ask you to lie down until you are feeling better, and to get up slowly.

It is not known if Paragard can cause long-term effects on the fetus if it stays in place during a pregnancy.

• reactions after placement or removal: Some women have had reactions such as dizziness (syncope), slowed heart rate (bradycardia), or seizures, immediately after Paragard was placed or removed. This happened especially in women who have had these conditions before.

Who should not use Paragard?

• have unexplained fever, flu-like symptoms or chills

• are or might be pregnant

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

This information does not take the place of talking with your gynecologist or other healthcare provider who specializes in women’s health. If you have any questions about Paragard, ask your healthcare provider. You should also learn about other birth control methods to choose the one that is best for you.

You might choose Paragard if you:

• are willing to use a birth control method that is inserted in the uterus

• AIDS, HIV, or any other sexually transmitted infection

• expulsion: Paragard may partially or completely fall out of the uterus by itself. This is called expulsion. Expulsion occurs in about 2 out of 100 women. Excessive pain, vaginal bleeding during placement of Paragard, pain that gets worse, bleeding after placement, or not being able to feel the threads may happen with expulsion. You are not protected from pregnancy if Paragard is expelled.

• miss a menstrual period

Paragard works by preventing sperm from reaching the egg, preventing sperm from fertilizing the egg, or possibly preventing attachment (implantation) in the uterus. Paragard does not stop your ovaries from making an egg (ovulating) each month.

• have a condition of the uterus that changes the shape of the uterine cavity, such as large fibroid tumors

What are the possible side effects of Paragard? Paragard can cause serious side effects, including: • ectopic pregnancy and intrauterine pregnancy risks: There are risks if you become pregnant while using Paragard (see “What if I become pregnant while using Paragard?”).

• have an untreated pelvic infection called pelvic inflammatory disease (PID) now

How long can I keep Paragard in place?

• have multiple sexual partners or your partner has multiple sexual partners

• pelvic inflammatory disease (PID) or endometritis: Some IUS users get a serious pelvic infection called pelvic inflammatory disease (PID) or endometritis. PID and endometritis are usually sexually transmitted. You have a higher chance of getting PID and endometritis if you or your partner has sex with other partners. PID and endometritis can cause serious problems such as infertility, ectopic pregnancy, and pelvic pain that does not go away. PID and endometritis are usually treated

Who might use Paragard?

Paragard is a small, flexible plastic “T” shaped intrauterine system with copper wrapped around the stem and placed on arms of the “T”. Two thin white threads are attached to the stem (lower end) of Paragard. The threads are the only part of Paragard you can feel when Paragard is in your uterus; however, unlike a tampon string, the threads do not extend outside of your body.

Paragard T380A intrauterine copper contraceptive is used to prevent pregnancy. It does not protect against HIV infection (AIDS) or other sexually transmitted infections (STIs).

Read this Patient Information carefully before you decide if Paragard is right for you.

• have an untreated lower genital infection now in your cervix

• seizures

After Paragard has been placed, when should I call my healthcare provider?

• use or abuse intravenous drugs

You and your partner should not feel Paragard during intercourse. Paragard is placed in the uterus, not in the vagina. Sometimes your partner may feel the threads. If this occurs, or if you or your partner experience pain during sex, talk with your healthcare provider.

• have unexplained bleeding from your vagina

• Thisbackacheisnot a complete list of possible side effects with Paragard. For more information, ask your healthcare provider. Tell your healthcare provider about any side effect that bothers you or does not go away.

• have unusual vaginal discharge or genital sores

Yes, you should check that Paragard is in proper position by feeling the threads. It is a good habit to do this 1 time a month. Your healthcare provider should teach you how to check that Paragard is in place. First, wash your hands with soap and water. You can check by reaching up to the top of your vagina with clean fingers to feel the 2 threads. Do not pull on the threads.

How is Paragard placed in the uterus?

If you continue your pregnancy see your healthcare provider regularly. Call your healthcare provider right away if you get flu-like symptoms, fever, chills, cramping, pain, bleeding, vaginal discharge, or fluid leaking from your vagina. These may be signs of infection.

• vaginal irritation • pain and cramping

• cannot feel Paragard’s threads or can feel the threads are much longer

• can get infections easily. For example, if you:

• dizziness (syncope)

Common side effects of Paragard include:

• any of the conditions listed above

•Don’t use Paragard if you are or may be pregnant, have ﬁbroids, a pelvic infection including pelvic inflammatory disease (PID), get infections easily, certain cancers,

Important Safety Information

•Paragard does not protect against HIV or OnlySTDs.you and your HCP can decide if Paragard is right for you. Available by prescription only.

“It’s like having the best of both worlds,” Dr. Desai said. “It’s an IUD, and it’s got one simple active ingredient: copper. But it is reversible and can

Healthcare providers can offer placement of Paragard during a routine office visit, and because it can be removed just as easily, it’s also a fully reversible procedure.

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•At ﬁrst, periods may become heavier and longer with spotting in between.

last for up to 10 years, is 100% hormone-free, and is 99% effective in preventing pregnancy.”

•Additional common side eﬀects include anemia, pain during sex, backache, and vaginal discharge.

You are encouraged to report negative side eﬀects of prescription drugs to the FDA at www.fda.gov/ medwatch or call 1-800-FDA-1088.

•Tell your HCP you have Paragard before having an MRI or a medical procedure using heat therapy.

Taking control

That’s why, for many women, a great option for contraception might be a long-acting reversible contraception (LARC) like Paragard®, which uses copper to prevent the sperm from reaching and fertilizing the egg, and may also prevent implantation.

Birth ReversibleActingEffective,That’sControlLong—and

Je�f Somers

Challenges

For more information about Paragard, please see Brief Summary of Full Prescribing Information on previous page

Paragard is a hormone-free IUD (intrauterine device) that prevents pregnancy for up to 10 years using copper.

Please see Full Prescribing Information at Paragard.com.

In today’s changing world of reproductive care, women want to be in control of their choices and their future.

“We are all busy people and we need birth control that works for us today,” said Vrunda B. Desai, M.D., Vice President of Medical Affairs at CooperSurgical®, a women’s health and fertility company. “Approximately 40% of pregnancies are unintended. 2 Women need a reliable long term birth control answer that doesn’t cause them to wait and worry if they are pregnant.” That makes many types of birth control less than ideal.

About 65% of women between the ages of 15 and 49 use some form of birth control. 1 Choosing the right birth control that fits a woman’s lifestyle is an important task and deserves thoughtful consideration.“There is no best choice, because every person’s body is different,” explained Shieva Ghofrany, M.D., FACOG, of Coastal Obstetrics and Gynecology in Stamford, Connecticut. “And every person will have changes throughout their life and has.”

Reproductive care has been front and center lately, with multiple views that can leave a person feeling uncertain.Whatis for certain is that there are options for long-acting reversible contraception available that allow women to take control of their future and map their journey forward, however they see it. n

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women looking to avoid hormone-based contraception, a copper-based intrauterine device may be the perfect choice.

The long-term efficacy of Paragard means it can be placed for up to 10 years and it can be easily removed during an office visit — which means it can adapt to changing circumstances.“Paragard is an excellent form of birth control, period, full stop,” Dr. Ghofrany said. “It is a non-hormonal birth control that is as effective as systemic hormones or hormonal IUDs.”

2 Sedgh G, Singh S, Hussain R. Intended and unintended pregnancies worldwide in 2012 and recent trends. Stud Fam Plann. 2014 Sep;45(3):301-14. doi: 10.1111/j.17284465.2014.00393.x. PMID: 25207494; PMCID: PMC4727534.

placement, miss a period, have abdominal pain, or if Paragard comes out. If it comes out, use backup birth control.

The future

unexplained bleeding, Wilson’s disease, or a copper allergy. IUDs, including Paragard, have been associated with an increased risk of •PregnancyPID. with Paragard is rare but can be life threatening and cause infertility or loss of •Paragardpregnancy.may attach to or go through the uterus and cause other problems.

•Tell your healthcare provider (HCP) if you develop severe pain or fever shortly after

Daniels K, Abma JC. Current contraceptive status among women aged 15–49: United States, 2015–2017. NCHS Data Brief, no 327. Hyattsville, MD: National Center for Health Statistics. 2018.

VF, a form of assisted reproductive technology, or ART, offers families struggling with infertility something priceless: hope. Only about 5% of couples dealing with infertility pursue it today1, but technology in this space has developed significantly over the last decade to give families more opportunities for success. However, the journey is still filled with ups and “Choosingdowns.aconsistently successful, and reliable IVF Program is the first challenge when patients are seeking a convenient and economical option for good patient care while considering IVF therapy,” said Michael J. Tucker, Ph.D., HCLD, scientific director of Shady Grove Fertility. “The IVF clinic must ensure personalized and effective approaches to infertility therapy to optimize chances for birth of a healthy baby.”

IVF involves collecting mature eggs from a woman’s ovaries, which are then fertilized using sperm from a partner or donor in a laboratory setting. If fertilization is successful and the fertilized eggs further develop into embryos, one can be selected to be implanted into the uterus, hopefully resulting in a pregnancy.One of the biggest challenges for the medical team is identifying developing embryos that have the highest likelihood of resulting in a healthy pregnancy and baby. A process known as preimplantation genetic testing for aneuploidies (PGT-A) has become a common screening of embryos for chromosomal abnormalities. One of the challenges for embryologists is identifying these healthy embryos.

tive fertility journey and success for all kinds of families.

“From the early days, there was a vision in CooperSurgical for providing a complete fertility solution,” Dr. Auerbach said, “always centered around patients, providers and outcomes.” n

“In

Fertility challenges

End to end CooperSurgical has strived to be an “end-to-end” resource in the ﬁeld, furthering their commitment to a posi-

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Through new innovations across the In Vitro Fertilization (IVF) journey, one company is providing “end-to-end” solutions for families trying to get pregnant.

advance by providing further clinically impactful information.”

Je�f Somers