Focus on Fertility A Primer for Muslim Women on Reproductive Health and Well Being

Haifaa Younis


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The speakers emphasize the importance of finding the right spot for birth control tablets and memorizing the appropriate language. They also discuss the potential side effects of the tablets and their safety.

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Press and spotlight sister Maha let's do that Thank You Shane hot just behind

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a semi Gorgonzola Bearcat to this man that had ramen our Haman hamdu Lillahi Rabbil Alameen wa Salatu was Salam ala Sayidina Muhammad wa ala Le he was happier Salam. Welcome everyone. My name is Maha I am the president of the Muslim community of Knoxville. And I just wanted to very briefly welcome everyone to this program that I'm very excited about. And thank a few people as well, of course, we want to thank our very esteemed speakers shefa, Dr. Hofer Yunus and Dr. Mona and CO Hale, we're very excited to have the opportunity to tap into the great wealth of resources available for Muslim women in the United States, to take advantage of the knowledge that you both have to address

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this really important topic. And I wanted to thank istead, the zeyneb, for her amazing work putting this program together, as well as the administrative team at tastier for all their work and setting up this webinar. And just briefly, this is a topic that, you know, a few of us talked about really wanting to highlight, because we don't think it's highlighted enough in our Muslim communities, we talk so much about how important the family is to Muslims, how important the various roles that women serve, and, and often talk about the most important being the mother and, you know, just the emphasis of family and motherhood and raising children in our communities. And we often ignore the

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fact that for a lot of people, it's not easy to become a mother and that people are struggling more and more with, you know, being able to have children and the importance of us talking about that, and being open about that. And to have our great resources that that we have in Dr. Haifa, who can talk about, you know, who can bring with her her Islamic scholarly knowledge as well as her knowledge in obstetrics and gynecology to address some of the issues that people deal with so that we can know what's normal, what's not normal, what's available for Muslims, what's not available for Muslims. And then as well having Dr. Mona, who can talk about the sort of the often even more

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ignored, mental health aspects of it as well. So, again, I really thank you all for being here. I'm excited for it to start the program. I'm going to leave it to a sad Zeynep to continue and you all know so the Zainab is the is full time faculty of tastier seminary a female scholar in residence for the Muslim community in Knoxville, where she's been blessing us for the past several years in those roles, and I'm happy for Sarah zeyneb to take over from here and Shaw Lodge is Akamatsu.

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Just like a lot laid off thank you so much dear sister Maha mashallah our fearless leader and Muslim community of Knoxville you know the last few weeks have been difficult for Sister man her family is her beloved father passed away lawyer hello so I would really love to request of our panelists and our audience to to keep

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our our beloved uncle Abu Hani in your in your drought so much I really appreciate your resilience and thank you so much for being here. Now in sha Allah we are going to invite our dear one of our one of our alumni Masha Allah that's the female plural of alumna. We're going to invite sister Amina Han to recite the Quran for us little bit about Sister administer. Amina is a graduate of the fifth year of tasers seminary, the one year immersive program in Islamic Studies and that was class of 2020. And I mean as currently working on her Master's her master's degree in mental health counseling and a shout out to Amina because I called her right before the webinar saying Amina we

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need to have beautiful girl please come and recite for us. So sister Amina inshallah will recite a selection of Sudha to shooter to get us started so definitely yeah I mean

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email law he tells Leo Google

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a lot having

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the name of Allah The most Gracious, the Most Merciful.

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Respond to your Lord before the coming day from a law that cannot be averted.

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There will be no refuge for you then no grounds denial of sins,

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nor grounds for denial of sins.

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But if they turn away, we have not sent you a prophet as a keeper over them. Your duty is always to deliver the message. And indeed, when we let someone taste a mercy from Us, they become prideful because of it. But when afflicted with evil, because of what their hands have done, then one becomes totally ungrateful.

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To Allah alone belongs the kingdom of the heavens and the earth. He creates whatever He wills, He blesses whoever He wills with the daughters and blesses whoever He wills with sons, or grands, both sons and daughters, to whoever He wills, and leaves whoever He wills, infertile. He is indeed all knowing, most capable.

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It is not possible for a human being, to have a law communicate with them, except through inspiration, or from behind a veil, or by sending a messenger angel to reveal whatever He wills by his permission. He is surely most hi all lies.

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And so we have sent to you a prophet of revelation by Our command. You did not know of this book and faith before, but we have made it a light by which we guide whoever we will have our servants and you are truly leading all to the straight path, the path of Allah to Whom belongs whatever is in the heavens, and whatever is on the earth. Surely to Allah all matters will return for judgment.

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But Allah Halim Sokoloff

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To sokola Hydra Mashallah. Tabata QCL la dearest Amina, I really appreciate you thank you for coming on board with such short notice and I really wanted to have that buttock of opening our program with the beautiful words of Allah subhanaw taala. So again, Amina, she's Akela Hydra. And with that in sha Allah, my dear audience, it is my great honor to introduce our first presenter for our very first and really kind of historic focus on fertility webinar. So it is my great honor to bring to you Dr. Charcot haisa Yunus, who is an American Board Certified Obstetrician and Gynecologist with roots in Iraq. Shayla Haifa is the founder and chairwoman of agenda Institute and a resident scholar

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at Agenda Institute and the Islamic Center of Irvine in California. She graduated from the Mecca Institute of Islamic Studies and Allahu Allah Quran memorization school in Jeddah or she completed the memorization of the Quran Masha Allah automaticall law currently she lives and works in the US and teaches various Islamic Studies courses with an emphasis on test kiya purification of the heart before we invite our beloved Shayla to speak I just want to say on a personal level, that che ha Masha Allah is tremendously busy and I'm so grateful to Shayla for rearranging your schedule to join us this evening. Shayla hosted me and my children her home, several years back, and I will never

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forget this, my dear audience, she literally gave her house to me and my children. And it was such a lovely visit and it left behind a wonderful impression of economic Muslimeen. And, you know, I regard che ha as my teacher and mentor and Shayla, we are so honored to have you with us today. And Shangela haIf inshallah will be our first presenter, enlightening us from both the filthy shudder I aspects of our subject, as well as medical advice. So che ha, welcome. Hello. Hey, may Allah make me better than what everything said about me? And forgive what the everyone don't know about me. Hamler Blimey, it's a pleasure to be here. A disclaimer anything she has been sorry say the answer is yes.

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I just can't say no. And exactly, actually, I was supposed to be flying yesterday or early morning today. But if I did that, then I will miss the webinar. So I had to delay my flight. But what a pleasure to be here with especially with all this hamdulillah beautiful attendees. So Bismillah Alhamdulillah wa salatu salam ala Rasulillah Allah Allah, he was happy he will Manuela indeed having children is a blessing from Allah subhanaw taala. And exactly what our beautiful sister just recited is this is usually the verse and I'll share it's actually I have it on my slides is really lovely Matthew somehow it will muffled Yeah, hopefully my show enhanced and we Masha is the core of user

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withdrawal, I'll use a widget on the chronoa. In other words, Alma mashallah team in the Hollywood idea. This is usually the verse that is being said about infertility and I will have it in my slides. Infertility, or an inability to conceive is one of the most challenging to couples. And by the way, it's not only for Muslims, it's one of the hardest things for me to counsel. Couples, definitely Muslims, but again, non Muslims when the answer is, is you cannot have children and

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any one of the May one of the reasons couples get married, or a woman and a man and a woman get married, to have children, it's a blessing. And Marley Welborn owns UnitedHealth duniya the wealth and children is the beauty of this life. So I'm going to take you through and I'll share the slides with you I'm actually prepared some for from the medical point of view, and I hope all of you can see me hamdulillah Brian, so basically, yes, you can see me hamdulillah already. So basically what it is, it's the fertility, I'm going to say ABC because this is exactly I'm going to speak the language of the patient, not the language of a physician speaking to another physician, so I call

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this fertility ABCs. Right. So basically, what is this and this is the verse that we just heard, and this is again, it's the verse that we all dilla he will, somehow it will, Allah belongs the kingdom or whatever everything in the earth and in the heavens yalobusha He create whatever He wills Yabu mania show in whom he was to give them girls and home he was give them boys. I'm going to comment on one thing here, because it's so much related to the stress and the difficulty and the anxiety that we go through. Or the couple go through when they don't have children and this is why you need to ask yourself always, Why did Allah subhanaw taala said this, why did he start this verse? Lila? He

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will customize what you will. He owns everything. He owns what we see and we don't see what has been created.

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What is not being created or if it's going to be created when it will be created, how it will be created? Everything disappeared is belongs to Allah, including the child that you want. And this is actually a comfort. Yeah Hello Maya is another thing is now a de emphasis not only on the kingdom, but on the smaller Hill hollow on the attribute of a Hulk, because children, babies, fetuses is a creation of Allah, He creates what He wills. And then he says, Yeah, William Aisha, and you have the Heba is not a gift. Only it's a gift without even asking. And without expecting anything back. This is extremely important for the couple's Muslims to strengthen their relationship with Allah in this

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process. Subhanallah Yeah, booty mania show Inasa we are bringing my Isha and he gives to him he was

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I don't know why I can't move it. Subhanallah let me just see Bismillah let's see, this way.

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And 105 So what is infertility?

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Okay, or actually, let me just say, Yeah, we making the call. There's another verse. I'll use a wiggle room to Quran and we're in Arthur, or they give he Subhana gives boy and girl, I will use a widow home to Conaway Natha meaning the family will have boys and girls. Now the next one will age Aluma Yasha, TEMA and whom he was make them infertile, our team, our team is there is no nothing comes out of it. And one of the descriptions of the

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Yamana our team one of the descriptions of the Day of Judgment is our team, the same word we use for infertility. And then in Hollywood will Kadir pay attention to the end of the verse, IBM ongoing audio capable and I always use this when I counsel Muslim couple of ally Moon Kadir, even when I say you know what, you're not going to Madison this hour, the words I use. I say Madison says you can't have children, but Allah Halima Claudia. So it's very important as a Muslim couple, really, really in this difficult to process is to get very much connected with Allah subhanahu ATOD. So let's see here. Bismillah what is infertility? And this is again, very important because I get this. She got

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married after three months, and now she's not pregnant, and everybody is very, very stressed out. No, it's not getting pregnant, having carefully timed unprotected relationship for one year.

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This is very important to remove a lot of the stress. There's a lot of stress on the couple, maybe not a couple of themselves but the family there her parents, his parents, grandparents, you know, and I always say to people leave people, private life. You want to ask a couple when they just got mad. Oh, you're not pregnant yet. And I remind everyone when Hosni stammering Mr. kumara Yanni from a sign one of the signs of good Iman and good Islam, Hosni Islam and Mark excellences now just stay away from the from matters that is not related to us. So it's not related to me why they didn't get pregnant. Maybe they don't want maybe Allah is testing them Munna? Why do I want to ask you this

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question? So this is for those who are related, or to you know, even friends sometimes as don't ask, but for the couple who got married, usually, no intervention will be done. In general, of course, there's always exceptions to the rule. If it is not one year, it needs to be one year. It needs to be unprotected relationship and timed. Sometimes what happens he works in one state, she works in another state, they are separate or he traveled. And then and this is one of the questions we always ask. And I always say La Jolla if indeed, there is no bashfulness when it comes to learn the deen and I said how often you have an intimate relationship. And if she or he tells me once or twice a

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month, it was like, I'm not going to start anything you need to have it. In general, we say three times a week. The only exception of the year is the woman is above 35 years of age, we normally start this process, usually after six months because of the age. How common. This is very important for everybody. So don't feel that you're left out. Don't let it feel like I'm the only one No, it is extremely common problem Subhanallah in the United States, 10% of the woman 6.1 million aged 15 To 45 to 44 of pregnant have problems getting pregnant. These are studies 2019 The US Department of Health and Human Services 6.1 million. Look at this number. You're one of them. So it's not like

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you're eating

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feels like you're the only one. Well, I'm the only one in my family. Yeah. But there's 6.1 Other people only in the United States. And this is only for the for the woman aged between 15 and 44. So you're not the only one time okay, this is what I, okay. This is the most important question all the couples asked me why? Why I'm not getting pregnant. My first answer. Allah has not willed it yet. And I say yet, you know why? Because yet gives you hope.

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Because when he wills, you will get pregnant. So why, number one Islamically. And I'm putting only the magical slides here, but I'm going to keep reminding you and me that we are Muslims. We are Muslims very different when I counsel a Muslim patient versus non Muslim patient. And even sometimes I put my religion in it. And I said, In Islam, this is how we do so why, let's say Bismillah? Why the couple of don't get pregnant.

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I say this, and I normally in my office, actually, I bring a piece of paper and I draw to the to the couple because they really need to understand to get pregnant. You need a man, you need a woman, you're going to tell me obvious, I said, Yeah, because I need you to think this is not the woman only. And it's not the man only. We need them both. And we need the intimate relationship. So I need a man, we need them a woman. And then we need the intimate relationship, as I said the regular average three times a week to get pregnant. So which one is more is the problem.

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Look at this one. And this is medicine. So the infertility causes, I want you to pay attention to the following 30% is men. We call it a male factor, meaning there is a problem that the issue is in the husband and 30% in the woman

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so that when we say female, meaning the problem is in the wife combined, both of them. She has issues with ovulation, he has issues with his sperm combined. Remember this number? This what frustrated people?

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We don't know. And I keep reminding everybody we don't know. We don't know. That's why or how quickly the ailment I mean, above every knowledgeable person. Allah is the One who knows. And that is one of the reasons Allah ended divorce, I removed a deal. He's all knowing he's all capable other coach, we basically usually the relationship is not as frequent as it should be. So remember this Don't blame your especially wives. And I'm sort of speaking here to my dear sisters. Don't blame yourself, because I see it all the time. It's something wrong with me. So how do you know? It could be both in actually your seats now? Okay, so let's come in each one. It's often assumed that the

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fertility difficulty are with the woman. And I see this in reality says this is the

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American Association on its website, but it's even more 40 to 50% of infertility and couple male factor. We call it male factor, sperm, the number the quality, the ejaculation, I don't want to give you a lot of medical terms, but you really have to think it is not your fault only the woman or for the man don't feel it is it is your fault only No, it could be him. It could be her it could be both

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and I put something very simple. I can't go into a lot of medical details. But this is the most important thing for the man and we're going to come to the woman only what is life changing events mean? We need to change the lifestyle weightloss number one for the man can significantly increase semen volume.

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And I'm going to just give you something very simple what I tell the couple for the man to to be okay clear. The issue is not demand we need the number and we need activity

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and we need quality. Remember these are three I need a number for the semen meaning how many sperms not for how many? The perfect number 20 and above the number that is Subhanallah is zero.

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The more the number, the better the the options above 20 Were fine.

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Between five and 10. Low 10 to 20 I said it's not a big deal. Now number is one but I need the quality. What quality the the sperm is and we need something called forward movement Subhanallah Vida Allahu for the egg. Now either hula hoop for

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The egg

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to get for the sperm to penetrate the egg. During the intimate relationship, millions of sperms are ejaculated inside the woman, millions, I need only one. And that one has to move forward with a quick swift movement getting into the egg. Once that sperm gets into the egg, the sperm the egg shut off, like you shut up the door, and no more sperms comes in SubhanAllah. So weight loss increasing. So this is what I need. I need semen number, quality, forward movement and volume because the sperm lives in fluid. And if there is no fluid, it's going to be difficult to get pregnant, weight loss. And it's and it's affected volume, the concentration meaning the number, the mobility, and the

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normal, normal morphology, they need to be looking normal,

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consuming vitamin C, so be healthy. And we always say this, this is for the mind be healthy. Weight loss is huge, vitamin C, these are all normal, natural, easy. Now she's not pregnant, the man is absolutely fine. So the first step, and I say this to all my patients and a couple of you are listening to me. We don't start with a woman, I let the husband give me a semen analysis. Because it is much easier. This is how I want you all to know, to get pregnant. When Allah subhanaw taala did not allow it to happen naturally, there is roads we take as physicians, and I am not going to jump to the most complicated road unless I am sure it's the steps. So literally, this is what I tell the

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patients it's a step by step by step by step, I'm not going to jump to the top. It can cost a lot of money can cost a lot of anxiety and a lot of side effects. I may not need all this first step is semen analysis. I look at the husband and I said please, I need a sample. You go to the lab, we give them instructions. And if one comes abnormal, wait, we normally repeat we need to samples that tells me it is abnormal, then we're going to say ah, I have a problem in the math. Why do I need to know this? Because if it is a male infertility, we call it male factor. The the road will take absolutely next step we need what we call it assistance now. We're not going to be giving medications to the

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woman and doing all this like you know what, usually you will be referred to the fertility specialist because now we need assistance. Now she the man is absolutely fine, but you didn't get pregnant. Now I'm going to come and say okay, let's look at the next 30% What is the factors in the woman that will delay for the woman? What do I need? I need ovary I need fallopian tubes. I need a uterus. I need cervix and I the vagina, the vagina where the man comes in and ejaculate but I need a uterus where the baby is going to stay. I need ovaries where the eggs is going to come out and I need fallopian tubes. So the egg move and their sperm moves and they meet in the fallopian tubes.

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The most common problem in the woman is ovulation is something is not right. And she is not bringing the eggs in the right time. Why did I put this picture? Because number one problem in the woman that cause an ovulation is actually overweight or significantly underweight.

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So when the when your physician tells you lose weight, don't say she didn't do anything, believe me. And I always look at them and says, Just trust me in this three months go. Exercise. Watch what you are eating. Ask Allah Subhana Allah to help you to lose weight. Give me an hour as I look at the number I said give me a number starts with this. And if you didn't get your cycle or didn't become regular, or you didn't get pregnant, we'll talk. So don't underestimate I am four I am focusing on the natural ways, because that will help us a lot a lot. Now, stress. Absolutely. stress caused a lot of problems. And I'm talking about real stress and anxiety and that's where the talamona is

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going to come and talk stress itself. cause problems with ovulation not getting pregnant, increase the stress. So what do we have to do too much stress. And this is what I wanted you to pay attention, lack of effective coping strategies. For me as a Muslim general OBGYN. I start reminding the couple and especially the woman that's the verse we just read. Only Allah who will give you the children. Allah is very generous. Don't say I will never get pregnant.

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And if everything we tried and she's still not getting pregnant, then I say I

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Are you better than say Dasha? She didn't have children and she was the youngest wives of Roswaal. Esau to the most beloved to him and the only virgin but she didn't. But usually I say you know what, always be positive. always rely on Allah. Always think of the, of the mercy and the Wrath of Allah. But we need effective coping strategy. If you're going through a lot of stresses, changing jobs, you're not finding a job your husband lost financially or marital issues or in laws, all these definitely will affect ovulation.

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What does that mean?

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Something you're not going to own like it's age,

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age absolutely affect fertility. Or the woman above 35 It starts decreasing. This is what I tell patients. My mom delivered me she was in her 40s So fact you are 37 or 38 or 40 or 41 doesn't mean you're not going to get pregnant. Absolutely not. Because there is people who are in their 20s and the woman did not. But in general and I counsel the couple this way, if you are planning on having children, especially if you're having on planning more than planning to have more than one child and you got married at age 30 Then you need to from now plan better to have your family before 35 doesn't leave us before 40 However, if you are 38 and now you got pregnant and now you got married I

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said you know what?

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Go and get pregnant right away and Allah Santana will help you I have delivered the patient 45 year old natural Allah gave it to her Subhanallah but age is definitely a factor.

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and I put these because this is our day and age changes. Sleep regularly working a night shift these are all studies by the way, are not sleeping enough. Absolutely affect your hormone production and affecting hormone production is will make you

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on ovulate because this is usually the problem with the ovaries is on ovulation, you will see a regular cycle or sometimes regular cycle, but you're not ovulating. Meaning there is no eggs coming up. Sleep changing lifestyle is so important in this and don't tell me I can't I keep telling her you know what ask Allah he will help you. I can't find a job ask Allah he will help you. He will help you smoking huge problem. And this is by the way for both smoking affects the man sperm quality and number and for the woman affects absolutely ovulation. And even worse than that, which everybody think it's fine. It is not it's worse than smoking because it has much higher concentrate of

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nicotine Subhanallah people don't know that. And it's becoming almost a pandemic. I've seen people after in Ramadan after if you're after if power SubhanAllah. And you just obey the law all the time. And then here they are

00:33:02--> 00:33:26

doing shisha or hookah as they call it here. It has sometimes 10 15% or 15 times more nicotine concentration than in cigarettes. And what does it do affect the sperm quality and number and affect ovulation? And I'm going to show you and I want everyone to notice the ruling. I have to say this to everybody.

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The ruling on smoking, whether it's what the cigarettes or whether it's hookah, it's moved and she has a knob. She made even more comment on that later on. It used to be mcru used to be disliked,

00:33:41--> 00:33:56

but not haram. It changed the ruling to haram. It's haram is like drinking alcohol when patient tells when I asked her Do you smoke? She said yes. And I said do you drink and she looked at me I was like how do you even think I can drink and I said well it's the same.

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Why? Based on this verse when smoking. This studies clearly

00:34:05--> 00:34:50

confirmed that smoking cigarettes add to it now nicotine, hookah cause cancer and there is no doubt about it. You see it is even on the packet when you buy it. Then the ruling moved from macro to haram because now it became harmful to the body and this is what Allah says so this is a sort of out of why your hell you Lahoma QP bat Are you have any more Alikum will hover he commanded them to do good and forbid evil. permit your help for them the lawful and for a bit for them the impure hubba is impure, the harmful So smoking cigarettes are hookah there is nothing called Fun. There is no fun in Haram.

00:34:51--> 00:34:59

Same as someone says you know what? I just drink wine for fun. Is that okay? No. So this is the same and it affects you

00:35:00--> 00:35:02

Fertility and especially for the man actually.

00:35:04--> 00:35:28

Coffee, coffee, caffeine. It also affect caffeine consumption of over 200 milligram per day. Three cups or more affect ovulation affect the fertility. This is especially for the woman. So life changes or lifestyle changes is extremely important. Infertility, very important infertility.

00:35:29--> 00:35:30

What is that?

00:35:33--> 00:35:38

Very heavy physical activity the opposite. We are on Masada.

00:35:39--> 00:35:43

We are a nation, Allah created us to be in the middle.

00:35:44--> 00:36:30

We are not this or that we are not no exercise. And we are overweight and eat whatever we want. We're not but also we are not this severe, vigorous exercise where there will be no cycle. If the woman is like, for example, the marathon runners, one of the problems we see is not like you do it one time for a cause. But those people were always is actually they don't have their cycle. And now it's a huge problem. Because if you have no cycle, it's very unlikely you will get pregnant. So heavy and vigorous activity which means fiber over five hours a week, more than five hours a week. It affects fertility also. So life style changes. Go back to the basics go back to be modern meaning

00:36:30--> 00:36:35

in the middle and this is why I put this verse okay Delica Johanna co Martin Masato.

00:36:36--> 00:36:52

Allah said this in Surah to la cara, second chapter of the Quran. This is the worst. The first verse, Allah made us a nation of the middle middle ground among people always ask me are you a robot publican or Democrats? I said I'm a Muslim. We're in between

00:36:54--> 00:37:31

same thing I Muslims are not overweight. And Muslims are not underweight Muslims are don't they don't sleep at all law. And Muslims is not sleeping, you will always in the middle. As a Rasul Allah saw to Islam and the three men in this famous Hadith, you all probably know or at least you have heard it when they came. And they said, they asked one of his wives, what does he do when they she told them what he his act of worship? And they found it like this is it? And then what did they do that one of them says I am going to pray all night, I'm not going to see the other one going to I'm going to fast and I'm not going to eat. The third person says I'm not going to get married. And I'm

00:37:31--> 00:37:50

going to stay away from woman and this switch to Roswaal usato son, and he came and told them no, I am the most knowledgeable of Allah among you. And I'm the closest to Allah among you, yet. I steep and I am up, I eat and I fast. And I networked has ordered Lisa and I married

00:37:51--> 00:37:52


00:37:53--> 00:38:37

drinking alcohol and this will be the last one because I am very limited in time. I think I'm almost over time at drinking alcohol also increase the woman's risk of ovulation disorder. So you have to remember as a woman, very quickly, I'm going to go through this. To get pregnant, you need your ovaries, and you need the ovaries working. So when the ovaries working, meaning I need the eggs healthy and come out in the same time they are able to come out of the uterus. That's ovulation. So when you hear you say you're not ovulating, the problems in the ovary, then you have the fallopian tube, which is the the canal if you want to use the word and that word the egg Subhanallah will pass

00:38:37--> 00:39:07

you through it in the 1/3. Last 1/3 The sperm comes in, that's why the sperm needs to move forward, they need and then the she gets pregnant, these Nila Of course, and then this comes together. And then they go and stay in the root in the uterus. So for the woman the ovary has should work, the tube needs to be open or paitent. That's when they tell you you need an X ray. And then uterus needs to be there. So that is the womb or RAM where the notify

00:39:09--> 00:39:30

where the Aloka and the medulla is going to be forming there, which is the the combination the blood will be hanging to the wall of the uterus and then it becomes more like a chewing gum. What Allah Subhana Allah says in surah to mean, so simply speaking, and just to summarize everything, and I'm going to stop sharing here, basically, it's a common problem.

00:39:31--> 00:39:59

And you're not the only one. It is not the woman fault. Always or the man fault always it is both and 25%. We don't know. Only Allah knows. It's stressful. But I'm going to share a last story and I always like stories because it's real. This is a couple the woman was at least 2324 but very anxious. Very anxious. Two years married. No children.

00:40:00--> 00:40:35

We tried everything. So usually it tends to be unexplained, which is really frustrating. Neither the husband has an issue nor she has an issue. But before we get to the issue, I needed to do the X ray, which is uncomfortable. So by the time I convinced her Hamdulillah, they were almost uncouple. So she wants and came back and did and she said this video, whatever, and she was not happy with the X ray. And then I come and says it hamdulillah it is all normal. It says Then why I'm not getting pregnant, you get some times, which is expected, you get even more frustrated when there is no reason.

00:40:37--> 00:41:15

And then I said, Okay, I'm gonna we need to send you out to the specialist, usually unexplained most of the time, you need now to send them to this question. So she gave it to the specialist come back to me, so frustrated, because whatever, whatever, whatever, and finally said, Okay, we're going to do IVF. She did IVF once, and she didn't get pregnant. Subhanallah very anxious. She came to me. And I remember very well, this is very well, I remember, she looked at me and says, You know what, I don't care. If I'm going to get pregnant again. I'm done. I'm not going to do anything. The husband was sitting in my office, and I'm not going to do anything. And looked at her husband says I'm

00:41:15--> 00:41:59

leaving. And she left. I looked at the husband, I said, she will get pregnant. And he said why? I said, because now she left it to Allah subhanaw taala. And guess what I delivered three times I delivered her. The last thing I will say to the couple, you take the means everything I shared with you are the means. But don't depend on the means only. Because once you depend on the means I took the medication, I did the IVF I did the surgery, I did this and I didn't get pregnant. And you forgot the most important factor in this whole equation, which is Allah subhanaw taala as will as we shared in the beginning, it's going to be very difficult. Always remember in this process, that he

00:41:59--> 00:42:39

is with you, his your companion, you lack patient, tell him to keep you up to make your patient. You want this to work, please make it work or lets me accept the decree. But don't depend on the physician or on your ability and your planning because Allah sometimes test us with this. And may Allah subhanaw taala elevate the stress of everyone and may Allah subhanaw taala give everyone they want not only one or two children, the number they want but most importantly right just children. Your OB Amis Hannah CalOptima will be handy. I said to Elijah and stuff we will cover today salam ala Sayidina Muhammad wa ala alihi wa sahbihi Steven cathedra

00:42:44--> 00:43:23

Giacomo Clara Dara Shayla Haifa we are so grateful to Masha Allah I learned so much from shapeless presentation it was detailed Masha Allah thorough and really emphasized my what I took away from shapeless presentation is that there's a spiritual aspect of this which is relying on Allah Subhana Allah and not our own means as as human beings, and also understanding that you have to tie your camel and trust in Allah that there are certain steps that the couple has to take. So Shayla, I really appreciate your very candid presentation. And, you know, and again, for our audience, please keep in mind, this is intended for a mature audience with their young children around, please, you

00:43:23--> 00:43:52

know, exercise discretion, but we chose the subject matter, because we really wanted to, again, raise awareness around what has become kind of a taboo topic. It's a difficult topic, it's sensitive. And I really love the approach embodied by share Cohiba, which is that we speak about these matters in a very forthright way. But also with you know, with hikma also with, you know, with, with Subhanallah, balance and wisdom and again, Sheikh was so grateful to for your presentation. Absolutely.

00:43:53--> 00:44:38

Shallow, we have q&a. So just a quick housekeeping note that there are questions that were sent when you registered and we have those questions right here. We are going to select from those questions for our esteemed panelists. We also have questions that have come in live from our participants tonight, and inshallah we're going to get to those questions as well. So, let's, Inshallah, we're gonna give our attention to our next panelist, but please rest assured that we have dedicated time for q&a hamdulillah and Masha Allah I'm Shayla, you're exactly on schedule. Batticaloa Viki, again, such a beneficial and inspiring presentation. Now with that in sha Allah, it is my great pleasure

00:44:38--> 00:44:45

and honor to introduce our second panelist, Dr. Mona elico. Hale and Dr. Mona mashallah

00:44:46--> 00:44:59

is someone that I've been admiring from afar I wish we could spend more time together. Dr. Mona mashallah is a licensed clinical psychologist specializing in reproductive and Perinatal mental health

00:45:00--> 00:45:42

her and she received her BA in neuroscience and behavior from Barnard College, Columbia and Columbia University, and her MS and PhD in Clinical Psychology from Drexel University and she did her postdoctoral fellowship at Drexel University's mother, baby connections and intensive outpatient mental health program for pregnant and postpartum women and their infants. Dr. Mona has years of experience providing evidence based therapy to women with mental health challenges related to infertility, pregnancy, birth and postpartum experiences. And she's also the founder of the award winning Muslim fertility project so it is again my honor to have Dr. Mana, enlighten us and again I

00:45:42--> 00:45:51

want our audience to know that mashallah that you have some some genuine expertise here and we're very grateful to our panelists so Bismillah Dr. Mona, please take it away.

00:45:53--> 00:46:27

Oh, thank you so much the status and I am so happy and honored to be here and what a beautiful talk by our dear shahada, masha Allah I could just listen to her talk all day. And I am so honored to be invited to this talk. I'm honored to be speaking alongside such a great scholar, masha Allah. And I wanted to just thank you said as Nina began for inviting me and thank the entire pace your team and MC K for for all the work that went into organizing this important talk. Alright, bissman. So just bear with me. I'm going to share my slides here.

00:46:30--> 00:46:32

And I just want to make sure everything

00:46:33--> 00:46:36

looks the way it's supposed to.

00:46:37--> 00:46:39

Okay, so

00:46:40--> 00:46:56

are you all? Does it look okay, on your end? hamdullah. Yes, it looks great. Thank you. Okay, great. All right, this man. So today, my plan is to talk about the psychological aspects of infertility. And just briefly,

00:46:57--> 00:47:00

a quick overview of what I'll be talking about. So

00:47:01--> 00:47:36

I'll talk a little bit about infertility and Assam, the likelihood of pregnancy, miscarriage, infertility, the mental health consequences of infertility, pregnancy loss, and infertility treatment, as well as just touch on some coping strategies, and some advice for those who are here to learn about how they can support their loved ones who are experiencing infertility. And in terms of my research, I'll tie that in when talking about mental health consequences as well as coping, inshallah.

00:47:40--> 00:47:47

Alright, so I want to start off, and I have some of this will overlap a little bit with,

00:47:48--> 00:48:31

with our dear show has talked. So I'll try to kind of move through some of those points more quickly. But I want to start off again, by just acknowledging that there is such a major emphasis on having children in Islam, right, children are considered a blessing, a source of great joy, and reward. And there are several verses in the Quran that emphasize the importance of having children, and the blessings that come from parenthood. And so the the verse I have here is the same one that our dear share has shared, so I won't read it again. But again, I just don't think that the importance of producing offspring in Islam can really be overstated. So I just want to start off by

00:48:31--> 00:48:32

sharing that point.

00:48:34--> 00:48:47

And the Prophet Muhammad peace be upon him also emphasize the importance of having children and raising them well, so for example, he said, Mary, for I will boast of your great numbers before the nations on the Day of Resurrection.

00:48:49--> 00:49:18

And one of the ways that this emphasis on having children manifests itself in our lives is often through questions we get from others. So unfortunately, it has become socially normative and commonplace for newlyweds and childless couples to be asked questions about their plans for having children. Right. So when are you going to start your family? Do you want to have children? Do you want boys or girls? And,

00:49:19--> 00:49:30

you know, these questions, I think, inherently come with this assumption that couples are just in complete control of their family building plans, which is just simply not the case.

00:49:32--> 00:49:43

And so I'll discuss this a little bit more later. But I just want to mention here, you know, please, you know, don't ask people if they have kids, if they want kids if they want more kids,

00:49:44--> 00:49:59

because we just don't know if they're struggling to start their family if they just experienced a pregnancy loss or anything else about their reproductive histories. And frankly, it's just none of our business. You know, in our dean, you know,

00:50:00--> 00:50:23

teaches us to leave the things that do not concern us. And this is certainly one of those things that we need to just leave. So if you are, and I know it comes from, you know, for most people, this is coming from a good place, they just, you know, love this couple, and they are just, you know, wanting to see them, you know, start their family. So, rather than ask them just to make up for them, I think that's the best thing that we can do.

00:50:26--> 00:50:42

And aside from these social norms of asking about family building plans, there are other sources of messaging about, you know, ease of having children, and that comes through in the media that we consume. So whether it's movies or TV shows,

00:50:44--> 00:51:18

and we're seeing, you know, more and more now, celebrities getting pregnant in their 40s and 50s. And, you know, what's most likely happening there is that many of them probably froze their eggs at a much younger age, or are using donor eggs. And I know some of them are disclosing that from the moment that may not. But I just want to, you know, share that information, because I think that's important context. And again, these things may give the impression that getting pregnant is easy, that it's completely in our control that it can happen at any age.

00:51:21--> 00:52:03

But Allah addressed this in the Quran over 1400 years ago, right when he tells us, again, I won't I won't review these these verses, because they've already been shared. But ultimately, he is telling us that it is in his control, right. So when it comes to the matter of having children, it is in his control. So even if couples avail themselves of the most, you know, cutting edge innovative, innovative fertility treatment, they really need to understand that these therapies are simply a means that Allah has created for us for building our families. But ultimately, the end result is in his hands. And he either grants children or he doesn't.

00:52:06--> 00:52:16

And the reality on the ground is that getting pregnant is not always easy. That miscarriage isn't rare, and that infertility isn't uncommon.

00:52:18--> 00:52:40

In fact, for a young healthy couple, the chances of conception each month can vary. But generally, it's between 20 and 25%, for those under the age of 30. So that means that on average, it can take, you know, maybe four to five months of trying to conceive for a pregnancy to be achieved, and that there is nothing wrong with that.

00:52:42--> 00:52:59

And then as you can see from the graph here, by the age of 35, a woman's chances of conceiving per month is decreased by half. And the downward slope continues until by the age of 45. The natural fertility rate per month is about 1%.

00:53:02--> 00:53:18

About 10 to 20% of those pregnancies end in miscarriage. So miscarriage is also known as a spontaneous abortion. In case you're trying to, you know, look at the graph here and understand it. And that, you know, occurs prior to 20 weeks gestation.

00:53:21--> 00:53:30

So, again, you know, our share has shared the definition of infertility. So I'll just, you know, quickly share here that and emphasize

00:53:31--> 00:53:45

that it affects both men and women. And it can be caused by a variety of factors and a diagnosis of male factor infertility is just as common as a diagnosis of female factor infertility.

00:53:49--> 00:54:08

And infertility is, is is common, so it impacts one in eight couples. So that's about 12% of women in the United States. And so I learned this, you know, early on in my graduate training, and started to look into the literature and realized there's like barely any literature out there on

00:54:09--> 00:54:13

infertility, the infertility experiences of Muslims.

00:54:15--> 00:54:17

So I did

00:54:18--> 00:54:22

want to contribute to that literature Sunday and get into some of the research that I did.

00:54:24--> 00:54:42

So I conducted a study that aimed to assess stress and depression among Muslim women with infertility who are living in the US, Canada, Australia and the UK. And then I wanted to look at the relationships between stress depression and religious coping in this population.

00:54:44--> 00:54:56

And 100, and now we had almost 500 Muslim women participate in the study. This was a really, you know, really amazing outcome. Because I know initially,

00:54:57--> 00:54:59

my you know, one of my advisor and I were

00:55:00--> 00:55:21

sitting and talking about the study, you know, we talked about how I'm really targeting, you know, a minority within a minority within a minority. So not just Muslims muscle limit, and not just Muslim women, but Muslim women with infertility. And I was, you know, we weren't expecting this response. And we were really happy to see how engaged the community was with this research. So a huge thank you to the women who participated.

00:55:23--> 00:55:30

And you know, just a little bit about the participants. So at the time of the study, they were all trying to conceive

00:55:32--> 00:55:50

their ages range from 20 to 44 97%, experienced difficulty conceiving, and almost 40% experienced difficulty carry a pregnancy to live births, and 50% of the women who participated were currently in fertility treatment at the time of this study.

00:55:52--> 00:56:34

So just keep that in mind, as we talk about the results of the study is that all of the women were really in the thick of it, they were trying to conceive the written fertility, or, you know, half of them were in fertility treatment. And I think that's important context to have. And what we found is that stress was prevalent in this sample and experienced at high levels. So almost 100% of the sample reported experiencing stress related to their infertility and 36% of the women scored in the very high stress range. And I didn't look at, you know, this arrow on the left here that I'm going to describe this is not from my study in particular, but I wanted to highlight here, that from other

00:56:34--> 00:56:57

research, we know that stress tends to worsen over time for fertility patients. So it can get to the point where you know, so you know, stress might start at a certain level pretreatment. It'll increase after a failed failed cycle and attends to continue to increase and can get to the point where it is equal to the distress experienced by cancer patients.

00:57:01--> 00:57:33

And we also found that infertility related stress impacts various life domains for the women who participated in the study. So it impacted them physically, socially, sexually, emotionally, it impacted their marriages, it impacted them financially and impacted how they saw themselves in their identities. And I'll just dig a little bit into each of these areas, just to give you an idea of what this looks like. So physically, you know, women experience multiple vaginal exams, injections of hormones or other medications during fertility treatment.

00:57:34--> 00:58:16

And these medications can have side effects, including, you know, bloating, hot flashes, nausea, etc. So it's a very physically uncomfortable experience. And that's just one, you know, that's just one aspect of infertility that they're dealing with. And 97 99% experienced stress due to social concern. So this is concern related to things like sensitivity to reminders of their infertility comments, they're hearing from others questions about their infertility, feelings of alienation or isolation from their peers and their family, and finding social activities challenging or difficult to participate in.

00:58:19--> 00:58:59

And 100% of the women experienced stress due to sexual concern. So things like loss of enjoyment of sexual relations, feeling pressure to schedule sex, and loss of sexual self esteem. And we see a lot of marital discord particularly early in fertility treatment, when couples are trying to conceive naturally. Because there is this, you know, shift from recreational sex to procreation, all sex reduce, you know, forget about the recreational and focus on the procreation and recreational sex is really important for a couple. And when that fun, you know, is taken out

00:59:00--> 00:59:09

it, you know, it becomes a job. And there is a lot of pressure on men because they have to have this physiological reaction.

00:59:10--> 00:59:34

And that struggle or you know, that pressure can get to them. So, if they're not able to perform once, then they might think, you know, the next month, when they're trying Well, you know, what, if it happens again, there's, there's anxiety, there's worry that they, you know, might not be able to perform, and then we, we end up seeing sexual dysfunction and it can worsen because of that anxiety that comes.

00:59:36--> 00:59:41

So, you know, certainly we see a lot of, you know, stress related to

00:59:42--> 01:00:00

sexual issues between the couple, and infertility is an emotional roller coaster to say the very least, you know, you can feel hopeful that you know, this time you're you're pregnant you've conceived, you know, have this hope and excitement and then you know, dip being

01:00:00--> 01:00:02

devastated when you get yet another

01:00:03--> 01:00:23

negative pregnancy test. And there's you know, anxiety, shame panic, there are all sorts of emotions that come up for, for couples and partners, I'll just highlight that partners could have very you they may have very different emotional reactions to this experience of infertility.

01:00:25--> 01:00:28

And sometimes that in and of itself could cause tension between them.

01:00:30--> 01:00:50

Another thing to keep in mind is often there are side effects to the medications that they're taking. And sometimes just the meds alone could cause low mood, irritability, tearfulness. And there's also sedation anxiety for those who are in fertility treatment. So definitely lots of emotions coming up for those who are experiencing infertility.

01:00:53--> 01:01:05

And in so in my study, 97.5% experienced stress due to marital concern, so things like problems and communicating openly or construct or constructively about infertility,

01:01:06--> 01:01:10

difficulty accepting gender differences and concerns about the future of the relationship.

01:01:11--> 01:01:17

And certainly all these areas that we're talking about, you know, the physical issues, social, etc, all these things can end up

01:01:19--> 01:01:23

taking a toll on the marriage. And that's, you know, important to keep in mind as well.

01:01:26--> 01:01:53

Financially, you know, the cost of IVF can vary, and it could depend on what state you live in, and what's mandated in terms of coverage and your insurance, etc, etc. But I just wanted to give just an idea to those who may not know that, it's a very expensive process, and on average, it could cost, you know, a single IVF cycle in the US can range from 12,000 to $15,000. And I've had,

01:01:54--> 01:02:08

I've had couples who were taking out loans to cover their fertility treatments. So certainly there can be a lot of financial stressors that come into play, especially for those who are pursuing fertility treatment.

01:02:10--> 01:02:24

And then finally, you know, over 90% expressed stress due to identity concerns, so close identification with the role of parents, the role of being a parent and parenthood as a primary or essential life goal.

01:02:25--> 01:02:34

And the negative use of a child free lifestyle or status quo, feeling like you know, I'm not going to be happy if I don't become a parent.

01:02:36--> 01:02:40

questioning their purpose in life. So we see a lot of that as well.

01:02:41--> 01:02:57

Now, I know we talked a lot about stress. And I know, a question that is probably on a lot of people's minds is, you know, does stress directly cause infertility or pregnancy loss? So what I'll say about this is that as the research currently stands

01:02:58--> 01:03:13

on stress, and its relationship to infertility on stress, and its relationship to pregnancy loss, right now, there is no, there isn't a strong or consistent relationship between these different constructs.

01:03:15--> 01:03:26

And, you know, that's, that's where we are right now, in terms of the research. So I know a lot of people are like, Well, what about you know, all those, those anecdotes that we hear about, you know, my father's cousins, aunts,

01:03:27--> 01:03:30

you know, sister's best friend who got pregnant.

01:03:31--> 01:03:43

And, you know, it's because they quit their job, or they went on vacation, or they decided they're gonna adopt and just, you know, decided that they're not going to try to conceive naturally anymore, you know, they stopped going to their fertility treatments.

01:03:45--> 01:03:53

So what's important to keep in mind here is that we are talking about people who are experiencing infertility, they are not sterile, and those are different things, right.

01:03:54--> 01:04:16

So they were not sterile in the first place. So these are probably just normal chances of conception that we're seeing. And also, we, there are stories out there of people who do relax and who do destress and they still don't get pregnant. And those stories, you know, we're not hearing them as often, but they are certainly out there.

01:04:20--> 01:04:37

And in the so in my study, we also found that, you know, in addition to all the stress the women were experiencing, we also found that depression was common in this sample with over 50% of the women who participated in the study experiencing

01:04:38--> 01:04:48

symptoms in the depressed range. So they were they were depressed and you know, depression can be very debilitating and it's certainly something that requires professional attention.

01:04:51--> 01:04:59

Another point I just want to make quickly just you know, similar to what I mentioned before with that arrow and stress, we see that similarly with depression, where depression can also increase across

01:05:00--> 01:05:11

It's time, particularly for those who engage in fertility treatment. And you know, with each IVF cycle that doesn't work out, we tend to see depressive symptoms worsen.

01:05:14--> 01:05:26

And I just want to take a moment here to highlight grief, which is a very normal, natural response to losing a loved one. So grief following pregnancy loss, it is

01:05:28--> 01:06:12

traumatic and devastating, I think, to say the very least, it could be one of the most traumatic and devastating things to happen to a mother is to lose her child, you know, to have a pregnancy loss, and symptoms that you know, have acute grief. So this is immediately following the loss of their baby, we see depressed mood, anxiety, sadness, appetite, and sleep disturbance and functional impairment. And what I what I think is really important to highlight here is that this is actually similar to the intensity and the duration to the loss of a spouse or a loved one. So we don't see this difference in the intensity of the grief, but just because it was a pregnancy loss.

01:06:14--> 01:06:30

And it typically, typically can actually take up to two years for symptoms tournament, and usually that remission happens, because there is this healthy processing of emotions, exploring your thoughts around the loss, and, you know, creating rituals to remember your baby.

01:06:31--> 01:07:16

However, in this population, or among women, in general, who experienced pregnancy loss, we do see, unfortunately, disenfranchised grief following pregnancy loss, which is, you know, this denial of the processing of grief by society, it could be healthcare providers, it could be family, it could be friends, because some people just find it really hard to understand, well, like, you know, why, why would they be so sad, you know, for, you know, over a child that hasn't lived long enough to have, you know, to define him or herself. And so that grief, you know, they believe it shouldn't just be shouldn't be so long or profound or intense. And this, you know, this, you know, this belief

01:07:16--> 01:07:42

ends up actually hindering proper recognition of the experience and results in the loss being discarded or ignored. And that actually, that in and of itself could actually worsen someone's mental health symptoms, and make it very difficult for them to actually move through the normal process of grief. And in that case, we end up seeing complicated grief where symptoms aren't remitting and symptoms are getting worse over time.

01:07:45--> 01:08:05

Now, despite you know, stress and depressive symptoms that we saw in the sample, in the study that that I conducted, unfortunately, only 10% actually reported that they were currently in mental health treatment. And, you know, because of time, I'm not going to get into all the possible barriers to treatment.

01:08:06--> 01:08:33

But because of this finding, what I ended up doing is conducting another study, where I created an online depression treatment protocol for Muslim women experiencing infertility. It's the first ever created and it's, it's based on its cognitive behavioral therapy, but it integrates our deen and also is, is tailored to the infertility experience.

01:08:34--> 01:08:43

So I will, you know, I don't have time to get too much into that study. But what I did is kind of cherry pick some of the coping strategies that we talked about in that treatment.

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So I'm going to transition now to talking about some coping strategies. There are so many different ways to cope and coping can look different for different people, different strategies are helpful for you know, it could be helpful for one person and not as helpful for the other. So again, I'm just cherry picking here, just a few that I wanted to mention. But, you know, I think it's important to know that there's a lot of different ways to cope that I'm not mentioning here as well.

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So, in our sample, you know, the, you know, almost 500 Muslim women, what we found is that all of them actually turned to religion to cope with their stress to cope with their depressive symptoms. But there were two ways to do this. So there was positive religious coping and negative religious coping. And I just put some examples here just to explain what that what that can look like. So positive religious coping and example is you know, I tried to see how God might be trying to strengthen me in this situation, whereas negative religious coping is, you know, an example would be I wondered what I did forgot to punish me. And what's really I think interesting, that we found you

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know, when we did the stats, is that negative religious Cobain was

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significantly and positively associated with stress and depression. So what does that mean? So, you know, based on the type of study that I did, we can't say that one causes the other. So we're not saying you know, that negative religious coping causes depression or that depression causes negative or, you know, increases the likelihood of,

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or causes someone to use negative religious coping strategies, all we know is that there is a strong relationship between them. And we tend to see that the more depressed someone is, the more the more engaged, they are in negative religious coping strategy strategies, and vice versa. So what we want to do is we want to stop using negative religious coping strategies, we want to move away from that, and inshallah engage in more positive ways,

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or adaptive ways of coping.

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So what I have here, sestra reminder that the purpose of marriage is not to have children, the purpose of life is not to have children, and that our Creator gave us a much greater purpose, which is to know Him and to worship Him. Our value is certainly not tied to our ability to conceive, you know, you are not your femininity or masculinity, all those things are not based on your ability to conceive.

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And some of the best people ever created, experienced infertility. I shared with Ilan, how we know that she did not have children. We also know that she was one of the greatest leaders and scholars that ever lived.

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And the Prophet SAW as he,

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he experienced infertility, and you know, roughly the last 10 years of his life where he was, you know, he had multiple wives.

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But he only conceived with one of them, and many of his wives had previously been married. And they had children from previous marriages. So we know that they were able to, to conceive, but they did not conceive with him. And so we would never say that, you know, they're, you know, that I should know, they all have an agenda or the Prophet saw some are deficient in any way, because they experience infertility. And I think that's a really important thing to keep in mind. And it's something that's often you know, forgotten.

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And this is, you know, I think a very important heads of youth that I wanted to share, it is one that I found personally, so much healing. And when I

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I lost a baby girl in the second trimester, and I had many friends who shared this hadith with me, and it just, there was such profound healing that I found in it. So I'll just read it here. So by the one and whose hand is my soul,

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the miscarried fetus will drag its mother by the umbilical cord to paradise if she endured patiently and saw the rewards of God for her loss. So I think this is so beautiful, because it doesn't just, you know, promise that you're going to be reunited with your baby. But it also shows that this, this test this miscarriage, this loss could actually be a path to gender for you.

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And, you know, another in terms of coping, one thing I want to share is that healing is not meant to be done alone.

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So please, for those who are experiencing the burden of their mental health symptoms, they're finding that it's getting in the way of them, enjoying their life, living a meaningful life. And it's time to reach out to a mental health provider, it's time to really get professional help.

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Also, social support is so important. So think about who lets you just be, you know, non judgmentally who are those friends that you can count on? Who can you cry to you and not feel judged and just be yourself and, you know, connect with those friends, reach out to them connect with family members who do the same. And, you know, just be careful about who you share this news with. But also at the same time, don't come through the isolate yourself and deal with this all alone.

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Of course, first and foremost, you also, you know, healing will come from our relationship with Allah Spano vada. So make that strengthen your relationship with him.

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And also, make sure to turn to our teachers, we have amazing teachers and scholars who we can turn to especially when, you know, I get all sorts of questions about infertility, it can get very complicated you know,

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especially when it comes to fertility treatment, people have a lot of fit questions that come up for them. So you know, and a lot of stress and anxiety and comfort just not knowing the answers to those questions. So please just reach out to the scholars and and let them answer those questions for you so you can get the help that you need.

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I just want to share this example from my research. So

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01:15:06--> 01:15:08

I'm gonna check on my time here.

01:15:10--> 01:15:13

Okay, I'm just, I'm gonna wrap up soon inshallah so

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in my, you know, the second study that I conducted the depression treatment protocol, one of the activities that I had the women complete every week was a memory verse. So they would, you would take an idea from the Quran, and they would memorize it, and they were instructed to actually put it in multiple places. And I think I put this here especially because, you know, Ramadan is coming up, it's the month of glucose, and many of us, you know, really dedicate time to the Quran and memorization etc. And so one thing you can do, if you're someone who is experiencing infertility is, you know, find those ads in the Quran that really give you peace, that provide that healing that

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are a source of, of hope, excetera anything that you are needing, find those ads in the Quran and memorize them and put them in places that you're going to see put them in your bedroom. But you know, put, you can put a post a note in your phone, or, you know, put it in a cabinet that you open every day, just find those places in your home that you frequent. and have it be there as a reminder, so you're seeing it often you're memorizing it.

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And I just wanted to share, I got a lot of great feedback about a lot of the different coping strategies that were discussed in the treatment. And this is just one quote from a research participant who said that she really enjoyed having the verse memorized, because when she would spiral into negative thoughts, it would be a good interrupter to repeat. So this is like one of the ways that you can use these beautiful words from Allah subhanaw taala is to interrupt all that negative chatter in your mind.

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You know, it's just, I think it's a beautiful way to to use to use the Quran.

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For those who are looking to provide support to a loved one or a friend, family member, etc, who's going through infertility, I want to just start off with some things that you should not do. So please, again, as I mentioned the beginning don't ever ask someone if they have kids, if they want kids, if they want more kids,

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please do not tell anyone that they can just get pregnant at any age, we know that that is just simply not the case that our eggs are as old as we are a have our same birthday. And it's just it does tend to get more challenging over time. Never tell someone to just relax and they'll get pregnant as I mentioned before, it just research does not support that.

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01:17:48--> 01:18:17

never tell someone that really anything don't say anything to someone that is in any way going to minimize the distress that they are experiencing as a result of losing their baby those very real pain that they're experiencing, they are grieving so don't say things that are dismissive like oh, you know just be thankful that now you know you can get pregnant or you know anything of that nature that is dismissive of the very real pain that they're experiencing and the the real baby that they are missing

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and don't tell someone that they should just adopt that is not a that's not the solution to infertility although it's a very noble thing to do and everyone you know, it's emphasized in our deen etc. But it is not in and of itself a direct solution to infertility it's an emotional rollercoaster all on its own there's a lot of things that couples need to consider it's not a one to three kind of quick process to adopt it tends to take time etc so it's not an easy process.

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So instead be a good listener offer practical support you know, like researching local fertility clinics which one had which ones have the best rates, respect boundaries, be mindful of triggers, and you know, educate yourself about infertility instead of placing the burden on the person going through it to do all the educating

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and finally, I'll just share these are some you know, for people who are just starting to learn about infertility or want more information the use of some credible institutions that have you know, good information on on infertility that you can that you can check out inshallah

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Thank you

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she's like a lockira Thank you so much Dr. Mana, very grateful to And subhanAllah I benefited so much from your presentation. And I really wanted to know just the importance as Dr. Mora sort of the kind of the cycles social emotional aspect of this, you know, Dr. Morris presentation, you know, I thank you for being so vulnerable with us and sharing and being so open about

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about your own experience of pregnancy loss. And I noted a couple of very important things from Dr. Mona's presentation. One is the connection between mental health and wellness and the way that we frame our understanding of the loss and I really liked the distinction Dr. Mona made between positive and negative religious coping, IE is this do we view this Allah Subhana Allah as

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punishment or as his mercy that is super important. And the other is just to make sure that we are validating the experiences of women and of couples that are dealing with infertility with pregnancy loss with miscarriage. So thank you so much, Doctor, one, I really appreciate you. So Inshallah, what we will do is I will now switch to our q&a. So this is one that I have added or him where he will be heinous dying was what was the most useful cutting. So

01:20:54--> 01:20:58

let's go ahead and take a look at this. So we have a lot of questions coming in.

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First things first, are we recording we are recording and inshallah all registrants will receive a copy of tonight's webinar. So the first question will go to Shayla Haifa and Shayla, this is a question about

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symptoms like PCOS or PCOS polycystic ovarian syndrome. Questions about endometriosis? So I'm trying to group these questions together questions about

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a young lady who ovulate and does not have regular regular cycles. So she I know that that's, you know, obviously, this is not a medical consultation. But if you could give us a quick kind of like one on one in terms of what are these conditions PCOS and endometriosis? And how common is it for young lady to not have regular menstrual cycles and what should ladies be really paying attention to when it comes to their cycle? Alright, so Bismillah Alhamdulillah wa salatu salam ala Rasulillah PCOS polycystic disease of the ovary or polycystic ovarian syndrome depends how you define it is simple terms. The woman ovulate, the eggs are formed but they don't leave the ovary. That's why it's

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a polycystic. So if you take an ultrasound, you'll see a lot of cysts meaning eggs where they cannot come out. So remember what I said it's the ovary. It's like an egg Exactly. So I tell patients eggs you have to break the egg. And the yellow is what we need to get pregnant. So in polycystic many eggs, exactly many eggs in the container but not can come out. Very common.

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The communist reason is overweight actually. And we all I always say this to patients. We don't know the egg from the chicken or the chicken from the egg. Is it the overweight causing PCOS or PCOS causing overweight when we know for sure to break that cycle again, I there's so many details in this. But I always say this to patients to break the cycle. Whether this is the cause or the result. The result is there is no ovulation. I need to ovulate to get pregnant, lose weight. And we and I have seen it work toward workport and not everybody who has PCOS. They are overweight. So you need to know this but the majority are and there's other signs it's basically an increase in also we call

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to insulin resistance and an increase in the male hormone but the bottom line, I'm not ovulating. And if I don't ovulate, I can get pregnant. So that's number one. Endometriosis is a completely different story. Endometriosis has nothing to do with ovulation is actually the lining of the uterus, which we call it the enormous endometrium is actually coming out. Not it's coming out but same cells are outside they are on the top of the fallopian tube on the ovaries and about 30% of people with endometriosis and infertility. Most of this the for endometriosis usually will need help like for PCOS or 30 Lose weight will give you medication but for endometriosis if there is and there

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is no male factor means the husband is fine. Usually you will need an A help meaning we usually will refer you to fertility specialties most of the time it's in the tube, the tubal factor and the tubal factor usually you will need an assistant and this can you be ovulating and you cannot have and you don't see your regular cycle the answer is yes, it's very uncommon, but it is seen so for for this is just for everybody. If I am a woman who is now handler brand I mean decided me and my husband to get pregnant. What do I need to do differently keep what we call it menstrual calendar. Very simple. Just put it on your calendar, you can download there's a lot of apps or just just put it on your

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calendar. When did you see the first day of the bleeding? And then when did it end and when the next month and normally I sell patients show me the last three months because usually the three months what gives you what is your cycle now

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Changes happens if I travel like in Ramadan very common because the sleep and the food and change very commonly will get not in the right time. That's okay. Don't panic, the changes if it's a three months consistently change, then your cycle has changed. I hope I answered I don't like to give a lot of medical terms and words you know people get overwhelmed.

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Thank you. So Shayla, and if I may ask you a follow up question. So there is a question related to this from one of our attendees. And the question is, Is it okay to manage PCOS, with birth control for the unmarried woman? Is that problems down the line? No, a lot of people are very worried about it. So this is how I, in a nutshell, if the patient divided into two kinds patient is pregnant, is married, wants to get pregnant, patient is unmarried or doesn't want to get pregnant now. So usually is there's two things you want to have the cycle comes and you want to treat the underlying problem, the underlying problem you have here, usually they give you medications to the same medications we

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use for diabetes. And we can absolutely use birth control tablets. For those who doesn't get their cycle, or the cycle as irregular, you need to get your regular cycle to will be healthier for the body. So absolutely fine. And since you brought up the birth control, are you I have another name and nickname I used. It's the accused is the birth control tablets birth control tablets have been on the market since 1960. So it is 60 years plus, we have lived it enough to show that it is overall very safe. There is side effects, everything has side effects. But overall birth control tablets is a safe medication, especially the newer ones, which are much less hormone dose of hormones one to

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Berkin total risk does not cause infertility, believe me there would have been removed from the market long time ago. They don't many, many, many, many studies have shown that work in total does not cause infertility. So you don't have to worry about it. I know a lot of the mothers gets very uncomfortable when you say you know, you're 1617. And I'm going to put her just for a trial for three months to see. And she gets very uncomfortable. It does not cause infertility, because that's the main worry they worry about.

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She's like aka Russia. Thank you so much. Dr. manaan. We have a question about your research. So there's a question here, where it says you noted no correlation between stress and infertility in the mental health research was it also noted that there was no correlation between depression and infertility and anxiety and fertility? So it sounds like maybe they had a question about about what you mentioned, via correlation.

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Yeah, so we certainly see obviously a high prevalence of depression among people who are experiencing infertility.

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I think what's important to think about here is like the behavioral consequences. So if you are so stressed, you know, you're so stressed that you can't be intimate with your partner, obviously, then, you know, stress is getting in the way of you achieving your reproductive goals. If you are so depressed, that you are saying, you know, I just can't do fertility treatment anymore, I just can't do it, then we actually there's a lot of research on this to where

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the people who are depressed tend to drop out of infertility treatment prematurely, prematurely. So this is the way these are the different kinds of behavioral ways that stress and depression could get in the way of you achieving your reproductive goals. But in terms of the biological connection or physiological impact, I think there is some discrepancies in the research there as to whether or not there is any sort of direct impact.

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I think Dr. Mone so I have a follow up question. First, for Dr. Mona then for Shayla, hey, fat now, if our respected scholars wouldn't, would prefer not to answer because this one's a sensitive one. And again, I'm pleased, you know, discretion advice. We don't really need the young kids for this particular question to be kind of listening in. So a couple questions have come in about a condition called veganism. So I hope I'm pronouncing that properly. And the questioner has been going to pelvic floor physical therapy sessions, making dua and she says it's something that girls struggle with, and there's probably a lot of shame around it. And because of this issue of vaginal mesh, she

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feels that she'll never be able to have children. Because she struggles with intimacy. It's an it's a real obstacle to intimacy. So it's at your discretion if you want to answer it, but it has a question that what that has come in so first, Dr. Mona, then Shayla Hefa based upon your comfort level.

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Yeah, thank you so much. So that person who asked that question, because I think it's actually probably more common experience, then we realize, I think maybe maybe in particular among Muslims. I'm not really sure. But it's certainly common. And, you know, for that, I would say