“I was getting to a certain age and knew that if we didn’t have children yet and continued to wait, it could become an issue,” she recalls. “Then it presented to us that the only way we could actually get pregnant was to do IVF.” At the same time that she and her husband started exploring it, Dr. Levin decided to open her own practice, making her already hectic schedule even busier. “I think there is this perpetuating belief, or rather myth, that women can have it all, and I’ve always been very candid about the fact that you really can’t,” the dermatologist says. “So, when I opened my practice, I made a decision not to have children because I knew that I couldn’t manage it personally. My focus was my career, and I wanted that to be my focus.” A year and a half later, at the start of 2020, though, Dr. Levin’s practice was not only up and running but it was doing quite well, and with the heavy lifting of starting a business now behind her, she started to reconsider having kids. She and her husband returned to the fertility specialist and began the process once again, scheduling the first cycle of IVF for March. However, their plans soon changed when an unforeseen global pandemic took shape and rendered their appointment impossible. Dr. Levin felt lucky to have been only at the beginning of her IVF journey when Covid struck; still, the events of 2020 took an undeniable toll on her, and it wasn’t until September that she felt ready to restart the process. In the months that followed, the dermatologist did two rounds of IVF and egg retrievals, and not long after that, she found out that she was pregnant. Now in the final weeks of her pregnancy, Dr. Levin reflects on the decisive moments that got her here, her advice for others going through IVF, and how parenthood is already changing her as a person. Verywell Family: Tell us about your path to pregnancy. Did you hit any roadblocks? Dr. Melissa Levin: When January 2020 rolled around, and I finally had the time, we started the process. We were supposed to have our first cycle of IVF, but then COVID-19 happened in March, so everything was canceled. [This] was actually fine because I had to focus on the business again, so it didn’t bother me. I probably could have rescheduled my first round for some point last summer, but with COVID-19, Black Lives Matter, and everything happening, I was really in no place to think about IVF. It took me until around September to feel ready to restart that process. For women, there are so many things that we are burdened with. And as a doctor, I knew IVF would be tough—mentally, physically, and emotionally. There was already so much on my plate that I wasn’t sure if I actually wanted to have kids. There is so much unhappiness in the world, and I wasn’t sure that it was the most responsible thing to bring a child into it. And I thought about this a lot. But another woman I know, who went through IVF and embryo freezing, told me that something really interesting happens during IVF, in that it can actually present to you a clear decision about whether or not you want to have children. Obviously, my husband and I are so lucky in that we have great health insurance and benefits and that it was an option for us to do this financially. We still had to pay a huge amount out of pocket for all the testing that’s not covered. So, you’re taking on a significant financial burden on top of all the emotional, mental, and physical [ones]. It really forces you to ask whether it’s worth it and whether having a child is even something that you want. During my first cycle of embryo freezing, it really became so clear to me that I wanted children, and it was the first time in my life that I didn’t have to question it, which is a feeling I’d never had before. We did two rounds of egg retrieval to freeze embryos. The second round was tough physically because I had complications, so I didn’t feel like I could go straight from egg retrieval to a transfer. I needed time off. I took a couple of months off, and then when I did my transfer, I had a pretty hefty bleed and was convinced that it was a miscarriage, but luckily, she stuck, and we progressed along with the pregnancy. I probably felt better around week 20, which is when you have the anatomy scan and can see all of the organs and everything. We had done so much genetic testing before the pregnancy because of IVF, so we opted not to do the additional amniocentesis biopsy during the first trimester. We felt like we had enough information about our pregnancy, and we didn’t want to be put in the position of something coming up that would force us to consider aborting. We started telling people early because everyone knew I was doing IVF. Most couples wait until the end of the first trimester, but I was telling people at like week eight. It wasn’t until week 20 that I felt good about buying stuff and actually preparing for the baby though. VWF: You’ve been pretty open about your IVF journey. What have you learned through it? Advice for others going through it? ML: I was so open about my IVF, and a lot of people have asked what advice I’d give to women or couples. I obviously don’t know what it’s like to be a parent yet, but I think IVF kind of prepares you because there’s so much you can’t control; and for a lot of us, we live in a time when we feel like we can control everything. So, IVF kind of challenges that and forces you to accept that it’s not within your control. There’s so much judgment and so many misconceptions around pregnancy. For instance, so many women—and especially women who go through IVF—are terrified to exercise during pregnancy because they are afraid they’ll hurt the baby or even lose the baby after fighting so hard to have it. But there are ways to adjust so you can still do the things that bring you a sense of self and a sense of control. VWF: How did you find out you were pregnant? What was your reaction? How did you tell people?
ML: When I found out I was pregnant, it wasn’t like this big, exciting thing. I did the transfer and had to wait 10 days before I could go in for the pregnancy test. Then I got a phone call saying that I had a confirmed chemical pregnancy, which means that I have a positive HCG (pregnancy hormone). My numbers were low, so they were cautiously optimistic, but had to have me come back in two days to see if the HCG doubled. I remember getting that call, putting the phone down, and just crying. And even now, when people ask if I’m excited, it almost feels like I can’t allow myself to be excited because IVF is filled with so many stories of loss and heartache.I never made any kind of formal announcement about my pregnancy because I just don’t feel like I’m that important. My pregnancy is important to me and to my husband and our family and friends, but I didn’t feel like I needed to reveal anything or announce it to the world. So, I posted this photo of myself just saying I needed to buy a bigger dress, and people started putting two and two together. Some of them were annoyed because they felt like I’d been so open about the whole IVF journey and then when it was the happy moment, I didn’t even announce it. But for me, it was just a casual thing. VWF: How do you feel during your pregnancy?ML: I remember always thinking people were crazy when they told me how wonderful pregnancy was because, for a lot of women, it can be such a difficult time. But I personally have loved being pregnant. It’s so fascinating, especially as a physician, to see your body change. I always feel very lucky to be in New York because we have such great healthcare here and so many options. There’s so much less stigmatization around talking about certain elements of pregnancy.For instance, I’d never done therapy, and honestly, I feel like it’s just something that’s not really a part of East Asian culture. But it was something that my OB-GYN recommended because there are so many changes during pregnancy, and it’s been so wonderful. Then the other thing is physical therapy, which a lot of women don’t really think about or talk about, but there are physical therapists that specialize in the pelvic floor. So, I have PT scheduled for the last two months of my pregnancy that focuses on the pelvic floor and the abdomen. In a way, even though pregnancy and IVF can be so challenging in so many ways, it’s also this really special moment in your life when you can embrace your feminine side and explore all these different avenues of self-care and wellness that you may not have before. Obviously, not all of these things fit, but it’s been nice to be able to give them a try. And there may even be things that I keep doing after pregnancy. VWF: What have you learned about yourself during your pregnancy? Areyou surprised by what you’ve learned?
ML: I’ve lived a very almost monolithic life of career and work being my number one priority; and I think that’s true for many of us, especially in New York. I never really realized how infiltrative that is, so I think this pregnancy made me much more aware of that because, suddenly, I had to make time for these appointments and for myself. This idea of having a balanced life, and that it’s okay and good to not always be consumed with work is something I’ve always struggled with. Pregnancy has really made me rethink that, and hopefully, that’s something that I continue to carry with me after. VWF: What’s your wellness routine like? As a dermatologist, are you doing anything special to care for your skin or belly?
ML: Skincare is always the backbone of everything for me. I still do my morning routine, just with small adjustments to ensure everything is safe for pregnancy. I use Glytone Enhance Brightening Serum, which is a combination of azelaic acid with a low percentage, glycolic acid, and antioxidants. Then I do the Alastin Restorative Eye Treatment for peptides, which is pregnancy safe, [followed by] either Skinbetter Alto Defense Serum or Skinbetter Trio Moisture Treatment, depending on how dry my skin feels. I use EltaMD’s Barrier Renewal Complex, which has a little bit of lactic acid, and a sunscreen. Right now it’s Alastin’s HydraTint, because I like to have coverage without having to wear too much makeup. And it’s a physical blocker, so it’s pregnancy safe. At night, I use Neostrata’s Glycolic Cleanser if I’m not dry, then prescription-strength 15% azelaic acid. I’ll do the Skinbetter Even Tone Correcting Serum for pigmentation and SkinMedica’s Neck Correct Cream for peptides. I [use] the Alastin Restorative Skin Complex as my moisturizer.For my belly, I look for collagen-stimulating ingredients that are not vitamin A derivatives (retinol). I think there’s almost something joyful about just rubbing and caring for your belly every day as it changes. VWF: How are you feeling about maternity/paternity leave? What are your plans? ML: It’s funny because at first, I only planned to take two weeks off. That’s what my mother did, and she’s also a physician, but my OB-GYN told me that was crazy. Of course, then I asked her how many weeks she took off, and she said two. But she did convince me to take six, even though I was very uncomfortable with the idea.At my last OB-GYN appointment, they told me I should dial down patients at week 36 because the baby could come as early as then, and I was very upset by that. I think every woman is different, and we live in a very messed up culture in the U.S. when it comes to looking at maternity leave—it’s so ingrained in us. I know that I probably have a mentality that isn’t respecting the process in the way it should, but it’s still hard. I’ve come around to the idea of six weeks, but I think it’s great that some women can and choose to take even longer now.My husband is in finance, so he basically never takes a minute off. On paper, he has two weeks off for paternity leave, but it comes with a grain of salt. VWF: How are you finding me time during pregnancy? Any special routines you’ve adopted?
ML: Obviously, I’m a dermatologist so I’m going to be very focused on skin, but I like to tell women that during IVF, pregnancy, or post-partum, there’s something really special about having a ritual or a routine because that gives you control. As humans, we like that because it gives us comfort and predictability, so I really try to extend that to my skincare routine. You’re going to do it every morning and every night, it’s just for you. It only takes a few minutes, and it provides a ritual that’s just for the woman. It’s really important and easy and can help you feel like you’re in control of an uncontrollable situation—but it’s something that can be overlooked.I also think it can be helpful to prep for IVF implantation or for pregnancy like you’re prepping for an event. So, I scheduled all of my skin treatments right before. I got my Botox, [dermal] filler, and Ultherapy. I just felt so ready—that I’d done everything I could to be the best, most confident version of myself.  VWF: How do you think parenthood will change you as a doctor and as a person?
ML: I already see myself changing, especially in the way I deal with my patients. As a woman, I’ve always been able to counsel women about different things with their skin when they’re pregnant or postpartum, but it’s a completely different level when you’ve experienced it yourself. Becoming a mother is just another life experience that I can share with other human beings, and I think that will create more empathy, which is a big part of being a doctor and just a fellow human being. I mean, when I used to hear a baby crying on a plane, I would roll my eyes, but now I’m like I feel so bad for the baby and her poor ears—and I don’t even have a baby yet! If anything, big transitions and big changes can make you a more compassionate person, which makes you a better doctor.