The infertility journey, as shared by Walgreens pharmacists

Infertility. It’s a word fraught with emotion and a condition that’s difficult to define. The causes vary and it can take years of testing and treatment to diagnose why a person is unable to conceive. As a medical diagnosis, infertility is also inadequate in capturing the challenges different types of families face, especially LGBTQ families. As a result, it can make those facing infertility feel confused, frustrated and alone.

But it doesn’t have to be that way.

One in eight different-sex couples has experienced infertility, which is defined as the failure to establish a pregnancy after 12 months of regular, unprotected sexual intercourse. According to the Centers for Disease Control and Prevention (CDC), the number of people in need of fertility treatment is growing.

No two people’s experiences with infertility are the same. In fact, the only constant may be the stress that comes with understanding and treating your diagnosis—or lack thereof. Walgreens recognizes this issue as a critical one facing its customers, and in response, has dedicated the past 30 years to specially training pharmacists and offering expert guidance, financial assistance, expedited prescription shipping options and compassionate care through specialty pharmacies.

Walgreens local specialized fertility pharmacies, available across 11 locations in the U.S., offer a multitude of resources to help individuals and couples, of all backgrounds and sexualities, equip themselves with the information and support they need. From in-person injection training and same-day medication delivery to financial counseling and 24-hour availability, the resources continue to grow and evolve as we learn more about the fertility journey.

These specialty pharmacies exist to offer a personal, trusted source of support for customers. Helping shape how these care teams operate are Rina Shah and Laly Havern, two pharmacists, Walgreens team members and mothers who have been there before.

 Rina Shah, group vice president, pharmacy operations and services
“I’m the first of three children and got married relatively young at 26. When you’re young, you don’t anticipate having issues and assume your timeline based on your upbringing. My parents immigrated from India and to my knowledge, did not have issues having children, so I assumed it would be an easy process for me, as well. They had kids in their twenties, and the last one at age 30. My husband and I believed 30 was the new 20. We wanted focus on our marriage, work and being young, and thought ‘let’s start in our early 30s’. After we started trying, and some time passed, we realized that this may require some help. I consulted my doctor, who recommended a few tips, like tracking my ovulation and eating healthier, but we still didn’t have any luck.

At 34, we started the fertility process of intrauterine insemination and I began taking Clomid. When still nothing changed, we began IVF. We went through a few rounds until an embryo latched on. After three weeks, the pregnancy didn’t progress. Our doctor couldn’t really explain why our fertility options weren’t working and we were confused. Being a pharmacist myself, I assumed that if I followed the regimen, it should work. That being said, I knew how important it was that I followed the doctor and pharmacy’s instructions. I started going to a Walgreens specialty pharmacy because I wanted a clear understanding of the timing around my ongoing injections and the cost. Fertility treatments are driven by taking precise doses of medications at the right time. Making a mistake can be the difference between a successful cycle and an unsuccessful one.

After years of trying, we started seeing a new fertility doctor who was known for his expertise, but he was a bit abrasive when communicating, telling me that I was already old. I was going through this inner turmoil, and it was starting to feel that we were in this situation because of me. I started questioning the decisions I had made. It was just very overwhelming and emotional.

After another round of IVF, which was not successful either, my stress was mounting. I was 37. My husband and I took a trip to reset and we decided to start looking into adoption. I felt immediate relief that starting a family wasn’t solely resting on my shoulders anymore due to our unsuccessful attempts with fertility. My husband and I could get to our end goal of expanding our family through the adoption process. However, a few months later, COVID hit.

Adoptions were slowed everywhere and I was nearing 40. We thought, ‘why not just try IVF one last time?’ I returned to doing the injections and taking the medications. At this point, I was working directly with the Walgreens pharmacy team in my neighborhood. They were fantastic and helped me manage my medications, which ranged from vitamin D and thyroid medication I needed to regulate my endocrine levels to taking a variety of fertility injections. It helped tremendously to have a team manage my medications. It was one less thing to have to stress about.

The fifth time with IVF was the charm. I became pregnant. It was a high-risk pregnancy due to my age and history, but we accepted that whatever would happen would happen: this baby is a miracle. We didn’t do an amniocentesis or genetic testing; we were prepared to give our child the love and care he or she needed no matter what. My daughter was born healthy and we feel extremely blessed.

Throughout this journey, it cemented the value of having a team around our patients to help them through their journey – may it be for prescriptions, expertise in fertility, mental health, injection technique or even pharmacy delivery. It also reinforced the value of women in healthcare leadership roles as we oftentimes have first-hand experience with healthcare issues affecting our patients. There is a certain degree of understanding that can translate into more effective training for our pharmacy teams. Diversity in leadership is crucial for building the program and services that are of most value, empathizing with our customers and helping them navigate their unique journeys. By having these experiences, we directly understand the complexity of fertility and the emotional rollercoaster it involves, which will help us build an even better specialty pharmacy program for our patients.”

Laly Havern, specialty health solutions director, oncology and fertility
 “I started my career as a pharmacy technician at Walgreens and ended up pursuing pharmacy school after two years in the role. I returned to Walgreens to intern after my graduation at the same time my husband was commissioned into the U.S. Air Force.

I got pregnant the first month my husband and I started trying. I tracked my ovulation and thought, ‘well, that was easy!’ Nine weeks later, our OBGYN said I had a 50% chance of miscarriage, and sure enough, three weeks later, I miscarried our first baby. Our doctor assured us that miscarriages are common and that it was most likely a genetic issue, so there was nothing for us to be concerned about. Six months went by. He put me on Clomid, a medication that stimulates the growth and release of eggs, and thus ‘officially’ began my fertility journey. Six more months went by without getting pregnant.

My husband was then deployed to Afghanistan, and I couldn’t bear the thought of not being able to try for the next 6-12 months. While he was deployed, and I went through our first IVF cycle. After the horrendous two-week wait, I was overjoyed to take a pregnancy test and receive a faint positive result. However, the blood test showed a borderline elevated level of the hormone hCG, which can indicate potential issues with the embryo.

Weeks went by where the hCG kept fluctuating and nothing was happening, so the doctors decided to do a procedure called a D&C, which would remove an embryo that would otherwise not successfully grow to term. However, they didn’t see anything in my uterus. They assumed the embryo had floated into a fallopian tube, which is known as ectopic pregnancy. The treatment for this is taking a medication called methotrexate that stops cell growth, and due to its effects, would mean I’d have to wait months to try getting pregnant again. To make matters worse, the day after I was given the methotrexate, my fallopian tube ruptured, and I was forced to have emergency surgery where they had to remove the entire tube.

Shortly after, my pharmacy supervisor called and offered me a position to manage our Fertility Center of Excellence, which have evolved into our current-day fertility specialized. She thought it would be the perfect position for me since I was in the middle of my own journey, and it was! Working as a professional and a patient inspired me to consult with my doctor as I did my own research. I realized how important it was to have a provider who listens to you and supports you.

After starting this role, I resumed IVF, and on my second cycle, we got pregnant with my daughter Layla. Four cycles later, we were able to conceive my son, Manny. By my sixth cycle, my doctor and I had been able to produce nine genetically ‘normal’ embryos. We’ve recently decided to donate them to a couple that had been struggling with infertility for a decade and are so happy to share that they are well into their second trimester of pregnancy. Embryo donation is something that I had never thought I could do prior to facing infertility. After everything that we’ve gone through, the fact that we get to help someone is absolutely amazing!

I spent the past 11 years taking pharmacy roles around the country until most recently transitioning into the specialty health solutions director role at the Office of Clinical Integrity, specializing in oncology and fertility strategy. I tell my story to encourage other people to speak up. When I was researching what to do with my embryos, I read a book called ‘The Other Mothers: Two Women’s Journey to Find the Family That Was Always Theirs’, and it really opened my eyes up to the struggles and disparities that many people face when fighting infertility.

Not only did it inspire me to donate my embryos but also to get involved with two advocacy organizations, Family Equality, the leading national organization for LGBTQ families and RESOLVE, who began the National Infertility Awareness Week movement. I’m so proud to share that Walgreens has signed a sponsorship that will allow our team members at fertility specialized pharmacies to participate in a special diversity and inclusion training with these organizations. With 3.9 million LGBTQ millennials building their families in the coming years, this will ensure that we truly have a welcoming environment in our pharmacy for everyone.”When you seek support from a Walgreens specialty pharmacy, services start with a personal fertility benefits investigation and coordination of insurance benefits for each patient. Once a patient’s prescription has been processed, medications can be sent immediately or at the start of the patient’s cycle. Pharmacists will contact patients to coach them on the purpose and timing of medications and establish reorder reminders.

Walgreens team of experts are available 24 hours a day and on holidays for support whenever a patient needs it, whether over the phone, virtually, or in-person in select markets. Whether you’re looking for information on financial resources, emotional support, clinical knowledge or are simply looking to talk with someone who can understand your journey, a Walgreens care team can help.
  Visit www.walgreens.com/fertility for comprehensive information on Walgreens fertility services offered through our local fertility-specialized pharmacies and AllianceRx Walgreens Prime. Use our search feature to find a local specialized pharmacy in your area and speak directly with the pharmacy team. You can also speak with your local Walgreens retail pharmacist who can direct you to a Walgreens specialty pharmacy.