• REMINDER: YOU get to pick the messages you see on social media and how they frame the world. . In my ask for medical misinformation, several of you supplied posts (thank you!) and info you’ve encountered that you knew was misleading. Many also shared how bad, nervous, or stressed these accounts and posts make you feel. . Recently, a follower told me that a Facebook mom groups she joined during pregnancy and has been in for years is a constant source of misinformation and anecdotal medical advice that goes against doctor’s recommendations. . Ilusiory bias is a cognitive bias where the more often we see a statement, the more likely our brains are to judge it is true, even if we knew it was false the first time. Don’t let this bias take hold and actively protect your brain from medical misinformation. . You can choose accounts with reliable information, from experts who care about individual and public health. A good clue is that they provide their credentials, sources, and nuances to topics. . This post is about medical and health misinformation and disinformation, not about complex social issues. These topics require reading different perspectives and feeing discomfort when we face our biases around racism, transphobia, and more. . So thank you for being here, I humbled and grateful for your sense of trust in me. I promise to treat it with respect by double and triple checking information I present and let you know when a topic is controversial and provide nuance. Let’s fight misinformation together 💪🏻
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    REMINDER: YOU get to pick the messages you see on social media and how they frame the world. . In my ask for medical misinformation, several of you supplied posts (thank you!) and info you’ve encountered that you knew was misleading. Many also shared how bad, nervous, or stressed these accounts and posts make you feel. . Recently, a follower told me that a Facebook mom groups she joined during pregnancy and has been in for years is a constant source of misinformation and anecdotal medical advice that goes against doctor’s recommendations. . Ilusiory bias is a cognitive bias where the more often we see a statement, the more likely our brains are to judge it is true, even if we knew it was false the first time. Don’t let this bias take hold and actively protect your brain from medical misinformation. . You can choose accounts with reliable information, from experts who care about individual and public health. A good clue is that they provide their credentials, sources, and nuances to topics. . This post is about medical and health misinformation and disinformation, not about complex social issues. These topics require reading different perspectives and feeing discomfort when we face our biases around racism, transphobia, and more. . So thank you for being here, I humbled and grateful for your sense of trust in me. I promise to treat it with respect by double and triple checking information I present and let you know when a topic is controversial and provide nuance. Let’s fight misinformation together 💪🏻
  • 🎥NOW ON YOUTUBE🎥 *5 Minute Birth Prep* . I’ve been alluding to working on birth-specific content for the last few weeks and I’m so excited to announce my new YouTube channel! . We’ll cover everything related to birth - vaginal birth, C-sections, tearing, operative deliveries, what to bring to the hospital, inductions of labor, and much more! . Be sure to subscribe at link in bio & via swipe up in stories! . Leave a comment below with requests for what you’d like to see an episode on!
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    🎥NOW ON YOUTUBE🎥 *5 Minute Birth Prep* . I’ve been alluding to working on birth-specific content for the last few weeks and I’m so excited to announce my new YouTube channel! . We’ll cover everything related to birth - vaginal birth, C-sections, tearing, operative deliveries, what to bring to the hospital, inductions of labor, and much more! . Be sure to subscribe at link in bio & via swipe up in stories! . Leave a comment below with requests for what you’d like to see an episode on!
  • Me & this baby have some exciting announcements coming up in the next few weeks and the first one is TOMORROW! . My relative silence is because I’ve been working on some other ways to effectively educate and empower. I think you’re going to LOVE what I have in the works. . Any guesses what’s coming??? 🤔
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    Me & this baby have some exciting announcements coming up in the next few weeks and the first one is TOMORROW! . My relative silence is because I’ve been working on some other ways to effectively educate and empower. I think you’re going to LOVE what I have in the works. . Any guesses what’s coming??? 🤔
  • Dr. Perez here. I have a ❓. Do you trust your doctor? . Optimizing doctor/patient communication is a passion of mine. For the past week, I’ve been considering the intersections of trust and patient education because of a few situations. . I’ve received an uptick in messages from asking me for a virtual “second opinion” from friends and strangers alike. Many are from really smart women who take a doctor’s recommendation and “do their own research.” It’s clear many of them have spent hours on this. While I’m honored they value my opinion, my other thought is, ‘jeez, how stressful and time consuming to try to conduct the research it took physicians many years to learn and understand.’ . We are in a time in history where there is a distrust in experts of all fields, a belief that anyone can “do their research” with internet searches and access to medical literature abstracts. Has this negatively impacted the doctor/patient relationship? . Contrast this to a recent response Michael and I had to a recommendation we didn’t understand about a family member’s medical issue. Even though we have university access to full journal articles and also went to medical school, we didn’t “do our own research” but instead came up with clarifying questions to review with the doctor, because they are the expert in their field. . At the same time, I understand that there are bad doctors who stray from evidenced based care. I know that historically, marginalized groups have ample reason to distrust doctors. But I can’t help but see how much mental anguish and time could be saved by a follow up with clarifying questions and/or a second opinion. . If you don’t trust your doctor, it’s absolutely time to find a new one. I promise, there are fantastic, caring, and communicative physicians out there. When you find one, communicate with them, ask them your questions. I’m not telling you never to google, I’m here giving you lots of education online! But there is a difference in feeling empowered by consuming education and a distrust and anxiety that drives hours on searches. If the latter of you, it’s time to find a relationship with communication and trust.
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    Dr. Perez here. I have a ❓. Do you trust your doctor? . Optimizing doctor/patient communication is a passion of mine. For the past week, I’ve been considering the intersections of trust and patient education because of a few situations. . I’ve received an uptick in messages from asking me for a virtual “second opinion” from friends and strangers alike. Many are from really smart women who take a doctor’s recommendation and “do their own research.” It’s clear many of them have spent hours on this. While I’m honored they value my opinion, my other thought is, ‘jeez, how stressful and time consuming to try to conduct the research it took physicians many years to learn and understand.’ . We are in a time in history where there is a distrust in experts of all fields, a belief that anyone can “do their research” with internet searches and access to medical literature abstracts. Has this negatively impacted the doctor/patient relationship? . Contrast this to a recent response Michael and I had to a recommendation we didn’t understand about a family member’s medical issue. Even though we have university access to full journal articles and also went to medical school, we didn’t “do our own research” but instead came up with clarifying questions to review with the doctor, because they are the expert in their field. . At the same time, I understand that there are bad doctors who stray from evidenced based care. I know that historically, marginalized groups have ample reason to distrust doctors. But I can’t help but see how much mental anguish and time could be saved by a follow up with clarifying questions and/or a second opinion. . If you don’t trust your doctor, it’s absolutely time to find a new one. I promise, there are fantastic, caring, and communicative physicians out there. When you find one, communicate with them, ask them your questions. I’m not telling you never to google, I’m here giving you lots of education online! But there is a difference in feeling empowered by consuming education and a distrust and anxiety that drives hours on searches. If the latter of you, it’s time to find a relationship with communication and trust.
  • COVID & Pregnancy Update. . I have 2 highlights of explanations and posts as data has evolved over the last few months. Here are some recent studies I found interesting & a list of topics we understand a little and those we don’t at all (there is no aspect of this that comes close to well understood). Articles with longer explanations are in stories. . 🦠Vertical Transmission: virus passes mother➡️fetus via placenta. -For other viruses, some do, some don’t, & is dependent on trimester. Outcomes of VT in different trimesters can be different, pregnancy loss may be a risk. -For COVID, 2 recent articles came out looking at 3rd tri placental histopathology. One looked for pieces of SARS-CoV-2 RNA and only found it on the maternal side of the placenta, no evidence of viral VT. The other looked not for virus but characteristics of placental injury noted in a previous case study consistent with vasculitis at the placental bed & did not find a difference between + mothers and pre-pandemic placentas. -My 💭: These studies strengthen the “likely no VT” side of conflicting data in the 3rd tri. We still don’t know if vasculopathies like those seen in PreE that can lead to IUGR and stillbirth are possible but study #2 does not support this. . 🦠A small observational study analyzed breastmilk from 18 COVID+ mothers had only 1 sample with viral RNA (not complete virus, unable to reproduce), supports safety of breastmilk, but hand hygiene, mask wearing are a MUST. . 🦠Risk factors for COVID & pregnancy after universal screening on L&D: We continue to see this pandemic disproportionally affect those who are most vulnerable not by biology, but by our created systems of inequality (also, kids might be vectors). Beautiful conclusion by authors in stories. Take a hard look at this folks, we as a society are responsible for the suffering of our sisters & their families. . ‼️Check my stories (saved in COVID #2 highlight) for my summaries on topics we know some about and topics we don’t know anything about with COVID & pregnancy. I ran out of room! . As always, questions welcome!
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    COVID & Pregnancy Update. . I have 2 highlights of explanations and posts as data has evolved over the last few months. Here are some recent studies I found interesting & a list of topics we understand a little and those we don’t at all (there is no aspect of this that comes close to well understood). Articles with longer explanations are in stories. . 🦠Vertical Transmission: virus passes mother➡️fetus via placenta. -For other viruses, some do, some don’t, & is dependent on trimester. Outcomes of VT in different trimesters can be different, pregnancy loss may be a risk. -For COVID, 2 recent articles came out looking at 3rd tri placental histopathology. One looked for pieces of SARS-CoV-2 RNA and only found it on the maternal side of the placenta, no evidence of viral VT. The other looked not for virus but characteristics of placental injury noted in a previous case study consistent with vasculitis at the placental bed & did not find a difference between + mothers and pre-pandemic placentas. -My 💭: These studies strengthen the “likely no VT” side of conflicting data in the 3rd tri. We still don’t know if vasculopathies like those seen in PreE that can lead to IUGR and stillbirth are possible but study #2 does not support this. . 🦠A small observational study analyzed breastmilk from 18 COVID+ mothers had only 1 sample with viral RNA (not complete virus, unable to reproduce), supports safety of breastmilk, but hand hygiene, mask wearing are a MUST. . 🦠Risk factors for COVID & pregnancy after universal screening on L&D: We continue to see this pandemic disproportionally affect those who are most vulnerable not by biology, but by our created systems of inequality (also, kids might be vectors). Beautiful conclusion by authors in stories. Take a hard look at this folks, we as a society are responsible for the suffering of our sisters & their families. . ‼️Check my stories (saved in COVID #2 highlight) for my summaries on topics we know some about and topics we don’t know anything about with COVID & pregnancy. I ran out of room! . As always, questions welcome!
  • 📚Educators, I want to support you. . 🙋🏼‍♀️ I know what it’s like to go to work in a pandemic. It takes courage and resilience. 🙋🏼‍♀️I know what it’s like to put the health and well-being of those you serve (patients / students) above your own trepidation. 🙋🏼‍♀️ I know what it’s like to see the disparities we’ve created in America, and to see the effects of this virus grow them. It makes you feel frustrated and helpless. . That’s why physicians are coming together to support teachers who are BIPOC or primarily teach BIPOC students. In a time when need is so great, these are concrete and little things we can do to make the world better for our children through the teachers who give so much. . Mrs. Pearson is a middle school social studies teacher in Detroit. AND SHE NEEDS OUR HELP setting her classroom and kids up for success because her district isn’t able to provide everything it’s teachers need. Her amazon wishlist is linked in my stories, if you chip in to help her out, comment below & I will pick one person on Friday as a winner who gets pick a topic for a post yourself and it can be anything you want! . Check her out on tiktok MrsP_socialstudies! . Thank you to @drjenniferlincoln for organizing #EssentialWorkersforEducators and vetting our teachers! You make the world a better place.
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    📚Educators, I want to support you. . 🙋🏼‍♀️ I know what it’s like to go to work in a pandemic. It takes courage and resilience. 🙋🏼‍♀️I know what it’s like to put the health and well-being of those you serve (patients / students) above your own trepidation. 🙋🏼‍♀️ I know what it’s like to see the disparities we’ve created in America, and to see the effects of this virus grow them. It makes you feel frustrated and helpless. . That’s why physicians are coming together to support teachers who are BIPOC or primarily teach BIPOC students. In a time when need is so great, these are concrete and little things we can do to make the world better for our children through the teachers who give so much. . Mrs. Pearson is a middle school social studies teacher in Detroit. AND SHE NEEDS OUR HELP setting her classroom and kids up for success because her district isn’t able to provide everything it’s teachers need. Her amazon wishlist is linked in my stories, if you chip in to help her out, comment below & I will pick one person on Friday as a winner who gets pick a topic for a post yourself and it can be anything you want! . Check her out on tiktok MrsP_socialstudies! . Thank you to @drjenniferlincoln for organizing #EssentialWorkersforEducators and vetting our teachers! You make the world a better place.
  • 🩸Treating Heavy Periods.🩸 . Menorrhagia is the medical term for abnormally heavy periods. What is “abnormally heavy”? We don’t ask you to measure. As a doctor, when either you have health effects from your heavy period (like anemia) or you it impacts your quality of life (period accidents, using double protection, prevents you from enjoying activities), it’s time to… 1. Find out if there is an underlying cause and 2. Treat it! . Finding an underlying cause ▪️There is a basic workup that includes ruling out thyroid disease, imaging for structural causes (fibroids, endometrial polyps), and excluding pre-cancer (based on risk factors). ▪️Sometimes there is no underlying cause and that’s ok too, just because your “normal” is heavy periods, does not mean you should suffer when we have so many ways to treat them.🙌🏻 . Treating menorrhagia ▪️Procedural management if a structural cause exists: Hysteroscopy is a minimally invasive procedure where a very small camera and device is placed through the cervix in the uterus to remove a polyp or a small fibroid in the cavity. Large fibroids or ones not accessible through the uterus can be removed with a hysterectomy or a myomectomy. ▪️Uterine ablation is a short procedure where the endometrial lining is destroyed with radiofrequency ablation, about ⅔ of women will have either very light or absent periods. It is only for those who are done having kids. ▪️Hormonal medication: hormonal contraception is excellent at lightening periods because it thins the endometrial lining. Pills (combined hormonal & progesterone only), patch, ring, Nexplanon, and most effectively, hormonal IUDs are excellent at this. Progesterone at non-contraceptive doses taken continuously or episodically can also help. The hormonal IUD is my top choice, it has about the same success as an ablation but higher patient satisfaction! ▪️Tranexemic acid is a non-hormonal medication taken 3x/day during the first 5 days of a cycle and can decrease the volume of bleeding by half. It’s the only non-hormonal, non-procedural option. . 🩸This is a brief overview, are there specific questions you want posts on? Or should I do a Q&A? Let me know!
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    🩸Treating Heavy Periods.🩸 . Menorrhagia is the medical term for abnormally heavy periods. What is “abnormally heavy”? We don’t ask you to measure. As a doctor, when either you have health effects from your heavy period (like anemia) or you it impacts your quality of life (period accidents, using double protection, prevents you from enjoying activities), it’s time to… 1. Find out if there is an underlying cause and 2. Treat it! . Finding an underlying cause ▪️There is a basic workup that includes ruling out thyroid disease, imaging for structural causes (fibroids, endometrial polyps), and excluding pre-cancer (based on risk factors). ▪️Sometimes there is no underlying cause and that’s ok too, just because your “normal” is heavy periods, does not mean you should suffer when we have so many ways to treat them.🙌🏻 . Treating menorrhagia ▪️Procedural management if a structural cause exists: Hysteroscopy is a minimally invasive procedure where a very small camera and device is placed through the cervix in the uterus to remove a polyp or a small fibroid in the cavity. Large fibroids or ones not accessible through the uterus can be removed with a hysterectomy or a myomectomy. ▪️Uterine ablation is a short procedure where the endometrial lining is destroyed with radiofrequency ablation, about ⅔ of women will have either very light or absent periods. It is only for those who are done having kids. ▪️Hormonal medication: hormonal contraception is excellent at lightening periods because it thins the endometrial lining. Pills (combined hormonal & progesterone only), patch, ring, Nexplanon, and most effectively, hormonal IUDs are excellent at this. Progesterone at non-contraceptive doses taken continuously or episodically can also help. The hormonal IUD is my top choice, it has about the same success as an ablation but higher patient satisfaction! ▪️Tranexemic acid is a non-hormonal medication taken 3x/day during the first 5 days of a cycle and can decrease the volume of bleeding by half. It’s the only non-hormonal, non-procedural option. . 🩸This is a brief overview, are there specific questions you want posts on? Or should I do a Q&A? Let me know!
  • 🤱🏽Contraception while breastfeeding. . I have a post explaining Lactational Amenorrhea (breastfeeding suppresses ovulation and can be a contraceptive itself). After you read that you will understand that many women who do not fit its strict criteria or desire a more effective method will want birth control while still wanting to preserve the breastfeeding relationship. . There are two things to consider when administering a medication while breastfeeding: Will this affect my baby by its presence in breastmilk and will this affect my supply of breastmilk? . 🤱🏾The good news is that ALL methods of contraception are safe for babies. No concern there. . 🤱🏻How will contraception impact supply? -The second piece of good news is that most do not! The list of contraceptive methods that have NO effect on supply include: IUDs, Nexplanon, depo provera* (“the shot”), progesterone-only pills, and female sterilization (tubal ligation). Also, vasectomies!😏😏😏 -*Depo provera has not been shown to decrease breastmilk supply, but some argue that the studies are low quality and there may be a theoretical risk that a big (bigger than say, taking a pill) dose of progesterone may prevent lactogenesis, or milk coming in, if given immediately postpartum. So this is a grey zone and I counsel patients both ways, for a collaborative decision. -Combined hormonal contraception (pills that contain estrogen + progesterone, vaginal ring, and patch) - the estrogen has the potential to decrease breastmilk supply. It’s not given in the first 4 weeks postpartum because of blood clot risk, which is high immediately postpartum and we don’t want to add to that. After 4 weeks, I counsel women who are breastfeeding that it’s not a preferred option due to its potential to decrease supply. I have had women who have very strong supply start CHC and monitor supply without seeing a difference, but for most women it may not be worth it when there are so many other great options. . Make sure to read my post on lactational amenorrhea and check my birth control highlight for more info about each of the methods above! Coming soon: breastfeeding while trying to conceive my next child.
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    🤱🏽Contraception while breastfeeding. . I have a post explaining Lactational Amenorrhea (breastfeeding suppresses ovulation and can be a contraceptive itself). After you read that you will understand that many women who do not fit its strict criteria or desire a more effective method will want birth control while still wanting to preserve the breastfeeding relationship. . There are two things to consider when administering a medication while breastfeeding: Will this affect my baby by its presence in breastmilk and will this affect my supply of breastmilk? . 🤱🏾The good news is that ALL methods of contraception are safe for babies. No concern there. . 🤱🏻How will contraception impact supply? -The second piece of good news is that most do not! The list of contraceptive methods that have NO effect on supply include: IUDs, Nexplanon, depo provera* (“the shot”), progesterone-only pills, and female sterilization (tubal ligation). Also, vasectomies!😏😏😏 -*Depo provera has not been shown to decrease breastmilk supply, but some argue that the studies are low quality and there may be a theoretical risk that a big (bigger than say, taking a pill) dose of progesterone may prevent lactogenesis, or milk coming in, if given immediately postpartum. So this is a grey zone and I counsel patients both ways, for a collaborative decision. -Combined hormonal contraception (pills that contain estrogen + progesterone, vaginal ring, and patch) - the estrogen has the potential to decrease breastmilk supply. It’s not given in the first 4 weeks postpartum because of blood clot risk, which is high immediately postpartum and we don’t want to add to that. After 4 weeks, I counsel women who are breastfeeding that it’s not a preferred option due to its potential to decrease supply. I have had women who have very strong supply start CHC and monitor supply without seeing a difference, but for most women it may not be worth it when there are so many other great options. . Make sure to read my post on lactational amenorrhea and check my birth control highlight for more info about each of the methods above! Coming soon: breastfeeding while trying to conceive my next child.
  • Friday 💭: Don’t compare your climb to someone else’s mountaintop. . It took me years of work to become a board certified OBGYN. The journey wasn’t easy. It has been filled with long nights, weeks where I thought I would never get through them, and disappointments. . Michael and I took a little bit to figure out if our relationship would work, and when we did (my last year of residency after committing to a job), we faced years of long distance, and to be together I had to leave a job earlier than planned which was very difficult. . But right now, we’re at the mountaintop. We’re together, newlyweds, we both LOVE our work and feel it fits our lives. . My point is, whether you’re just starting the climb or nearly at the top, keep going. Don’t get discouraged by those who don’t have the courage to climb, they’ll never reach your peak. Don’t give up because someone else is already at the top, there’s room for you up there too. . Oh and the view is still really nice even with the disappointments and sacrifices COVID has thrown us, and sometimes you gotta just focus on the GOOD of now. . #perspective #lifeinmedicine #asawoman #couplesinmedicine #obgynlife #naturetherapy #marriedtomedicine
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    Friday 💭: Don’t compare your climb to someone else’s mountaintop. . It took me years of work to become a board certified OBGYN. The journey wasn’t easy. It has been filled with long nights, weeks where I thought I would never get through them, and disappointments. . Michael and I took a little bit to figure out if our relationship would work, and when we did (my last year of residency after committing to a job), we faced years of long distance, and to be together I had to leave a job earlier than planned which was very difficult. . But right now, we’re at the mountaintop. We’re together, newlyweds, we both LOVE our work and feel it fits our lives. . My point is, whether you’re just starting the climb or nearly at the top, keep going. Don’t get discouraged by those who don’t have the courage to climb, they’ll never reach your peak. Don’t give up because someone else is already at the top, there’s room for you up there too. . Oh and the view is still really nice even with the disappointments and sacrifices COVID has thrown us, and sometimes you gotta just focus on the GOOD of now. . #perspective #lifeinmedicine #asawoman #couplesinmedicine #obgynlife #naturetherapy #marriedtomedicine
  • 🧬My answer is… BOTH!🧬 . “Genetic testing” is confusing when we’re talking about making and having babies because there are lots of types of “genetics” and those tests can be done at different times. . We can screen or test for… 1️⃣Genetic problems that can be inherited from parents 2️⃣Genetic chromosomal abnormalities that are a new product of an egg and sperm meeting . 1️⃣Inherited genetic problems -In an otherwise healthy person without a preponderance of genetic problems in their family history, we do recommend *genetic carrier screening* preconception or, if not done, then at an early prenatal visit. -Genetic carrier screening means testing the egg owning person to see if they carry a mutation. If they do, then we test the sperm giving person. For recessive genetic diseases, the child only has a chance of the disease if both parents give the recessive gene. Remember punnet squares from high school biology? -Common examples include: sickle cell disease, cystic fibrosis, spinal muscular atrophy, and Fragile X syndrome (different b/c it’s X-linked). Certain ethnicities or heritages may be offered expanded screenings. -We don’t screen for any possible genetic disease that could affect a person in their lifetime, because these above are common and affect child health. . 2️⃣Chromosomal abnormalities -When an egg and sperm combine, there are 46 chromosomes, but that number can be off either because of a trisomy (most common: trisomy 21 or Down Syndrome) or monosomy (missing one, example: Turner syndrome). -We screen for these during the first and second trimester🤰🏼 (see my separate post about the different screening tests, linked in “Pregnancy” highlight) -If a screening test is positive, a diagnostic test is needed. -These types of screening tests do NOT screen for the types of inherited genetic problems described above OR for new genetic mutations or problems on individual genes. . This topic can be very confusing & is often misunderstood, so please ask questions! Of course, always ask your doctor what testing a right for you and what a positive result would mean for family building.
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    🧬My answer is… BOTH!🧬 . “Genetic testing” is confusing when we’re talking about making and having babies because there are lots of types of “genetics” and those tests can be done at different times. . We can screen or test for… 1️⃣Genetic problems that can be inherited from parents 2️⃣Genetic chromosomal abnormalities that are a new product of an egg and sperm meeting . 1️⃣Inherited genetic problems -In an otherwise healthy person without a preponderance of genetic problems in their family history, we do recommend *genetic carrier screening* preconception or, if not done, then at an early prenatal visit. -Genetic carrier screening means testing the egg owning person to see if they carry a mutation. If they do, then we test the sperm giving person. For recessive genetic diseases, the child only has a chance of the disease if both parents give the recessive gene. Remember punnet squares from high school biology? -Common examples include: sickle cell disease, cystic fibrosis, spinal muscular atrophy, and Fragile X syndrome (different b/c it’s X-linked). Certain ethnicities or heritages may be offered expanded screenings. -We don’t screen for any possible genetic disease that could affect a person in their lifetime, because these above are common and affect child health. . 2️⃣Chromosomal abnormalities -When an egg and sperm combine, there are 46 chromosomes, but that number can be off either because of a trisomy (most common: trisomy 21 or Down Syndrome) or monosomy (missing one, example: Turner syndrome). -We screen for these during the first and second trimester🤰🏼 (see my separate post about the different screening tests, linked in “Pregnancy” highlight) -If a screening test is positive, a diagnostic test is needed. -These types of screening tests do NOT screen for the types of inherited genetic problems described above OR for new genetic mutations or problems on individual genes. . This topic can be very confusing & is often misunderstood, so please ask questions! Of course, always ask your doctor what testing a right for you and what a positive result would mean for family building.