Extension of endometrial tissue into the myometrium
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In this episode, we review the high-yield topic Adenomyosis from the Gynecology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
Where's the strangest place you can find endo? Can you make more money when you're ovulating? And is it heartburn or a heart attack? In this episode we talk to gynaecological surgeon and endometriosis specialist, Dr Amani Harris and learn the telltale signs of a female heart attack. Sign up to the Well Newsletter to receive your weekly dose of trusted health expertise without the medical jargon. Ask a question of our experts or share your story, feedback, or dilemma - you can send it anonymously here, email here or leave us a voice note here. THE END BITS Follow us on Instagram and Tiktok. All your health information is in the Well Hub. For more information on endometriosis, visit Endometriosis Australia. For more information on periods and a pain and symptom diary, Dr Mariam recommends the Jean Hailes website. For more on heart attack signs and symptoms in women, visit the Heart Foundation. Support independent women’s media by becoming a Mamamia subscriberCREDITSGuest: Dr Amani HarrisHosts: Claire Murphy and Dr MariamSenior Producers: Claire Murphy and Sasha TannockAudio Producers: Scott StronachVideo Producer: Julian Rosario Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander cultures. Information discussed in Well is for education purposes only and is not intended to provide professional medical advice. Listeners should seek their own medical advice, specific to their circumstances, from their treating doctor or health care professional.Support the show: https://www.mamamia.com.au/mplus/See omnystudio.com/listener for privacy information.
Endometrial ablation has become a cornerstone procedure in the treatment of abnormal uterine bleeding, but is it the right solution for every patient that meets the indication? In this episode of the BackTable OBGYN Podcast, Dr. Ted Anderson from Vanderbilt University joins host Dr. Mark Hoffman to discuss the evolution of endometrial ablation and its contemporary utilization, including patient selection, technical considerations, and alternative treatments for abnormal uterine bleeding. --- SYNPOSIS Dr. Anderson begins by detailing the history of abnormal uterine bleeding alongside the evolution of the endometrial ablation techniques that have been used to treat it. Shifting focus to current day practice, he then shares his approach to endometrial ablation, covering patient selection and the technical aspects of his approach. Throughout the conversation, Dr. Anderson emphasizes the importance of how we define success in endometrial ablation, explaining that eumenorrhea (normal bleeding that no longer interferes with life events) is the goal, as opposed to the more traditional view that amenorrhea is the target outcome. The episode closes with a discussion on the role of alternative treatments, such as the Mirena IUD and hysterectomy for abnormal uterine bleeding. --- TIMESTAMPS 00:00 - Introduction 09:29 - History of Abnormal Uterine Bleeding and Endometrial Ablation 23:31 - Evolution of Endometrial Ablation Devices/Techniques 31:11 - Selecting the Right Patient for Ablation Success 34:38 - Post-Tubal Sterilization Ablation Syndrome 38:27 - The Role of IUDs in Managing AUB 44:07 - Reevaluating Endometrial Ablation Success Metrics 49:55 - Innovative Ablation Techniques: Cryoablation and Steam 51:48 - Adenomyosis and Fertility-Sparing Treatments 57:28 - Final Thoughts
This episode is powered by The Prelude Network, the largest and fastest-growing network of fertility clinics in the U.S. and Canada.Eloise is joined by Dr. Shannon Alexa from Mainline Fertility to explore the key differences between adenomyosis and endometriosis. They discuss how each condition impacts fertility, the latest treatment options, and what hopeful parents should know when considering IVF.Whether you're navigating a diagnosis or just want to learn more, this conversation is packed with valuable insights. Listen now.Support this podcast at — https://redcircle.com/fertility-spingboard/exclusive-content
In this episode, we dive into the nuances of adenomyosis and endometriosis in our listener questions. Join Dr. Carrie Bedient from the Fertility Center of Las Vegas, Dr. Abby Eblen from Nashville Fertility Center, and Dr. Susan Hudson from Texas Fertility Center as they spend time explaining how endometriosis and adenomyosis impact treatment decisions. Learn the differences between the conditions and how they impact your fertility. We discuss different modes of treatment and preparation for patients affected by endometriosis and adenomyosis. Whether you are living with these conditions or just want to learn more, tune in for this informative episode!
In this week's Podcast, Wendy K Laidlaw explores more about the unique and life changing holistic approach to understanding and healing endometriosis through self-discovery and psychological "parts work." She uses the metaphor of an apartment building to illustrate the different elements of one's personality and how they interact. Wendy discusses the power of curiosity and journaling in uncovering emotional wounds, stored trauma, and subconscious beliefs that may be affecting the body. She explains how shifting from fear to understanding biological truths—and embracing the body's natural ability to heal—can be a transformative process. With a compassionate and insightful perspective, Wendy emphasises that true healing is an internal journey. By listening to and nurturing different aspects of oneself, individuals can harness their innate ability to restore balance and well-being. Celebrating 10 years educating and empowering women, tune in to gain valuable insights into Wendy's holistic approach to endometriosis healing by focusing on emotional, physical, and spiritual well-being of a woman. To start your own journey go to https://HealEndometriosisNaturally.com and download your Top 5 Quick Start Tips. #HealEndometriosisNaturally #WendyKLaidlaw endometriosisawareness #endo #theendolifestyle #endometriosisawarenessmonth #endoeducation #endosupport #endofacts #endometriosisnaturally #HealAdenomyosisNaturally #EndometriosisNaturallyCookbook #EndoBoss #EndoBossAcademy #EmbracingEmotionsAcademy #EmbracingEmotions #PodcastsOnAmazonMusic @AmazonMusicUK #BookClub #BookTok
In this episode, Prof Chapman unpacks the differences and overlaps between adenomyosis and endometriosis. Professor Chapman explains how these conditions affect women, their symptoms, and their impact on fertility. With insights into diagnosis, challenges in treatment, and the latest medical approaches, we explore how women can navigate these complex reproductive health issues. Explore the 'Prof. Michael Chapman - The IVF Journey' Facebook Page, your reliable destination for cutting-edge insights and guidance within the realm of In Vitro Fertilization (IVF). Don't miss out on the IVF Journey podcast; stay informed with the latest episode updates. Tune in for expert discussions and valuable information on navigating the intricate path of IVF.
Another lovely human being interviewed for the Scars of Gold campaign and in this interview we have the beautiful Laura CS. NB This interview was recorded 'on the road' and so the audio quality may reflect this however the content is as powerful as always!Today Dr Liz is interviewing Laura who truly knows what it is to have your life turned upside down by chronic health. Laura shares her 12 year struggle with infertility; 4 rounds of failed IVF, over 11 surgeries and the impact on her mental health and employment. Her experience of trying to advocate, being medically gaslit and then isolated by her employers is unfortunately one so many people can relate to with similar gynae health conditions. Laura shares how she has found ways to distract herself and find strength despite the immensely challenging times. At the point of filming Laura was faced with having to decide when 'enough is enough' and decide whether to have an hysterectomy or consider attempting a 5th round of IVF. A raw and honest experience of how Endometriosis and Adenomyosis can lead to avoidable barriers within the workplace and healthcare. Laura is now an advocate for change and shares her story to help others and we are grateful to have her as one of our Voices for this campaign.Scars of Gold is a health awareness campaign sharing the voices of 100 women facing their mortality at a young age with life changing or incurable health conditions, led by Dr Liz Murray and photographer Sammy Weston. Produced by the charity @mortalandstrong (No. 1209448)#podcast #podcastprevious #interview #mortalandstrong #scarsofgold #kintsugi #hope #pov #dr #drliz #drlizmurray #art #documentary #realvoices #endomtriosis #adenomyois #mortal #womenshealth #healthmatters #healthadvocate #healthinequalities Hosted on Acast. See acast.com/privacy for more information.
CW: Mental Health, Gore, BloodMarjolein Robertson, celebrated for her raw, relatable humour has taken the comedy world by storm. With widespread acclaim at the Edinburgh Fringe Festival and a coveted spot on The List Hot 100, she has cemented her place as a rising star in comedy.In this episode, Marjolein opens up about being overlooked in the healthcare system, unpacks the link between neurodivergence and PMDD, Adenomyosis, and Endometriosis, and shares the story of her near-death experience. She also reflects on how as an ADHD comedian, the stage is the only place she has control of time._______On "The Hidden 20%," host Ben Branson chats with neurodivergent [ADHD, Autism, Dyscalculia, Dyslexia, Dyspraxia, Tourette's etc.] creatives, entrepreneurs, and experts to see how great minds.. think differently. Host: Ben BransonHead of Production: Bella NealeVideo Editor: James ScrivenSocial Media Manager: Charlie YoungMusic: Jackson Greenberg Brought to you by charity The Hidden 20% #1203348 _____________________________________ Follow & subscribe… Website: www.hidden20.orgInstagram / TikTok / Youtube / X: @Hidden20podcastBen Branson @seedlip_benMarjolein Robertson @marjoleinrobertsonIf you'd like to support The Hidden 20%, you can buy a "green dot" badge at https://www.hidden20.org/thegreendot/p/badge. All proceeds go to the charity. Hosted on Acast. See acast.com/privacy for more information.
On this week's podcast, Wendy K Laidlaw discusses the emotional and environmental factors affecting women with endometriosis, emphasising the importance of addressing the "5Ps" or poisons prevent healing; (produce, products, property, people, and past). Wendy highlights the impact of toxic, dismissive or abusive family environments on emotional intelligence and sensitivity and how the Endoboss® Academy, a 12-month program is designed to help women manage stress, relationships, and emotional triggers. She stresses the significance of daily hand written journaling, developing self-awareness, and setting boundaries to heal and improve quality of life. Wendy also mentions NEW specialised upcoming programs for late 2025 which will be more focused on turning one's sensitivity into a super power through embracing emotions, empathy, and energy, aiming to support women on their healing journeys. Download your Top 5 Quick Start Tips at https://www.HealEndometriosisNaturally.com #HealEndometriosisNaturally #WendyKLaidlaw endometriosisawareness #endo #theendolifestyle #endometriosisawarenessmonth #endoeducation #endosupport #endofacts #endometriosisnaturally #HealAdenomyosisNaturally #EndometriosisNaturallyCookbook #EndoBoss #EndoBossAcademy #EmbracingEmotionsAcademy #EmbracingEmotions #PodcastsOnAmazonMusic @AmazonMusicUK #BookClub #BookTok
In this episode, we review the high-yield topic of Adenomyosis from the Reproductive section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets
In this episode of The Health Detective Podcast by Functional Diagnostic Nutrition, host Evan Transue, AKA, Detective Ev interviews Sarah King, a Functional Diagnostic Nutrition practitioner and certified nutritionist. Sarah shares her extensive journey battling endometriosis and adenomyosis, highlighting her struggles with gut issues, chronic acid reflux, severe anemia, and heavy menstrual bleeding. She discusses the medical challenges and misdiagnosis she faced, and how she eventually found healing through natural modalities. Sarah's story emphasizes the importance of questioning conventional advice when warranted, addressing nutritional deficiencies, and taking personal responsibility for health. She also provides insights into her five-month program aimed at helping other women overcome similar health issues. The episode includes a discussion on the significance of minerals in healing, the impact of stress on gut health, and the interconnectedness of various health conditions. Want to become a rockstar functional practitioner like Sarah? Then head to fdntraining.com/resources. Where to find Sarah: Website: www.nutriroothealth.com.au Instagram: nutriroot_health Facebook: Sarah King
* Services you wish you had access to - I want to hear from you! * Suggest new guests/topics for the podcast here BLACK FRIDAY SALE - 50% OFF EVERYTHING: use code: BF2024 from Nov 22 - Dec 6 all products here Episode Highlights: What it is Adenomyosis vs Endometriosis Symptoms Impact on daily life, work & relationships Potential causes Getting a diagnosis (ultrasound, MRI + symptoms) Conventional treatments (pain killers, BCP, IUD, meds, hysterectomy, UAE, HIFU, ablation, adenomyomectomy) Adenomyosis & Fertility Nutrition (anti-inflammatory diet, avoid alcohol, coffee, nightshades) Stress + exercise TENS, pelvic floor physio, stop smoking, avoid toxins, heat, massage, acupuncture, castor oil, red light therapy, leave your job or bad relationship Supps: magnesium, omega-3, vitex, valerian, damask rose, rhubarb, chamomile, crampbark, B1, E, PEA, turmeric, ginger Support gut + liver Bye Bye Cramps course Connect with Alex: Currently accepting clients worldwide - work with me here All courses here Free resources IG: @nutritionmoderation TikTok: @nutritionmoderation nutritionmoderation.com DISCOUNTS: Discount on Canadian Supplements: https://ca.fullscript.com/welcome/aking Discount on U.S. Supplements: https://us.fullscript.com/welcome/aking1654616901 For podcast inquiries email: holisticwomenshealthpodcast@gmail.com
Join globally recognized expert Dr. Ken Sinervo, Medical Director of the Center for Endometriosis Care, as he discusses adenomyosis, its symptoms, impact on fertility, and treatment options. With decades of experience in advanced laparoendoscopic surgery and multidisciplinary care, Dr. Sinervo offers invaluable insights for patients and clinicians. Listen now to learn how to improve diagnosis and navigate treatment effectively.Adenomyosis Episode SummaryIn this episode of Fempower Health, we explore adenomyosis, a condition that affects millions of women but remains underdiagnosed and misunderstood. Dr. Ken Sinervo, a renowned gynecologic surgeon and the Medical Director at the Center for Endometriosis Care, brings over 25 years of expertise in laparoscopic surgery and women's health to the discussion. He sheds light on the differences between adenomyosis and endometriosis, the challenges of diagnosis, treatment options, and how clinicians and patients can work together for better outcomes. Whether you are a patient navigating symptoms or a clinician seeking to improve care, this episode is packed with invaluable insights.Key Discussion Points:What is adenomyosis, and how does it differ from endometriosis?How does adenomyosis impact fertility and pregnancy outcomes?What are the key symptoms of adenomyosis that patients and clinicians should look for?Why is adenomyosis often misdiagnosed, and how can it be identified earlier?What are the most effective treatment options for adenomyosis, including non-surgical approaches?When should a hysterectomy be considered for adenomyosis, and what are the risks involved?How can an anti-inflammatory diet help manage adenomyosis symptoms?What role does trauma play in chronic pelvic pain conditions like adenomyosis?Why is a multidisciplinary approach critical in treating adenomyosis and endometriosis?What can women do to advocate for themselves and ensure they receive the right diagnosis and care?"Around 20% of endometriosis patients also have adenomyosis, and it's often a key reason for persistent pain even after treating endometriosis." - Dr. Ken SinervoRelated to this episode on adenomyosis:Check out Fempower Health's resources on Endometriosis, Mental Health, and Fertility Learn more about Dr. Ken Sinvervo Follow the Center for Endometriosis Care on Instagram and FacebookIf you're passionate about advancing women's health, there are many ways you can support the Fempower Health Podcast. Here's how:Subscribe and Listen: Tune in to new episodes every Tuesday by subscribing to the Fempower Health Podcast on Apple Podcast, Spotify or your favorite podcast platform. Your regular listenership is invaluable!Leave a Review: Help us grow by leaving a review on Apple, Spotify or your favorite podcast platform. Your feedback not only supports us but also helps...
In this episode, Lizzie shares three alternative therapies that can support your fertility journey while navigating endometriosis. Each therapy offers unique benefits and actionable tips for implementation. Get your >> Endo Fertility Podcast Goodie Bag
In this week's podcast, Wendy K Laidlaw is delighted to share ANOTHER 'heal endometriosis naturally' success story! Meet Harriet, from the UK, who is an experience and sought-after First Mate who leads yacht crews sailing all around the world. However, from the young age of 15 years old she was in chronic debilitating pain every month. Her period became so bad at school that she would often have to run out of class due to the pain, cramps and nausea, and spent a lot of time in the medical room. In her early twenties she got an internal ultra sound scan that confirmed the existence of endometriosis and cysts. Whilst Harriet would learn how to handle the chronic fatigue and adjust her shifts round her pain, the apprehension of her monthly cycles haunted her. That's when Harriet went on to Google and found Wendy's book (How I Ended My Endometriosis Naturally) on Amazon, read it through and then signed up for the 21 Day Unstoppable EndoBoss® Challenge. Harriet then attended the in-person live Embracing Emotions Retreat in Portugal with Wendy K Laidlaw and was offered a place in the EndoBoss® Academy. It was through the 12 months EndoBoss® Academy with the expert support and guidance that she would learn how to address 'The Five P's' (Poisons: produce, products, property, people, and past) that contribute to endometriosis. After almost a decade in monthly pain, Harriet now experiences pain-FREE periods! She has improved energy, and better overall health including stronger hair and nails, and softer skin. Harriet has also learned the importance of paying attention to her emotions (as messengers) and setting boundaries with demanding or toxic people, which has empowered her and transformed her life. Will you be our next EndoBoss® and start on your own EndoBoss® journey of healing and self-discovery? If you're serious about real change, and eager to get transformation, over a 12 month's timeframe with our specialist and personalised support, then be sure to join our email list or apply for the EndoBoss® Academy. Go to https://HealEndometriosisNaturallyCourse.com to apply. Please note that EndoBoss® Client Academy is not a quick-fix program but a 12 months online transformational program. There are limited number of spaces (4) each year due to the high levels of personalised support through out the year. #HealEndometriosisNaturally #WendyKLaidlaw endometriosisawareness #endo #theendolifestyle #endometriosisawarenessmonth #endoeducation #endosupport #endofacts #endometriosisnaturally #HealAdenomyosisNaturally #EndometriosisNaturallyCookbook #EndoBoss #EndoBossAcademy #EmbracingEmotionsAcademy #EmbracingEmotions #PodcastsOnAmazonMusic @AmazonMusicUK #BookClub #BookTok
>>Get your Free Resources in the Ultimate Endo Fertility LibraryGet the Podcast Goodie Bag each week check this out for new goodie's from Lizzie and her guests. This episode is sponsored by the Ultimate Endo Fertility Library - sign up HERE to get yourself on the mailing list and started with a Quick Start Endo Fertility E-book, a symptom tracker, delicious recipes, workbooks, guided meditations, and other helpful resources. How to work with me: One off 1:1 coaching sessions e.g. blood test reviews and fertility strategy sessions Personalised 1:1 Endo Fertility coaching programs >>Book your free 30 minutes 1:1 coaching session HERE
In this episode, we're talking about endometriosis, adenomyosis, and fibroids, as well as what an integrative healing approach is. My job here as a nutritionist and coach (and here on the podcast) is to help you feel better. I want you to feel better. I don't mind how you get there as long as you get there but I've found through my experience and through helping hundreds of clients at this point, that a holistic approach is really powerful. It doesn't negate the other things like medicine and surgery, but actually, when you can treat the whole body, the whole person, and look at your diagnosis from that holistic lens, it can really work in helping you feel better. Over the years, I have had so many clients with either Endometriosis, Adenomyosis, Fibroids or issues with the womb and often they're left feeling really despondent and hopeless like there's nothing they can do. Even if they have surgery, then they will probably have surgery again and again. Often these are people in their 20s or 30s and they look at it like they have a life ahead that is full of constant surgeries to remove this kind of rogue tissue so I wanted to do a podcast episode on this. I want to talk a bit about these conditions, summarise them and give you a high-level picture. —- Are you wondering what the heck is going on with your body? What is with the bloating, the hormonal roller coaster, the pain, the fatigue, and your inability to lose weight? If you want something to change, but have no idea what direction to head in, click here to complete the quiz. Resources Book your free call with me here If you want to work with me, I have spaces in my new program, Bloom. Beat the Sweet: Sugar Detox & Recipe Collection
After a two-year break from the podcast, Lizzie returns to share her personal struggle with endometriosis, secondary infertility, and her journey of trying to conceive (TTC) across international borders. This comeback episode offers valuable insights for anyone dealing with fertility challenges with endometriosis. Episode highlights: Lizzie's fertility journey since her last update (Episode 44, May 2022) Balancing endometriosis management with trying to conceive Exploring IVF and donor egg IVF as fertility treatment options Navigating international moves while undergoing fertility treatments The impact of environmental factors (like mould exposure) on fertility and overall health Coping with failed IVF attempts and the emotional toll of infertility The importance of laparoscopic surgery in treating endometriosis Managing hormonal imbalances and their effect on fertility Addressing immune system issues in relation to implantation failure The role of mental health support in a fertility journey Key lessons for those trying to conceive: Embracing change during your fertility journey Maintaining positivity while dealing with infertility Prioritising self-care and stress management Trusting your instincts about your body and health Importance of nutrition in fertility and endometriosis management Building a support network while dealing with infertility Acknowledging the emotional aspects of the TTC journey Preparing for setbacks in fertility treatments Seeking professional guidance for fertility issues The value of persistence in facing fertility challenges Resources mentioned: Episode 44: Post-partum Recovery and Fertility Journey each week check this out for new goodie's from Lizzie and her guests. This episode is sponsored by the Ultimate Endo Fertility Library - sign up HERE to get yourself on the mailing list and started with a Quick Start Endo Fertility E-book, a symptom tracker, delicious recipes, workbooks, guided meditations, and other helpful resources. Upcoming episodes: Episode 47 [Next Episode] - Interview with a psychotherapist on fertility-related mental health Deep dives into donor IVF, choosing overseas fertility clinics, and preparing for fertility-related surgeries Expert interviews on topics including recurrent miscarriage, Mayan abdominal massage for fertility, and the connection between Epstein Barr Virus, endometriosis and infertility How to work with me: One off 1:1 coaching sessions e.g. blood test reviews and fertility strategy sessions Personalised 1:1 Endo Fertility coaching programs >>Book your free 30 minutes 1:1 coaching session HERE
Doctors go through this differential diagnosis for abnormal uterine bleeding. Adenomyosis is a possibility - but what is adenomyosis.? Could this be you?
My guest this week was model and blogger, the lovely Louise O'Reilly, who is someone I've known for a really long time, since the very early days of my former career in magazines and since the early days of her career as a curve model. Louise has not only modelled in magazines like Cosmopolitan, but has had a plus size fashion blog called Style Me Curvy for as long as she's been modelling, which is where some of you might know her from. There, she helps women everywhere to embrace their individuality no matter what their size. And now, at 31-weeks pregnant, she continues to do so. But Louise's journey to pregnancy wasn't straightforward, and in fact she was given a less than 2% chance of ever conceiving, even with the help of IVF, which she didn't even look into in the end. Her miracle, spontaneous pregnancy was so unlikely to happen as she has polycystic ovarian syndrome, otherwise known as PCOS. She talks about her symptoms, how she was dismissed time and time again by doctors who didn't take those symptoms seriously, and how women are often overlooked by doctors based on their weight alone. Our discussion around women's health in general was fascinating, and anyone with Endometriosis, Adenomyosis or PCOS would likely identify with what Louise went through in getting a diagnosis. It's one of those episodes where I leave knowing so much more about a topic but also with great nuggets of advice such as, as Louise says: Always trust your gut when it comes to your health. Enjoy, and I'll be back soon with more. Hosted on Acast. See acast.com/privacy for more information.
Presented in partnership with Fertility and Sterility onsite at the 2024 ANZSREI meeting in Sydney, Australia. The ANZSREI 2024 debate discussed whether patients with unexplained infertility should go straight to IVF. Experts on both sides weighed the effectiveness, cost, and psychological impact of IVF versus alternatives like IUI. The pro side emphasized IVF's high success rates and diagnostic value, while the con side argued for less invasive, cost-effective options. The debate highlighted the need for individualized care, with no clear consensus reached among the audience. View Fertility and Sterility at https://www.fertstert.org/ TRANSCRIPT: Welcome to Fertility and Sterility On Air, the podcast where you can stay current on the latest global research in the field of reproductive medicine. This podcast brings you an overview of this month's journal, in-depth discussion with authors, and other special features. F&S On Air is brought to you by Fertility and Sterility family of journals in conjunction with the American Society for Reproductive Medicine, and is hosted by Dr. Kurt Barnhart, Editor-in-Chief, Dr. Eve Feinberg, Editorial Editor, Dr. Micah Hill, Media Editor, and Dr. Pietro Bordoletto, Interactive Associate-in-Chief. I'd just like to say welcome to our third and final day of the ANZSREI conference. We've got our now traditional F&S podcast where we've got an expert panel, we've got our international speaker, Pietro, and we've got a wonderful debate ahead of us. This is all being recorded. You're welcome, and please think of questions to ask the panel at the end, because it's quite an interactive session, and we're going to get some of the best advice on some of the really controversial areas, like unexplained infertility. Hi, everyone. Welcome to the second annual Fertility and Sterility Journal Club Global, coming to you live from the Australia and New Zealand Society for Reproductive Endocrinology and Infertility meeting. I think I speak on behalf of everyone at F&S that we are so delighted to be here. Over the last two years, we've really made a concerted effort to take the podcast on the road, and this, I think, is a nice continuation of that. For the folks who are tuning in from home and listening to this podcast after the fact, the Australia and New Zealand Society for Reproductive Endocrinology is a group of over 100 certified reproductive endocrinologists across Australia and New Zealand, and this is their annual meeting live in Sydney, Australia. Today's debate is a topic that I think has vexed a lot of individuals, a lot of patients, a lot of professional groups. There's a fair amount of disagreement, and today we're going to try to unpack a little bit of unexplained infertility, and the question really is, should we be going straight to IVF? As always, we try to anchor to literature, and there are two wonderful documents in fertility and sterility that we'll be using as our guide for discussion today. The first one is a wonderful series that was published just a few months ago in the May issue, 2024, that is a views and reviews section, which means there's a series of three to five articles that kind of dig into this topic in depth. And the second article is our professional society guideline, the ASRM Committee Opinion, entitled Evidence-Based Treatments for Couples with Unexplained Infertility, a guideline. The format for today's discussion is debate style. We have a group of six experts, and I've asked them to randomly assign themselves to a pro and a con side. So I'll make the caveat here that the things that they may be saying, positions they may be trying to influence us on, are not necessarily things that they believe in their academic or clinical life, but for the purposes of a rich debate, they're going to have to be pretty deliberate in convincing us otherwise. I want to introduce my panel for today. We have on my immediate right, Dr. Raewyn Tierney. She's my co-moderator for tonight, and she's a practicing board-certified fertility specialist at IVF Australia. And on my immediate left, we have the con side. Going from left to right, Dr. Michelle Quick, practicing board-certified fertility specialist at IVF Australia. Dr. Robert LaHood, board-certified reproductive endocrinologist and clinical director of IVF Australia here in Sydney. And Dr. Clara Bothroyd, medical director at Care Fertility and the current president of the Asia Pacific Initiative in Reproduction. Welcome. On the pro side, going from right to left, I have Dr. Aurelia Liu. She is a practicing board-certified fertility specialist, medical director of Women's Health Melbourne, and clinical director at Life Fertility in Melbourne. Dr. Marcin Stankiewicz, a practicing board-certified fertility specialist and medical director at Family Fertility Centre in Adelaide. And finally, but certainly not least, the one who came with a tie this morning, Dr. Roger Hart, who is a professor of reproductive medicine at the University of Western Australia and the national medical director of City Fertility. Welcome, pro side. Thank you. I feel naked without it. APPLAUSE I've asked both sides to prepare opening arguments. Think of this like a legal case. We want to hear from the defence, we want to hear from the plaintiffs, and I'm going to start with our pro side. I'd like to give them a few minutes to each kind of introduce their salient points for why we should be starting with IVF for patients with unexplained infertility. Thanks, Pietro. To provide a diagnosis of unexplained infertility, it's really a reflection of the degree investigation we've undertaken. I believe we all understand that unexplained infertility is diagnosed in the presence of adequate intercourse, normal semen parameters, an absence ovulatory disorder, patent fallopian tubes, and a normal detailed pelvic ultrasound examination. Now, the opposing team will try to convince you that I have not investigated the couple adequately. Personally, I'm affronted by that suggestion. But what possible causes of infertility have I not investigated? We cannot assess easily sperm fertilising capability, we cannot assess oocyte quality, oocyte fertilisation potential, embryonic development, euploidy rate, and implantation potential. Surely these causes of unexplained fertility will only become evident during an IVF cycle. As IVF is often diagnostic, it's also a therapeutic intervention. Now, I hear you cry, what about endometriosis? And I agree, what about endometriosis? Remember, we're discussing unexplained infertility here. Yes, there is very good evidence that laparoscopic treatment for symptomatic patients with endometriosis improves pelvic pain, but there is scant evidence that a diagnostic laparoscopy and treating any minor disease in the absence of pain symptoms will improve the chance of natural conception, or to that matter, improve the ultimate success of IVF. Indeed, in the absence of endometriomas, there is no negative impact on the serum AMH level in women with endometriosis who have not undergone surgery. Furthermore, there is no influence on the number of oocytes collected in an IVF cycle, the rate of embryonic aneuploidy, and the live birth rate after embryo transfer. So why put the woman through a painful, possibly expensive operation with its attendant risks as you're actually delaying her going straight to IVF? What do esteemed societies say about a diagnostic laparoscopy in the setting of unexplained infertility? The ESHRE guidelines state routine diagnostic laparoscopy is not recommended for the diagnosis of unexplained infertility. Indeed, our own ANZSREI consensus statement says that for a woman with a minimal and mild endometriosis, that the number of women needed to treat for one additional ongoing pregnancy is between 3 and 100 women with endometriosis. Is that reasonable to put an asymptomatic woman through a laparoscopy for that limited potential benefit? Now, regarding the guidelines for unexplained infertility, I agree the ASRM guidelines do not support IVF as a first-line therapy for unexplained infertility for women under 37 years of age. What they should say, and they don't, is that it is assumed that she is trying for her last child. There's no doubt if this is her last child, if it isn't her last child, sorry, she will be returning, seeking treatment, now over 37 years of age, where the guidelines do state there is good evidence that going straight to IVF may be associated with higher pregnancy rates, a shorter time to pregnancy, as opposed to other strategies. They then state it's important to note that many of these included studies were conducted in an area of low IVF success rates than those currently observed, which may alter this approach, suggesting they do not even endorse their own recommendations. The UK NICE guidelines, what do they say for unexplained infertility? Go straight to IVF. So while you're listening to my esteemed colleagues on my left speaking against the motion, I'd like to be thinking about other important factors that my colleagues on my right will discuss in more detail. Consider the superior efficacy of IVF versus IUI, the excellent safety profile of IVF and its cost-effectiveness. Further, other factors favouring a direct approach to IVF in the setting of unexplained infertility are what is the woman's desired family? We should not be focusing on her first child, we should be focusing on giving her the family that she desires and how we can minimise her inconvenience during treatment, as this has social, career and financial consequences for those impediments for her while we attempt to help her achieve her desired family. Thank you. APPLAUSE I think the young crowd would say that that was shots fired. LAUGHTER Con side? We're going to save the rebuttal for the time you've allocated to that, but first I want to put the case about unexplained infertility. Unexplained infertility in 2024 is very different to what it was 10 and 20 years ago when many of the randomised controlled trials that investigated unexplained infertility were performed. The armamentarium of investigative procedures and options that we have has changed, as indeed has our understanding of the mechanisms of infertility. So much so that that old definition of normal semen analysis, normal pelvis and ovulatory, which I think was in Roy Homburg's day, is now no longer fit for purpose as a definition of unexplained infertility. And I commend to you ICMART's very long definition of unexplained infertility, which really relies on a whole lot of things, which I'm going to now take you through what we need to do. It is said, or was said, that 30% of infertility was unexplained. I think it's way, way less than that if we actually look at our patients, both of them, carefully with history and examination and directed tests, and you will probably reduce that to about 3%. Let me take you through female age first. Now, in the old trials, some of the women recruited were as old as 42. That is not unexplained infertility. We know about oocyte aneuploidy and female ageing. 41, it's not unexplained. 40, it's not unexplained. 39, it's not unexplained. And I would put it to you that the cut-off where you start to see oocyte aneuploidy significantly constraining fertility is probably 35. So unexplained infertility has to, by definition, be a woman who is less than 35. I put that to you. Now, let's look at the male. Now, what do we know about the male, the effect of male age on fertility? We know that if the woman is over 35, and this is beautiful work that's really done many years ago in Europe, that if the woman is over 35 and the male is five years older than her, her chance of natural conception is reduced by a further 30%. So I put it to you that, therefore, the male age is relevant. And if she's 35 and has a partner who's 35 years older than her or more, it's not unexplained infertility. It's related to couple age. Now, we're going to... So that's age. Now, my colleagues are going to take you through a number of treatment interventions other than IVF, which we can do with good effect if we actually make the diagnosis and don't put them into the category of unexplained infertility. You will remember from the old trials that mild or moderate or mild or minimal endometriosis was often included, as was mild male factor or seminal fluid abnormalities. These were really multifactorial infertility, and I think that's the take-home message, that much of what we call unexplained is multifactorial. You have two minor components that act to reduce natural fecundability. So I now just want to take you through some of the diagnoses that contribute to infertility that we may not, in our routine laparoscopy and workup, we may not pick up and have previously been called unexplained infertility. For instance, we know that adenomyosis is probably one of the mechanisms by which endometriosis contributes to infertility. Chronic endometritis is now emerging as an operative factor in infertility, and that will not be diagnosed easily. Mild or minimal endometriosis, my colleagues will cover. The mid-cycle scan will lead you to the thin endometrium, which may be due to unexpected adhesive disease, but also a thin endometrium, which we know has a very adverse prognostic factor, may be due to long-term progestin contraception. We are starting to see this emerge. Secondary infertility after a caesarean section may be due to an isthma seal, and we won't recognise that unless we do mid-cycle scans. That's the female. Let's look at the male. We know now that seminal fluid analysis is not a good predictor of male fertility, and there is now evidence from Ranjith Ramasamy's work that we are missing clinical varicoceles because we failed to examine the male partner. My colleagues will talk more about that. We may miss DNA fragmentation, which again may contribute via the basic seminal fluid analysis. Now, most of these diagnoses can be made or sorted out or excluded within one or two months of your detailed assessment of both partners by history and examination. So it's not straight to IVF, ladies and gentlemen. It's just a little digression, a little lay-by, where you actually assess the patient thoroughly. She did not need a tie for that rebuttal. LAUGHTER Prasad. Thank you. Well, following from what Professor Hart has said, I'm going to show that IVF should be a go-to option because of its effectiveness, cost-effectiveness and safety. Now, let me first talk about the effectiveness, and as this is an interaction session, I would like to ask the audience, please, by show of hands, to show me how many of you would accept a medical treatment or buy a new incubator if it had a 94% chance of failure? Well, let the moderator please note that no hands have been raised. Thank you very much. Yet, the chance of live birth in Australian population following IUI is 6%, where, after IVF, the live birth is 40%. Almost seven times more. Now, why would we subject our patients to something we ourselves would not choose? Similarly, findings were reported from international studies that the hazard ratio of 1.25 favouring immediate IVF, and I will talk later about why it is important from a safety perspective. Cost-effectiveness. And I quote ESHRE guidelines. The costs, treatment options have not been subject to robust evaluations. Now, again, I would like to ask the audience, this time it's an easy question, how many of you would accept as standard an ongoing pregnancy rate of at least 38% for an average IVF cycle? Yeah, hands up. All right, I've got three-quarters of the room. OK. Well, I could really rest my case now, as we have good evidence that if a clinic has got an ongoing pregnancy rate of 38% or higher with IVF with single embryo transfer, then it is more effective, more cost-effective, and should be a treatment of choice. And that evidence comes from the authors that are sitting in this room. Again, what would the patients do? If the patients are paying for the treatment, would they do IUI? Most of them would actually go straight to IVF. And we also have very nice guidelines which advise against IUI based on cost-effectiveness. Another factor to mention briefly is the multiple births, which cost five to 20 times more than singleton. The neonatal cost of a twin birth costs about five times more than singletons, and pregnancy with delivery of triplets or more costs nearly 20 times. Now, the costs that I'm going to quote are in American dollars and from some time ago, from Fertility and Sterility. However, the total adjusted all healthcare costs for a single-dom delivery is about US$21,000, US$105,000 for twins, and US$400,000 for triplets and more. Then the very, very important is the psychological cost of the high risk of failure with IUI. Now, it is well established that infertility has a psychological impact on our patients. Studies have shown that prolonged time to conception extends stress, anxiety, and depression, and sexual functioning is significantly negatively impacted. Literature shows that 56% of women and 32% of men undergoing fertility treatment report significant symptoms of depression, and 76% of women and 61% of men report significant symptoms of anxiety. Shockingly, it is reported that 9.4% of women reported having suicidal thoughts or attempts. The longer the treatment takes, the more our patients display symptoms of distress, depression, and anxiety. Safety. Again, ESHRE guideline says the safety of treatment options have not been subjected to robust evaluation. But let me talk you through it. In our Australian expert hands, IVF is safe, with the risk of complications of ectopic being about 1 in 1,500 and other risks 1 in 3,000. However, let's think for a moment on impact of multiple births. A multiple pregnancy has significant psychological, physical, social, and financial consequences, which I can go further into details if required. I just want to mention that the stillbirth rate increases from under 1% for singleton pregnancies to 4.5% for twins and 8.3% for higher-order multiples, and that multiple pregnancies have potential long-term adverse health outcomes for the offspring, such as the increased risk of health issues through their life, increased learning difficulties, language delay, and attention and behavior problems. The lifelong disability is over 25% for babies weighing less than 1 kilogram at delivery. And please note that the quoted multiple pregnancy rates with IUI can reach up to 33%, although in expert hands it's usually around 15%, which is significantly higher than single embryo transfer. In conclusion, from the mother and child safety perspective, for the reason of medical efficacy and cost effectiveness, we have reasons to believe you should go straight to IVF. We're going to be doing these debates more often from Australia. This is a great panel. One side, please. Unexplained infertility. My colleagues were comparing IUI ovulation induction with IVF, but there are other ways of achieving pregnancies with unexplained fertility. I'm going to take the patient's perspective a little bit here. It's all about shared decision-making, so the patient needs to be involved in the decision-making. And it's quite clear from all the data that many patients with unexplained infertility will fall pregnant naturally by themselves even if you do nothing. So sometimes there's definitely a place in doing nothing, and the patient needs to be aware of that. So it's all about informed consent. How do we inform the patient? So we've got to make a proper diagnosis, as my colleague Dr. Boothright has already mentioned, and just to jump into IVF because it's cost-effective is not doing our patients a justice. The prognosis is really, really important, and even after 20 years of doing this, it's all about the duration of infertility, the age of the patient, and discussing that prognosis with the patient. We all know that patients who have been trying for longer and who are older do have a worse prognosis, and maybe they do need to look at treatment quicker, but there are many patients that we see that have a good prognosis, and just explaining that to them is all they need to achieve a pregnancy naturally. And then we're going to talk about other options. It's wrong not to offer those to patients, and my colleague Dr. Quick will talk about that in a moment. Look, we've all had patients that have been scarred by IVF who've spent a lot of money on IVF, did not fall pregnant, and I think the fact that they weren't informed properly, that the diagnosis wasn't made properly, is very frustrating to them. So to just jump into IVF again is not doing the patients a justice. And look, there are negatives to IVF. There's not just the cost to the patient, the cost to society. As taxpayers, we all pay for IVF. It's funded here, or sponsored to some degree, and it's also the family and everyone else that's involved in paying for this. So this is not a treatment that is without cost. There are some harms. We know that ovarian hyperstimulation syndrome still exists, even though it's much less than it used to be. There's a risk of infection and bleeding from the procedures. And we can look at the baby. The data still suggests that babies born from IVF are smaller and they're born earlier, and monozygotic twinning is more common with IVF, so these are high-risk pregnancies, and all this may have an impact on the long-term health of the babies somewhere down the track at the moment. That is important to still look out for. But I come back to the emotional toll. Our colleagues were saying that finishing infertility quicker helps to kind of reduce the emotional toll, but the procedure itself does have its own toll if it doesn't work, and so we've got to prepare patients, have them informed. But at the end of the day, it's all about patient choice. How can a patient make a choice if we don't make a proper diagnosis, give them a prognosis and offer them some other choices that exist? And running the anchor leg of the race for the pro side. IVF in couples with unexplained infertility is the best tool we have in our reproductive medicine toolkit for multiple reasons. Professor Hart has clarified the definition of unexplained infertility. As a reflection of the degree of investigation we've undertaken. He's explained that IVF is often importantly diagnostic as well as therapeutic, both demonstrating and overcoming barriers to natural conception. Dr Stankiewicz has convinced us that IVF is efficient, safe and cost-effective. My goal is to show you that IVF is the correct therapy to meet the immediate and big picture family planning goals for our patients with unexplained infertility. More than 80% of couples with defined unexplained infertility who attempt IVF treatment will have a baby. In Australia, ANZSREI data shows us that the average age of the female patients who present with primary unexplained infertility is over 35 years. And in fact the average is 38 years. We're all aware that the average age of first maternity in Australia has progressively become later over the past two decades. Currently it stands in the mothers and babies report at 32 years. If the average age of first maternity is 32 years, this means that at least 50% of women attempting their first pregnancy are over 32 years. Research I conducted in Melbourne University with my student Eugenie Pryor asking university students of their family planning intentions and aspirations demonstrated that most people, male and female, want to be parents and most want to have more than one child. However, in Australia, our most recent survey shows that births are at an all-time low, below replacement rate and falling, with an ever greater proportion of our population being unable to have the number of children they aspire to and an ever growing proportion seeking assisted reproductive care. Fertility declines with age. Factors include egg quality concerns, sperm quality concerns and the accumulation of pathologies over time. Adenomyosis, fibroids, endometriosis are concerns that no person is born with. They exist on a spectrum and progress over time and may be contributing factors for unexplained infertility. Our patients, when we meet them, are the best IVF candidates that they will ever be. They are the youngest they will ever be and they have the best ovarian reserve they will ever have. They will generate more euploid embryos now than they will in years to come. The sooner we get our patients pregnant, the sooner they will give birth. It takes nine months to have a baby, 12 months potentially to breastfeed and wean and of course most patients will need time to care for a young infant and recover prior to attempting another pregnancy. IVF and embryo banking may represent not only their best chance of conception with reduced time to pregnancy but also an opportunity for embryo banking to improve their cumulative live birth rate potential over time. By the time our 38-year-old patient returns to try to conceive for a second child, she will undoubtedly be aged over 40. Her chance of live birth per cycle initiated at IVF at this stage has reduced phenomenally. The ANZSREI dataset from our most recent report quotes that statistic to be 5%. Her chance of conception with an embryo frozen at 38 years, conversely, is one in three to one in four. There is no room for doubt that IVF gives couples with unexplained infertility not only the most effective treatment we have to help them have a baby, but their best opportunity to have a family. Last but certainly not least, Dr. Quick, to round out the con sides arguments before we open up for rebuttal. And I'll make a small plea that if you have questions that you'd like to pose directly to the panel, prepare them and we'll make sure we get to them from the audience shortly. Thank you. So, whilst we have heard that we may be bad doctors because we're delaying our patients' time to pregnancy, I would perhaps put it to you that unexplained infertility is a diagnosis which is made based on exclusion. So perhaps you are the bad doctors because you haven't looked hard enough for the cause of the unexplained infertility. So, in terms of the tests that we all would do, I think, we would all ensure that the woman has an ovarian reserve. We would all ensure that she has no structural anomaly inside the uterus. We would all ensure that her tubes are patent. We would all ensure that she has regular cycles. We would ensure that he has a normal semen analysis. I think these are tests that we would all do when trying to evaluate a couple for fertility who are struggling to conceive. And therefore, the chance of them getting pregnant naturally, it's never going to be zero. And one option therefore, instead of running straight to IVF, would be to say, OK, continue timed intercourse because the chance of you conceiving naturally is not actually zero and this would be the most natural way to conceive, the cheapest way to conceive, the least interventional way to conceive. And whether that be with cycle tracking to ensure appropriate timed intercourse, whether that be with cycle tracking to ensure adequate luteal phase support. When you clear the fallopian tubes, we know that there are studies showing an improvement in natural conception. Lipidol or oil-based tubal flushing techniques may also help couples to conceive naturally. And then you don't have this multiple pregnancy rate that IVF has. You don't have the cost that you incur with IVF, not just for the couple but to Australian society because IVF is subsidised in this country. You don't have the risks that the woman goes through to undergo IVF treatment. You don't have the risks that the baby takes on being conceived via IVF. And so conceiving naturally, because it's not going to be zero, is definitely an option for these couples. In terms of further tests or further investigations that you could do, some people would argue, yes, we haven't looked hard enough for the reason for infertility, therefore we know that ultrasound is notoriously bad at picking up superficial endometriosis. We know that ultrasound cannot pick up subtle changes in the endometrium, as Dr Boothroyd referred to chronic endometritis, for example. So these patients perhaps should undergo a hysteroscopy to see if there is an endometrial issue. Perhaps these patients should undergo a laparoscopy to see if there is superficial endometriosis. And there are meta-analyses showing that resecting or treating superficial endometriosis may actually help these couples conceive naturally down the track and then therefore they avoid having more interventional treatment in order to conceive. There is also intrauterine insemination with or without ovarian stimulation, which may improve their chances of conceiving naturally. And that again would be less invasive, less intervention and cheaper for the patient. And we know that therefore there are a lot of other treatment options available to help these couples to conceive. And if it's less invasive, it's more natural, it's cheaper, that ends up being better for the patient. Psychologically as well, which the other side have brought up, even with Dr Stankiewicz's 38% ongoing pregnancy rate, that also means that 62% of his patients are not going to be pregnant. The psychological impact of that cannot be underestimated because for a lot of patients, IVF is your last resort. And when you don't get pregnant with IVF, that creates an issue too for them. Embryo banking, which was also brought up, what happens when you create surplus embryos and what's the psychological impact of having to deal with embryos that you are then not going to use in the future? So therefore for those reasons we feel that IVF is not your first line treatment for couples who are diagnosed with unexplained infertility. There are many other ways to help these couples to conceive. We just have a multitude of things to unpack. And I want to start off by opening up an opportunity for rebuttal. I saw both sides of the panel here taking diligent notes. I think all of us have a full page worth of things that kind of stood out to us. Since the pro side had an opportunity to begin, I'm actually going to start with the con side and allow the con side to answer specific points made by the pro side and provide just a little bit more detail and clarity for why they think IVF is not the way forward. My learned first speaker, wearing his tie of course, indicated that it was all about laparoscopy and IUI, and it's way more than that. I just want to highlight to you the paper by Dressler in 2017 in the New England Journal of Medicine, a randomised controlled trial of what would be unexplained infertility according to the definition I put out, the less than 35 ovulatory normal semen analysis. And the intervention was an HSG with either oil-based contrast or water-based contrast. And over the six months, there was clear separation, and this is an effective treatment for unexplained infertility or mild or minimal endometriosis, however it might work. And there's probably separation out to three years. So as a single intervention, as an alternative to IVF, the use of oil-based contrast is an option. So it's not just about laparoscopy and IUI. I guess the other thing the second speaker did allude to, fairly abysmal success rates with IUI being 6%. That is a problem, and I would like to allude to a very good pragmatic trial conducted by Cindy Farquhar and Emily Lu and their co-workers in New Zealand that really swung the meta-analysis for the use of clomiphene and IUI to clinical efficacy. And they reported a 33% chance of live birth in their IUI and clomiphene arm. I'm going across to Auckland to see what the magic is in that city. What are they doing? The third speaker did allude to the problem of declining fertility, a global problem, and Australia is not alone. We have solved the problem to date, which we've had for 40 years, with immigration. But Georgina Chambers' work shows beautifully that IVF is not the answer to the falling fertility rates. It is a way more complex social problem and is probably outside the scope of today's discussion. So those are my three rebuttals to our wonderful team. Thank you very much. So... You can't bury them. We'll give them an opportunity. Thank you for the opportunity. So I'd like to address some of the points that my learned debaters on the opposition raised. The first speaker really suggested quite a few things that we probably omitted, like endometritis, failing to examine the male. I think things like that... I think, at a good history, that is essential what we do as part of our investigation. We're looking for a history of cesarean section, complications subsequent to that. We're doing a detailed scan, and that will exclude the fact that she's got a poor endometrium development, she's got a cesarean scar niche. A good history of a male will allude to the fact that he has some metabolic disorder, degree of hypogonadism. So we're not delaying anything by these appropriate investigations. Adenomyosis will be raised. I talked about a detailed gynaecological examination. So I honestly think that a very... As my opening line was, a detailed gynaecological scan, obviously with a very good history taken, is essential. We're not delaying her opportunity to go straight to IVF if we've addressed all these factors. The second speaker talked about shared decision-making, and we'd all completely agree with that. But we have to be honest and open about the success, which my second speaker talked about, the success of the treatment we're offering. And one thing we should sort of dwell on is it's all... It's a fundamental description of the success of treatment is probably all about prognostic models, and that who not model, that's the original model about the success of conception, is really... Everything flows on from that, which basically talks about a good prognosis patient. 30% chance of live birth after a year. That's what they talk about, a good prognosis patient. Perhaps the rest of the world is different to your average Australian patient, but if we talked about that being a good prognosis, you've got a one in three chance of being pregnant by a year. I think most of our patients would throttle us. So that is what all the models are sort of based on, that being a good prognosis patient. So I completely agree with the second speaker that we do have a shared decision. We have to be honest with our patients about the success. We have to be honest about giving them the prognosis of any treatment that we offer. But really, as my third speaker was talking about, it's about giving the patient the opportunity to have a family, minimal career disruption, minimal life disruption. We have to be honest and talk about the whole picture. They're focused on the first child because really they can't think beyond that. We're talking about giving them the family that they need. The third speaker spoke very eloquently about the risks associated with the treatment we offer. I believe we offer a very safe service with our IVF, particularly in Australia, with our 2% twin pregnancy rate. We talk about the higher risk of these pregnancies, but they perhaps don't relate to the treatment we're offering. Perhaps, unfortunately, is the patient, if she's got polycystic ovary syndrome, if she's more likely to have diabetes, premature delivery, preeclampsia. So I think often the risks associated with IVF and potentially the risks associated to the child born from IVF perhaps don't relate to the treatment of IVF per se. It may well be the woman and perhaps her partner, their underlying medical condition, which lead those risks. So I strongly would encourage you to believe that you take a very good history from your patient, you do a thorough investigation, as I've alluded to, looking for any signs of ovulatory disorder, any gynaecological disorder by a detailed scan, checking tubal patency and a detailed history and the similarities from the man, and then you'll find you're probably going straight to IVF. APPLAUSE I'd like to talk a bit about the embryo banking and having been in this field for a long time, as a word of caution, we're setting a lot of expectations. I remember going to an ASRM meeting probably 10 years ago where they had this headline, all your embryos in the freezer, your whole family in the freezer, basically expecting that if you get four or five embryos frozen that you'll end up with a family at the end. We all know that for the patient, they're not a percentage, it's either zero or 100%. And if all the embryos don't work, they don't have a family at the end, you know, it didn't work for them and their expectations haven't been met. And the way we talk about the percentages and that we can solve the patient's problems, that we can make families, it doesn't always happen. So the expectations our position is setting here, we're not always able to meet and so we're going to end up with very unhappy patients. So this is just a warning to everyone that we need to tell people that this doesn't always work and sometimes they'll end up with no success at all. And from that point of view, I think the way it's presented is way too simplistic and we've got to go back to looking at the other options and not promising things we can't always deliver. So just taking into account all our esteemed interlocutors have said, we don't necessarily disagree with the amount of investigations that they described because nowhere in our argument we said that as soon as the patient registers with the receptionist, they will direct it to an IVF lab. I think to imply so, we'd be very rich indeed. Maybe there are some clinics that are so efficient. I don't know how it works overseas, but certainly not in Australia. The other point that was made about the cost of IVF and our, again, esteemed interlocutors are very well aware from the studies done here in Australia that actually every baby that we have to conceive through IVF and create and lives is actually more than 10 to 100 times return on investment because we are creating future taxpayers. We are creating people that will repay the IVF treatment costs over and over and over again. So I'll put to you, Rob, that if you are saying that we can't do IVF because it costs money, you are robbing future treasurers of a huge amount of dollars. I hope the American audience is listening. In America, we call embryos unborn children in freezers in certain parts and here they're unborn taxpayers. Con side, final opportunity for rebuttal before some audience questions and one more word from the pro side. Well, actually, Dr Stankiewicz was very happy to hear that you're not going to send your patients straight to the IVF lab because we've managed to convince you that that's not the right thing to do. I clearly have forgotten how to debate because I did all my rebuttals at the end of my presentation but essentially I'll recap because when we're talking about IVF, as we're saying, the chance of pregnancy is not going to be 100% and so there is a psychological impact to IVF not working. There is a psychological impact to banking embryos and creating surplus embryos that eventually may not be used and they were my main rebuttal points in terms of why IVF was not the first-line treatment. Thank you. So we've heard from the opposition some very valid points of how our patients can be psychologically impacted when fertility treatment is unsuccessful. I will again remind you that IVF is the most successful fertility treatment we have in our treatment armoury. We are most likely to help our patients have a baby with IVF. The cumulative pregnancy rates for IVF have started back in the late 70s and early 80s in single-digit percentages. We now, with a best prognosis candidate, have at least a one-in-two chance of that patient having a baby per embryo transfer and in our patients with unexplained infertility, the vast majority of our patients will have success. We also heard from the negative team about the significant chance of pregnancy in patients with expectant management. You're right, there's not a 0% chance of natural conception in patients who have unexplained infertility, but there is a not very good chance. We know from data that we've had for a really long time, going back as far as the Hutterite data, to today's non-contradictory models, which tell us that a couple's chance of conception per month in best prognosis candidates is one in five. If they've been trying for six months, it's one in ten. If they've been trying for 12 months, it's only 5%, and if they've been trying for 24 months, it's less than 1%. So it may not be zero, but it isn't very good. In terms of our team reminding us of the extended ICMART definition of unexplained infertility, we don't argue. When we say someone has unexplained infertility, we make the assumption that they have been comprehensively diagnosed by a robust reproductive endocrinologist, as everyone in this room is. And I would say one closing rebuttal. IUI success rates have been the same for the last 50 years, whereas IVF success rates continue to improve. Why would you offer your patient a treatment from 50 years ago when you can offer them one from today? Thank you. APPLAUSE I'm going to take a personal privilege and ask the first question, in hoping that the microphone makes its way to the second question in the audience. My colleagues on the pro side have said IVF, IVF, IVF. Can you be a little bit more specific about what kind of IVF? Do you mean IVF with ICSI? Do you mean IVF, ICSI, and PGT? Be a little bit more deliberate for us and tell us exactly how the patient with unexplained infertility should receive IVF. As I said in my statement, I think it's a diagnostic evaluation. I think there is an argument to consider ICSI, but I think ICSI does have some negative consequences for children born. I think perhaps going straight to ICSI is too much. I think going straight to PGTA perhaps is too much, unless there is something in their history which should indicate that. But we're talking about unexplained infertility. So I believe a standard IVF cycle, looking at the opportunity to assess embryonic development, is the way to go. I do not think you should be going straight to ICSI. I think the principle of first do no harm is probably a safe approach. I don't know whether my colleagues have some other comments, but I think that would be the first approach rather than going all guns blazing. I can understand, though, in different settings in the world, there may have... We're very fortunate in Australia, we're very well supported from the government support for IVF, but I think the imperatives in different countries may be different. But I think that approach would be the right one first. We'll start with a question from the audience. And if you could introduce yourself and have the question allowed for our members in the audience who are not here. It's Louise Hull here from Adelaide. The question I would like to put to both the pro and con team is that Geeta Mishra from the University of Queensland showed that if you had diagnosed endometriosis before IVF, you were more likely to have a pregnancy and much less likely to have high-order IVF cycles. Given that we now have really good non-invasive diagnostics, we're actually... A lot of the time we can pick up superficial or stage 2 endometriosis if you get the right scan. We're going to do IVF better if we know about it. Can you comment on that impacting even the diagnosis of unexplained infertility? Thanks. I'd love to take that. Can I go first, Roger? LAUGHTER Please do. Look, I'd love to take that question. It's a really good question. And, of course, this is not unexplained infertility, so this is outside the scope here. And I think, really, what we're seeing now, in contrast to where we were at the time of the Markku study, which was all... And the Tulandy study on endometrioma excision, we now see that that is actually damaging to fertility, particularly where there is ovarian endometriosis, and that we compromise their ovarian reserve by doing this surgery before we preserve their fertility, be it oocyte cryopreservation or embryo cryopreservation. So I think it's a bit outside the scope of this talk, but I think the swing of the data now is that we should be doing fertility preservation before we do surgery for deeply infiltrated ovarian endometriosis. And that would fit with Gita's findings. A brief response. Thanks very much, Louise. Yeah, we're talking about unexplained infertility here, and my opening line was we need a history, but a detailed gynaecological ultrasound. I think it's important it's a really good ultrasound to exclude that, because the evidence around very minor endometriosis is not there. I agree with significant endometriosis, but that's not the subject of this discussion. But I do believe with very minimal endometriosis there is really no evidence for that. Janelle MacDonald from Sydney. I'm going to play devil's advocate here. So everyone is probably aware of the recent government inquiry about obstetric violence. I'm a little concerned that if we are perceived to be encouraging women to IVF first, are we guilty as a profession of performing fertility violence? That's just digressing a little bit, just thinking about how the consumers may perceive this. I think our patients want to have a baby, and that's why they come to see us, and that's what we help them to do through IVF. I'm not sure the microphone's working. And just introduce yourself. I'm from Sydney, Australia. Can I disagree with you, Roger, about that question about minimal and mild endometriosis? I'm 68, so I'm old enough to have read a whole lot of papers in the past that are probably seen as relics. But Mark Khoo published an unusual study, because it was actually an RCT. Well, sorry, not an RCT. It was a study whereby... Well, it was an RCT, and it was randomised really well. It was done in Canada, and there were about 350 subjects, and they were identified to have stage 1 or stage 2 endometriosis at laparoscopy. And the interesting thing is it was seen as an intervention which didn't greatly increase the chance of conception, but it doubled the monthly chance of conception. So there was clearly a difference between those patients who didn't have endometriosis and those that had stage 1 and stage 2 endometriosis. So the intervention did actually result in an improvement. One of the quotes was, well, I heard since then, well, it didn't make much difference. But when you realise that infertility is multifactorial, there were probably other factors involved as well. So any increase like that in stage 1 and stage 2 endometriosis sufferers was clearly beneficial for them. So I wouldn't disagree with you completely, but I do think you've got to take it on board that there is some evidence that surgical intervention can help. And certainly in those patients whereby the financial costs of IVF are still quite, even in Australia, astronomical. Many patients can get this through the public sector or the private sector treatment of their endometriosis laparoscopically very cheaply or at no cost. Thanks, Dr Persson. So you're right that there was also a counter-randomised controlled trial by the Grupo Italiano which was a counter to that. And actually did not show any benefit. But I believe the Marcu study demonstrated an excess of conception and with treatment of minima and endometriosis of about 4% per month for a few months. So absolutely, that shared decision-making. Personally, I wouldn't like a laparoscopy to give me an extra 4% chance of a natural conception for four months, which I think the data was. So basically, the basis to my statement that I said without going into great detail was a review article published by Samy Glarner recently in Reproductive Biology and Endocrinology. And their conclusions were what I basically said, that from looking at all the data, there is no real evidence of intervention for minor endometriosis. We're not talking about pain or significant diagnosed endometriosis on the outcomes of IVF, ovarian reserve, egg quality, embryo development, and euploidy rate. So that was the basis of my... I hate to disagree... I hate to agree with my opponents in a debate, but I'm going to... But there is actually a new network analysis by Rui Wang and some serious heavyweights in evidence-based medicine that pulls together the surgical studies. And the thing that made the most difference to this of mild and minimal endometriosis from a fertility point of view, not pain, is the use of oil-based uterine contrast. And I commend that paper to you, which fits with exactly what Roger is saying. Hi, my name's Lucy Prentice. I work in Auckland. And I just wanted to point out the New Zealand perspective a little bit. Where we come from a country with very limited public funding for IVF. I'm currently running an RCT with Cindy Farquad directly looking at IVF versus IUI for unexplained infertility. And I'd just like to point out that both the ASRM and ESHRE guidelines, which are the most recent ones, both suggest that IUI should be a first-line treatment with oral ovarian stimulation. We have no evidence that IVF is superior based on an IPD meta-analysis published very recently and also a Cochrane review. And although we would love to be able to complete the family that our patients want from IVF and embryo banking, that option is really not available to a lot of people in New Zealand because of prohibitive costs. We know that IUI with ovarian stimulation is a very effective treatment for people with poor prognosis and unexplained infertility. And I also would just like to add that there's not a cost-effectiveness analysis that shows an improvement in cost-effectiveness for IVF. There's also never been a study looking at treatment tolerability between the two, so I don't think that you can say that IVF is a treatment that people prefer over IUI. So I may turn around and shoot myself in the foot based on our results that will be coming out next year, but I think at the moment I don't think you can say that IVF is better than IUI with ovarian stimulation for unexplained. We have time for two more questions from the audience, and we have two hands in the back. Now we can. It's the light green. OK. Hossam Zini from Melbourne. Thank you very much for the debate. It's very interesting. The problem is that all of the studies that have been done about comparing IUI to IVF, they are not head-to-head studies. The designs are different. They are having, like, algorithmic approach. For example, they compare three or four or five cycles of IUI to one cycle of IVF. But about 10 years ago, our group at the Royal Women's Hospital, we have done a study, a randomized control study, to compare IUI to IVF head-to-head, and we randomized the patients at the time of the trigger who only developed, so we did a low stimulation to get two to three follicles only, and that's why it was so hard to recruit lots of patients. So the criticism that was given to the study that it's a small sample size, but we end up with having IVF as a cost-effective treatment. Our IVF group had a live birth rate about 38%, and on the IUI, 12%. And with our cost calculations, we find out that the IVF is much more cost-effective than the IUI. But I believe that we all now believe in individualized kind of treatment, so patients probably who are younger than 34 years old probably wouldn't go straight to IVF. Maybe I'll do a laparoscopy and a histroscopy first, okay, and we may give them a chance to achieve a natural conception in the next three months or so. Patients who are older than 35, 37 years old probably will benefit straight from IVF. But again, in day-to-day life cases, we will not force the patient to go straight to IVF. I will talk to her and I'll tell her, these are your options, expectant treatment. This is the percentage that you would expect. IUI, this is what you expect. IUI with ovulation induction, this is what you expect. IVF, this is what you expect. And then she will discuss that with her partner and come back to me and tell me what she wants to do. Thanks. I saw a hand show up right next to you, so I'll add one more question given our time limitation. Thanks so much, Kate Stone-Mellon. I'd like to ask our panel to take themselves out of their role playing and put themselves in another role where they were the head of a very, very well-funded public service, and I'd like to ask the two sides what they really think about what they would do with a patient at the age of 35 with 12 months of unexplained infertility. Well, can I say that? Because that's my role in a different hat. LAUGHTER So, yeah, I run the state facility service in Western Australia. We looked at the data, because obviously that's what we're doing, IUI, IVF, and unfortunately we stopped doing IUI treatment. The success rate was so low. So we do go straight to IVF with unexplained infertility. Disappointing, as I'm sure you hear that, Kate, that we do. We looked at the data. Yeah, I think that I would still offer the patients the options, because some people don't want to do IVF. Even though it's completely free, they may not still want to do the injections and the procedure and take on the risks of the actual egg collection procedure. I don't know, religious issues with creating embryos. Yeah, I would still give patients the option. We have time for one more question in the back. We'll take the other ones offline afterwards. We'll get you a microphone just to make sure our listeners afterwards can listen. Following on from the New Zealand experience, which I've experienced... Hello? Yeah. From the New Zealand experience, and having worked here extensively and in New Zealand, you're not comparing apples with apples, Claire. That unexplained couple in New Zealand will wait five years to get funding and currently perhaps another two years to get any treatment. That's then an apples group compared to the pilot group who may, in fact, walk past the hospital and get treatment. The other thing about this, I think, that we need to forget, or don't forget, is the ethics of things here, two of which is that the whole understanding of unexplained infertility needs research and thinking. And if it wasn't for that understanding of what is the natural history of normal and then the understanding of pathology, we wouldn't do a lot of things in medicine. So if we have got a subgroup here that's unexplained, it's not just to the patient, we have a responsibility to future patients and ourselves to be honest and do research and learn about these factors. Now, it doesn't answer the debate, but it is something that's what drives the investigation and management of unexplained delay. And, for example, at the moment, there's quite a discussion about two issues of ethics, one about the involuntary childlessness of people that don't get to see us but don't have those children that they wanted to have because they didn't want to undergo treatment, or it was the involuntary childlessness of a second or subsequent child. And that's quite a big research issue in Europe, I realise, at the moment. And the final thing is about the information giving. The British case Montgomery 2015 has changed consent substantially, for those of you from England, that all information given to patients must include and document the discussion about expectant management versus all the different types of treatment, for and against and risks. And we're not currently doing that in IVF in this area, but if you read about what's happened in England, it's transformed consent in surgery. And I think a lot of our decision-making isn't in that way. So there are a couple of ethical principles to think about. Wonderful questions from the audience. Since we're coming up at the end of our time, we typically end the debate with closing remarks, but we'll forego that for this debate. And I'd actually like to just poll the audience. After hearing both the pro and the con side's arguments, by a show of hands, who in the audience believes that for the patient with unexplained infertility, as defined and detailed here broadly, should we be beginning with IVF? Should we be going straight to IVF? So by a show of hands. And I would say probably 50% of the room raised their hand. And those who think we should not be going straight to IVF? It feels like a little bit more. 40-60, now that I saw the other hands. Well, I'm going to call this a hung jury. I don't know that we have a definitive answer. Please join me in a round of applause for our panelists. In America, we would call that election interference. I wanted to thank our panelists, our live audience, and the listeners of the podcast. On behalf of Fertility and Sterility, thank you for the invitation to be here at your meeting and hosting this debate live from the Australian New Zealand Society for Reproductive Endocrinology meeting in Sydney, Australia. Thank you. This concludes our episode of Fertility and Sterility On Air, brought to you by the Fertility and Sterility family of journals in conjunction with the American Society for Reproductive Medicine. This podcast was developed by Fertility and Sterility and the American Society for Reproductive Medicine as an educational resource and service to its members and other practicing clinicians. While the podcast reflects the views of the authors and the hosts, it is not intended to be the only approved standard of living or to direct an exclusive course of treatment. The opinions expressed are those of the discussants and do not reflect Fertility and Sterility or the American Society for Reproductive Medicine.
Today I speak with IFBB Bikini Pro Kayla Krauss, a dedicated health & fitness coach, and nutritionist with a passion for empowering individuals to achieve their health and fitness goals. She began competing in 2017 and won her Pro card at 2024 Universe. Her journey has been all about balancing mental, emotional, and physical health while pushing towards her goals. TOPICS COVERED -having stage 3 endometriosis and adenomyosis -managing ADHD, anxiety, depression, and CPTSD -therapy and coping skills -sharing her journey -proving you can do it -healthy relationships -understanding your health -perspective on feedback -coaching with Dumbbells N Donuts CONNECT WITH CELESTE: Website: http://www.celestial.fit Instagram: https://www.instagram.com/celestial_fit/ All Links: http://www.celestial.fit/links.html CONNECT WITH KAYLA: Instagram: https://www.instagram.com/justkayla_ifbbpro/ Website: https://www.dumbbellsndoughnuts.com TikTok: JustKayla_AL TIME STAMPS 1:00 introduction 6:30 healing herself on her road to Pro 20:15 changes in her experience as an athlete 25:58 sharing her journey on TikTok 27:58 her Why for continuing to compete 40:57 living with endometriosis and adenomyosis 49:30 support from her husband 60:00 understanding your health 67:50 representing herself as a Pro 75:18 her perspective as a coach 79:40 new project at Dumbbells N Donuts coaching 85:55 advice fro competitors CLICK HERE TO SIGN UP FOR THE FREE FOOD RELATIONSHIP COACHING SERIES CLICK HERE TO SIGN UP FOR THE FREE POST SHOW BLUES COACHING SERIES LEARN MORE AND APPLY FOR MY 5 WEEK FOOD RELATIONSHIP HEALING & DISCOVERY COACHING PROGRAM FOR OTHER FREE RESOURCES, LIVE EVENTS, AND WAYS TO WORK WITH CELESTE CLICK HERE
Originally Released March 1, 2022Episode Summary:In this episode, we dive deep into the topic of dysmenorrhea, pelvic pain, endometriosis, adenomyosis, and other related conditions with Dr. Dan Martin, Medical and Scientific Director for the Endometriosis Foundation of America. We explore the complexities of diagnosing and treating pelvic pain, the importance of patient advocacy, and the societal normalization of pain in women. Dr. Martin provides valuable insights into the symptoms, challenges, and evolving treatments for conditions like endometriosis and adenomyosis, aiming to empower listeners with knowledge and actionable steps for managing their health.Discussion Points:What is the difference between dysmenorrhea and pelvic pain? Dr. Martin explains the nuances between dysmenorrhea and various forms of pelvic pain, highlighting how each condition presents itself and what symptoms to look out for.How can women effectively describe their pain to healthcare providers? Learn about the key descriptors and monitoring practices that can help women communicate their pain more effectively to doctors, leading to better diagnoses and treatment plans.Why do so many women feel dismissed by their doctors when reporting pain? We discuss the societal and medical reasons behind the normalization of pain in women and what can be done to advocate for proper care.What are the common misconceptions about diagnosing endometriosis? Dr. Martin clarifies the challenges in diagnosing endometriosis, including the limitations of imaging and the importance of laparoscopic procedures for accurate detection.When should women be concerned about pelvic pain and seek medical attention? Find out the key indicators that suggest when pelvic pain might require a doctor's evaluation and what the initial steps should be for managing pain at home.How effective are NSAIDs and birth control pills in managing pelvic pain? We explore the roles of NSAIDs and hormonal treatments like birth control pills in managing symptoms and the conditions under which they are most effective.What is the role of laparoscopy in diagnosing pelvic pain conditions? Understand when a laparoscopy is recommended and what it can reveal about conditions like endometriosis and adenomyosis that other diagnostic tools might miss.What are the potential risks and benefits of treatments like Lupron and surgical interventions? Dr. Martin discusses various treatment options for endometriosis and pelvic pain, including the controversial use of Lupron and the considerations for surgical interventions.How do conditions like adenomyosis and uterine fibroids differ from endometriosis? Learn the differences between these common gynecological conditions and how each affects women's health differently.What are the current research trends and future directions in treating pelvic pain and endometriosis? Get an overview of the latest research developments and what they could mean for the future of managing pelvic pain and related conditions.“A lot of that is coming from the normalization of pain in women. Some of this pain is not normal. If the pain is getting worse, if it's severe, it's not responding to medication, that's not normal pain.” - Dr. Dan MartinResourcesResources on EndometriosisLearn about the Endometriosis Foundation of AmericaIf you're passionate about advancing women's...
You absolutely can get pregnant with endometriosis. That being said, endo can also be a barrier to pregnancy, and it depends on how severe your tissue growth is, where it's located and other hormone levels that may be out of balance. Endometriosis is a condition where endometrial tissue, which normally lines the inside of the uterus, migrates to other parts of the body. This misplaced tissue can be found on the ovaries, fallopian tubes, and other organs within the pelvic region, causing pain, inflammation and other issues. Adenomyosis, on the other hand, occurs when the endometrial tissue embeds itself into the muscle wall of the uterus. This can result in painful cramps, heavy periods, and an enlarged uterus. Women can suffer from either condition or both simultaneously, and they are often associated with other hormonal disorders like PCOS (Polycystic Ovary Syndrome). There is no one-size-fits-all solution for women with endometriosis looking to get pregnant. Each woman's health history, how her body processes and detoxifies estrogen, and overall hormonal balance are unique. Some women may pursue surgery to excise or ablate the endometriosis. I do think it is important to get some hormone testing done. The Dutch Test (Dried Urine Test for Comprehensive Hormones) provides info on levels and how your body is metabolizing estrogen. For instance, if a specific detox pathway isn't working properly, addressing that can make a significant difference in managing symptoms and improving fertility. Fertility tips: Hormone Balance and Detoxification: Hormone testing, supplementation and lifestyle changes are key. Nutrient Support: Eat for your cycle, boost your protein and support your hormone needs. Reduce Inflammation: Diet changes, supplements and stress management. Acupuncture and Massage: These therapies can help manage pain, reduce inflammation, and improve lymphatic drainage, which is often impaired in women with endometriosis. There is also fertility specific acupuncture! Regular Monitoring: Monitor and adjust your treatment plans based on regular hormone testing and symptom tracking. I have worked with a number of women who have navigated this journey successfully. Some have managed to conceive and have healthy pregnancies, while others have significantly improved their symptoms to the point where pregnancy became a viable option. Let's connect! Facebook: https://facebook.com/drbethwestie Instagram: https://instagram.com/drbethwestie If you have questions or just want to connect, shoot me a DM on instagram @drbethwestie or contact@drbethwestie.com
That's Hysterical! Now, Get Out! | My Adenomyosis, Hysterectomy and Recovery Journey
“I think I'm more worried about this not being the end of my pain and discomfort. That is something that I have to acknowledge, and that is there. But you know what? Most people, most professionals, me personally, the person in charge of this body, we all think this is a good idea, and we're going to go with that.” — Emily, UTERUS EVICTION DAY!!! >>> SUPPORT THE SHOW https://ko-fi.com/thatshystericalpodcast >> SUPPORT THE SHOW https://ko-fi.com/thatshystericalpodcast
That's Hysterical! Now, Get Out! | My Adenomyosis, Hysterectomy and Recovery Journey
“They're going to think I'm faking it. I have this feeling that I'm going to wake up and my uterus is going to be perfectly fine. It'll be like, This is a huge mistake. Huge mistake. What are you doing? I'm perfectly fine. It was maybe just a really bad gas bubble for five, six, seven years.” — Emily, 1(!) Day Until Uterus Eviction Day >>> SUPPORT THE SHOW https://ko-fi.com/thatshystericalpodcast >> SUPPORT THE SHOW https://ko-fi.com/thatshystericalpodcast
That's Hysterical! Now, Get Out! | My Adenomyosis, Hysterectomy and Recovery Journey
“I am the Emily. I speak for the uteruses. I have to cut out my uterus, but it's only to get rid of the adenomyosis that is attacking it. Sometimes these things hit all at once. I realize I'm really happy to be recording a podcast and talking to others who understand this, who probably have these same frustrations and perhaps for the first time is hearing somebody say them out loud.” — Emily, 1(!) Day Until Uterus Eviction Day >>> SUPPORT THE SHOW https://ko-fi.com/thatshystericalpodcast >> SUPPORT THE SHOW https://ko-fi.com/thatshystericalpodcast
That's Hysterical! Now, Get Out! | My Adenomyosis, Hysterectomy and Recovery Journey
“My big goal with this podcast, with my hysterectomy, with dealing with adenomyosis was getting to the point where I could enjoy my body and it wasn't just painful to live day to day in it.” — Emily, 7 Months After Uterus Eviction Day >>> SUPPORT THE SHOW https://ko-fi.com/thatshystericalpodcast
This week, Wendy and her Head Coach, Maxine, discuss the critical importance of asking questions. As the Danish proverb goes, "Better to ask twice than to lose your way once." On your EndoBoss® journey, you will encounter various characters and personalities. Some may seem helpful but are actually like wolves in sheep's clothing. Others might pretend to offer assistance but are merely serving their own egos, potentially causing you harm. So, how do you ensure you are engaging with safe and genuinely caring people? The answer lies in questions, questions, questions! You can discern those who are less safe or not safe at all by observing how they respond to your inquiries. You know your body better than anyone else and will live with the outcomes of any decisions made. You have the power to transform your body, and when seeking external assistance or guidance, it's essential to ask important and relevant questions. President John F. Kennedy famously said, "The first key to wisdom is constant and frequent questioning," which is also our motto for EndoBosses. Whether it's your optician, travel agent, or boss, questions keep you safe and help build your confidence in a fast-paced, dazzling world. As the renowned writer and poet Rudyard Kipling said, "I keep six honest serving men...they taught me all I knew; their names are: what and why and when and how and who and where." Start or continue your EndoBoss® journey at https://HealEndometriosisNaturally.com and download your top 5 Quick Start Tips.
Join Prof Chapman as he discusses the dynamic world of fertility treatments, where cutting-edge technologies collide with age-old debates. From the enigmatic realms of adenomyosis and endometriosis to the forefront of AI-led embryo selection in IVF, we unravel the complexities shaping the future of reproductive medicine. Explore the 'Prof. Michael Chapman - The IVF Journey' Facebook Page, your reliable destination for cutting-edge insights and guidance within the realm of In Vitro Fertilization (IVF). Don't miss out on the IVF Journey podcast; stay informed with the latest episode updates. Tune in for expert discussions and valuable information on navigating the intricate path of IVF.
This episode of BackTable OBGYN features an extensive discussion with Dr. Keith Isaacson, a specialist in Reproductive Endocrinology and Infertility, regarding the complexities of diagnosing and treating adenomyosis, emphasizing surgery, medical treatments, and research in the field. Dr. Isaacson describes the pivots in the field's understanding of adenomyosis and endometriosis, including the impact of these conditions on fertility and potential treatment pathways. Adenomyosis has been redefined in the past five years as a disease that affects women of all reproductive ages and causes dysmenorrhea, heavy menstrual bleeding, and infertility. Because the disease is found in the myometrium of the uterus, it has historically been difficult to diagnose unless through pathology following hysterectomy; however, imaging has since improved and there are now criteria seen on ultrasound that are consistent with adenomyosis. Dr. Isaacson then discusses the differences and misconceptions about adenomyosis compared to endometriosis. Additionally, the episode touches on the evolution of treatment strategies over the years, including medical therapy versus surgery. Furthermore, Dr. Isaacson highlights the crucial role of research in uncovering disease pathophysiology and new therapeutic approaches. --- SHOW NOTES 00:00 - Introduction 04:06 - Definitions, Symptoms, and Insights 11:33 - Exploring Treatment Options for Adenomyosis and Infertility 21:30 - The Intersection of Endometriosis and Adenomyosis 30:09 - Imaging, Surgery, and Pathology 36:31 - The Future of Research and Patient-Centric Care --- RESOURCES Moawad G, Fruscalzo A, Youssef Y, Kheil M, Tawil T, Nehme J, Pirtea P, Guani B, Afaneh H, Ayoubi JM, Feki A. Adenomyosis: An Updated Review on Diagnosis and Classification. J Clin Med. 2023 Jul 21;12(14):4828. doi: 10.3390/jcm12144828. PMID: 37510943; PMCID: PMC10381628.
Two IVF warriors, Yaelle and Lucy, have come together to share their IVF Tales! Yaelle talks about seeking specialist advice, once ready to conceive due to both her and her husband being 40, and being told they would have a 7% chance of conceiving naturally. After this, they both had tests done and took the option of TTC for 3 months- they fell pregnant, which unfortunately ended in miscarriage. After seeking further advice, they decided to see a bulk billing fertility specialist and commenced IVF. Yaelle talks about multiple frozen embryo transfers before seeking a second opinion from another fertility specialist. This led to a different approach to treatment and revealing she had a thin lining. Lucy talks about TTC after being on contraception (to help with period pain) and realizing her cycles were irregular. Her and her husband tried to conceive for 12 months before seeing a GP for some further testing, soon after their IVF journey began. Lucy talks about her first IVF cycle and receiving disappointing results, having a laparoscopy and being diagnosed with Endometriosis and Adenomyosis. Lucy also decided to change fertility specialists. Her second IVF cycle led to some very surprising results! Thank you, Lucy and Yaelle, for sharing your stories.
Endometriosis remains one of the great mysteries in infertility and questions about it abound. Join Dr. Carrie Bedient from The Fertility Center of Las Vegas, Dr. Abby Eblen from Nashville Fertility Center and Dr. Susan Hudson from Texas Fertility Center as they answer your inquiries about endometriosis. They cover questions regarding endometrioma management before IVF, treatment options for adenomyosis, and when Receptiva testing can really help. They dive into surgery versus medical management prior to transfer in a patient with endo, as well as options when endometriosis is just one component of a couple's infertility. Listen in as the docs answer your questions! Have your own questions about infertility? Visit FertilityDocsUncensored.com to ask our docs. Selected questions will be answered anonymously in future episodes.Today's episode is brought to you by Needed and Cicero Diagnostics
This episode is about IVF Abroad in Mexico As you all know by now, I'm traveling to Canada for my next IVF cycle. I've definitely encountered some challenges and differences, but now that I know what to expect, I've settled in a bit. But, today is not about Canada. I'll create that episode once I'm done with my cycle. Today is about IVF in Mexico and this is from a perspective of one of our Warriors, Denise of IVF_denisejohnson. We talk about her experiences in Mexico and her experiences here in the US and we talk about the the advantages and disadvantages. Of course for many, cost is a big factor and for those who are not able to afford IVF in the US, traveling out of the country might be something to look into. So, if you're curious or you're thinking about IVF outside of the US and in particular, Mexico. This is your episode. Thank you so much for sharing your story Denise! I'm so grateful to have you on. By the way, this was recorded forever ago and I'm finally getting to releasing it! Thank you for your patience Denise!! —---------------------- To round out your IVF survival guide, I would recommend the following episodes before your first IVF cycle: Episode 23: What Happens to Your Fertility in your 20s, 30s, and 40s Episode 19: All About Sperm Episode 24: Controlling Your Weigh During IVF Episode 20: Stimulation Protocols Episode 21: All About Your Embryos in the lab Episode 33: All About Genetic Testing Episode 38: The Emotions of Infertility and How to Manage These Feelings ---------------------- Episodes about the Emotional Aspects of Infertility: Episode 12: WARRIOR STORY - The Infertility Journey of LuckyBabyLam AKA Annie at age 42 Episode 14 - ASK THE EXPERT - Grief, Trauma and Mother's Day Triggers with Dr. Wiyatta Fahnbulleh, PsyD Episode 26: WARRIOR STORY When a therapist is infertile. @Infertile_therapist_in_therapy shares her infertility struggle at 40, her experience with immunotherapy abroad, and struggling as a therapist Episode 28 - ASK THE EXPERT - The Emotions of Infertility and How to Manage Your Emotions and The Expectations of Yourself and Others with Miss Conception Coach AKA Chiemi Episode 30 - Infertility Man Jon Summers Talks Getting A Cancer Diagnosis, Dating While Going Through IVF with Male Factor Infertility, and Mindset in the Face of Your Medical Challenges. Episode 32 - WARRIOR STORY - Recurrent Pregnancy Loss, Endometriosis, Adenomyosis, Müllerian Anomaly and Finding Humor, Your Voice and Sanity During Infertility with @for_the_barreness - Meghan Faith Episode 37: WARRIOR STORY with Annie Kuo, DO - Integrative Medicine Physician discussing her 20 IVF Cycles Along with Endometriosis, Surrogacy, and Male Factor Infertility Episode 47: WARRIOR STORY with Dr. Dina - Unexplained Infertility, Infertility in 40s, Struggle AFTER IVF and Finding the Right Clinic -------------------------------------------------------- RESOURCES FROM THIS EPISODE Books mentioned in this episode and previously mentioned can be found here: www.amazon.com/shop/40andinfertile DONATE HERE: https://www.buymeacoffee.com/40andinfertile SPECIAL LISTENER OFFER FOR PRANAMAT: https://pranamat.com/af/ynkjmqzx?coupon=40andinfertile (CODE: 40andinfertile) -------------------------------------------------------- ON THIS EPISODE: --- Support this podcast: https://podcasters.spotify.com/pod/show/40andinfertile/support
If you've heard of endometriosis, you may know of a similar condition: adenomyosis. Adenomyosis is the growth of endometrial-like tissue growing into the muscle of your uterus. Adeno can create symptoms that are even more severe and difficult to resolve like pelvic pain and pain with your period. In this episode, I dive into the signs of adenomyosis and how to determine if you are struggling with it. DUTCH Test: https://drbethwestie.com/dutch-hormone-testing/
This episode is all about how changing the egg donor and recipient parent experience. Lauren, co-founder of CoFertility is gracious enough to spend time sharing her own experience with needing an egg donor and how that drove her to change the experiences. We explore the transformative impact of CoFertility's approach, which emphasizes community, support, and transparency throughout the egg donation process. We discuss how CoFertility provides resources and guidance for intended parents, empowering them to navigate the complexities of fertility treatment with confidence and compassion, while creating a safe space and experience for the donor. Lauren emphasizes the company's commitment to fostering a sense of solidarity and mutual support within the community. They address common questions and concerns about their program, including the screening process for donors, the number of eggs retrieved, and the emotional support provided to participants. By demystifying the egg donation process and providing comprehensive support, CoFertility is revolutionizing the way families are built, offering hope and guidance to individuals and couples on their path to parenthood. Thank you to Lauren for sharing her expertise and insights, highlighting the importance of conversations like these in destigmatizing egg donation and fostering greater understanding and support within the community. —---------------------- To round out your IVF survival guide, I would recommend the following episodes before your first IVF cycle: Episode 23: What Happens to Your Fertility in your 20s, 30s, and 40s Episode 19: All About Sperm Episode 24: Controlling Your Weigh During IVF Episode 20: Stimulation Protocols Episode 21: All About Your Embryos in the lab Episode 33: All About Genetic Testing Episode 38: The Emotions of Infertility and How to Manage These Feelings ---------------------- Episodes about the Emotional Aspects of Infertility: Episode 12: WARRIOR STORY - The Infertility Journey of LuckyBabyLam AKA Annie at age 42 Episode 14 - ASK THE EXPERT - Grief, Trauma and Mother's Day Triggers with Dr. Wiyatta Fahnbulleh, PsyD Episode 26: WARRIOR STORY When a therapist is infertile. @Infertile_therapist_in_therapy shares her infertility struggle at 40, her experience with immunotherapy abroad, and struggling as a therapist Episode 28 - ASK THE EXPERT - The Emotions of Infertility and How to Manage Your Emotions and The Expectations of Yourself and Others with Miss Conception Coach AKA Chiemi Episode 30 - Infertility Man Jon Summers Talks Getting A Cancer Diagnosis, Dating While Going Through IVF with Male Factor Infertility, and Mindset in the Face of Your Medical Challenges. Episode 32 - WARRIOR STORY - Recurrent Pregnancy Loss, Endometriosis, Adenomyosis, Müllerian Anomaly and Finding Humor, Your Voice and Sanity During Infertility with @for_the_barreness - Meghan Faith Episode 37: WARRIOR STORY with Annie Kuo, DO - Integrative Medicine Physician discussing her 20 IVF Cycles Along with Endometriosis, Surrogacy, and Male Factor Infertility Episode 47: WARRIOR STORY with Dr. Dina - Unexplained Infertility, Infertility in 40s, Struggle AFTER IVF and Finding the Right Clinic -------------------------------------------------------- RESOURCES FROM THIS EPISODE Books mentioned in this episode and previously mentioned can be found here: www.amazon.com/shop/40andinfertile DONATE HERE: https://www.buymeacoffee.com/40andinfertile SPECIAL LISTENER OFFER FOR PRANAMAT: https://pranamat.com/af/ynkjmqzx?coupon=40andinfertile (CODE: 40andinfertile) -------------------------------------------------------- ON THIS EPISODE: --- Support this podcast: https://podcasters.spotify.com/pod/show/40andinfertile/support
Carla shares her experience from exploring surrogacy options to the complex matching process and the major impact of spiritual faith on her decision-making. She also reflects on the important trust and connection required in the surrogate relationship, and the joys and challenges of pregnancy through the lens of surrogacy. Join us as Carla's story inspires and illuminates the possibilities of motherhood that go beyond conventional norms, embracing the transformative power of love as a single mom by choice.We discuss more about…..Carla's infertility journey and Adenomyosis diagnosis.Navigating the gestational surrogacy process.The physical, mental, and spiritual toll of being fully present for the surrogate mother.The intersection of faith and fertility.Mentioned Resourceshttps://www.familymatchconsulting.com/More info about coaching and community groups at www.singlegreatestchoice.com/coaching
Today is all about sperm and sperm banks. We speak with Alyse of Seattle Sperm Bank to talk about sperm donation and sperm banks. Kristin from @justbekristin had such a great experience, I thought I would find out what makes them different for anyone who needs a sperm donor to demystify everything involved with the process. If you're looking for Kristin's episode, you can find her story and experience in episode 42. We start with the basics. What's involved in the donation process, how they screen their donors, what happens to the sperm after donation, are there limitations in donors or families, and what to expect if you use their sperm bank. —---------------------- To round out your IVF survival guide, I would recommend the following episodes before your first IVF cycle: Episode 23: What Happens to Your Fertility in your 20s, 30s, and 40s Episode 19: All About Sperm Episode 24: Controlling Your Weigh During IVF Episode 20: Stimulation Protocols Episode 21: All About Your Embryos in the lab Episode 33: All About Genetic Testing Episode 38: The Emotions of Infertility and How to Manage These Feelings ---------------------- Episodes about the Emotional Aspects of Infertility: Episode 12: WARRIOR STORY - The Infertility Journey of LuckyBabyLam AKA Annie at age 42 Episode 14 - ASK THE EXPERT - Grief, Trauma and Mother's Day Triggers with Dr. Wiyatta Fahnbulleh, PsyD Episode 26: WARRIOR STORY When a therapist is infertile. @Infertile_therapist_in_therapy shares her infertility struggle at 40, her experience with immunotherapy abroad, and struggling as a therapist Episode 28 - ASK THE EXPERT - The Emotions of Infertility and How to Manage Your Emotions and The Expectations of Yourself and Others with Miss Conception Coach AKA Chiemi Episode 30 - Infertility Man Jon Summers Talks Getting A Cancer Diagnosis, Dating While Going Through IVF with Male Factor Infertility, and Mindset in the Face of Your Medical Challenges. Episode 32 - WARRIOR STORY - Recurrent Pregnancy Loss, Endometriosis, Adenomyosis, Müllerian Anomaly and Finding Humor, Your Voice and Sanity During Infertility with @for_the_barreness - Meghan Faith Episode 37: WARRIOR STORY with Annie Kuo, DO - Integrative Medicine Physician discussing her 20 IVF Cycles Along with Endometriosis, Surrogacy, and Male Factor Infertility Episode 47: WARRIOR STORY with Dr. Dina - Unexplained Infertility, Infertility in 40s, Struggle AFTER IVF and Finding the Right Clinic -------------------------------------------------------- RESOURCES FROM THIS EPISODE Books mentioned in this episode and previously mentioned can be found here: www.amazon.com/shop/40andinfertile DONATE HERE: https://www.buymeacoffee.com/40andinfertile SPECIAL LISTENER OFFER FOR PRANAMAT: https://pranamat.com/af/ynkjmqzx?coupon=40andinfertile (CODE: 40andinfertile) -------------------------------------------------------- ON THIS EPISODE: Seattle Sperm Bank Phone and Online Chat Hours: Monday to Friday: 4 AM – 6 PM PSTSaturday: 9 AM – 3 PM PST Office Hours: Monday to Friday: 6:30 AM – 5 PM PSTSaturday: 9 AM – 3 PM PST https://www.seattlespermbank.com/ --- Support this podcast: https://podcasters.spotify.com/pod/show/40andinfertile/support
In this insightful episode, Dr. Tara Brandner is joined by Dr. Adam Duke to explore the often-misunderstood world of Adenomyosis. This condition, characterized by the growth of endometrial tissue into the uterus's muscular wall, remains shrouded in mystery and misdiagnosis. They'll discuss what Adenomyosis is, its symptoms, and the reasons it goes undetected in so many women. Drs. Tara and Adam unpack the challenges in diagnosing this condition, shedding light on the latest diagnostic techniques that are bringing hope to countless sufferers. Listen in as they navigate through the complexities of Adenomyosis, offering expert insights and compassionate advice for those silently battling this condition. This episode also unveils key strategies for advocating effectively when you feel unheard by your healthcare provider. Schedule with Dr. Adam Duke ➡️ https://www.northwestspecialtyhospital.com/womens-care/ Join the Endometriosis Summit ➡️ https://theendometriosissummit.com Let Dr. Tara help you! ➡️ https://app.elationemr.com/book/simplyyou
Dr. Rahi Victory is BAAAAAACK! He's back and this time we're talking about transfer protocols. If you have not heard his episode on stimulation protocols, you need this if you're doing IVF This episode is all about transfer protocols. We talk about general protocols and protocols for special conditions like endometriosis, adenomyosis, infection, uterine anomalies, chronically thin lining. We also talk about testing that should occur beforehand, imaging studies and special testing considerations, which embryos do we transfer first as well as a brief discussion on reproductive immunology. Buckle up, folks. This is going to be an amazing episode! Thank you for continued support, Dr. Victory! We're so grateful for your generosity in educating this community of warriors! —---------------------- To round out your IVF survival guide, I would recommend the following episodes before your first IVF cycle: Episode 23: What Happens to Your Fertility in your 20s, 30s, and 40s Episode 19: All About Sperm Episode 24: Controlling Your Weigh During IVF Episode 20: Stimulation Protocols Episode 21: All About Your Embryos in the lab Episode 33: All About Genetic Testing Episode 38: The Emotions of Infertility and How to Manage These Feelings ---------------------- Episodes about the Emotional Aspects of Infertility: Episode 12: WARRIOR STORY - The Infertility Journey of LuckyBabyLam AKA Annie at age 42 Episode 14 - ASK THE EXPERT - Grief, Trauma and Mother's Day Triggers with Dr. Wiyatta Fahnbulleh, PsyD Episode 26: WARRIOR STORY When a therapist is infertile. @Infertile_therapist_in_therapy shares her infertility struggle at 40, her experience with immunotherapy abroad, and struggling as a therapist Episode 28 - ASK THE EXPERT - The Emotions of Infertility and How to Manage Your Emotions and The Expectations of Yourself and Others with Miss Conception Coach AKA Chiemi Episode 30 - Infertility Man Jon Summers Talks Getting A Cancer Diagnosis, Dating While Going Through IVF with Male Factor Infertility, and Mindset in the Face of Your Medical Challenges. Episode 32 - WARRIOR STORY - Recurrent Pregnancy Loss, Endometriosis, Adenomyosis, Müllerian Anomaly and Finding Humor, Your Voice and Sanity During Infertility with @for_the_barreness - Meghan Faith Episode 37: WARRIOR STORY with Annie Kuo, DO - Integrative Medicine Physician discussing her 20 IVF Cycles Along with Endometriosis, Surrogacy, and Male Factor Infertility Episode 47: WARRIOR STORY with Dr. Dina - Unexplained Infertility, Infertility in 40s, Struggle AFTER IVF and Finding the Right Clinic -------------------------------------------------------- RESOURCES FROM THIS EPISODE Books mentioned in this episode and previously mentioned can be found here: www.amazon.com/shop/40andinfertile DONATE HERE: https://www.buymeacoffee.com/40andinfertile SPECIAL LISTENER OFFER FOR PRANAMAT: https://pranamat.com/af/ynkjmqzx?coupon=40andinfertile (CODE: 40andinfertile) -------------------------------------------------------- ON THIS EPISODE: Dr. Rahi Victory on Instagram: https://www.instagram.com/rahivictory.md/ YouTube Channel: https://www.youtube.com/c/DrVictory Victory Reproductive Care: https://www.drvictory.com/ Clinic Contact and Locations: Victory Reproductive Care Windsor Location 8100 Twin Oaks Dr Windsor, Ontario, Canada, N8N 5C2 Telephone: (519) 944-6400 Fax: (519) 944-6406 Victory Reproductive Care Sarnia Location 105-704 Mara St Point Edward, Ontario Canada, N7V 1X4 Tel: 519-491-6080 Fax: 519-491-8646 --- Support this podcast: https://podcasters.spotify.com/pod/show/40andinfertile/support
In this deeply personal and enlightening episode of our health and wellness podcast, we sit down with Naomi, who courageously shares her journey with endometriosis. From the early signs and symptoms that were too easily dismissed, to the relentless pursuit of a diagnosis, Naomi's story is a beacon of strength and resilience for anyone navigating the complexities of this often misunderstood condition. Naomi takes us through the highs and lows, the challenges of finding treatment that works, and the pivotal moments leading up to her decision to undergo surgery. Her insights into the medical system, the importance of advocating for oneself, and the power of informed consent are invaluable lessons for us all. This episode is a must-listen for anyone who suspects they might have endometriosis, has been recently diagnosed, or is considering surgery as a treatment option. Naomi's experience sheds light on the critical questions to ask, the options to consider, and the importance of being fully informed before making any medical decisions. Beyond Naomi's story, we delve into the latest research on endometriosis, debunk common myths, and discuss how to seek support and build a community that understands. Whether you're navigating this journey yourself or standing beside someone who is, Naomi's story is a testament to the strength found in vulnerability and the importance of sharing our stories. Don't miss this episode if you're looking for understanding, empathy, and actionable advice on dealing with endometriosis. Naomi's journey might just be the inspiration you need to take the next step in your own path to wellness. Meet Naomi Here!
We speak with Dr. Mathew Leonardi, MD about general information on endometriosis and it's impact on fertility. I've been looking to discuss this topic for quite some time, particularly after I was diagnosed. Like so many it was initially dismissed by my gynecologist. With encouragement and a hysteroscopy that did not go as planned, I was finally about to be evaluated for endometriosis. In today's episode, we did not review treatment for those experiencing pain as the primary symptom. This episode is focused primarily on infertility and endometriosis. I make this distinction because the therapies can be different depending on whether you're treating only pain or if you're trying to address the issue of infertility. We spend a considerable amount of time discussing endometriosis and its signs and symptoms, as well as the diagnostic tools used. This disease process is complex and mysterious. There is still so much we don't know about it, but Dr. Leonardi does a great job of exploring what we know and don't know honestly and transparently. He is passionate and advocates for the advancement of care for endometriosis patients. In this episode, I felt my concerns as a patient were heard. This is a great episode if you are experiencing endometriosis and infertility. Thank you to Dr. Leonardi for his time for this episode today! I'm so grateful for your expertise! —---------------------- To round out your IVF survival guide, I would recommend the following episodes before your first IVF cycle: Episode 23: What Happens to Your Fertility in your 20s, 30s, and 40s Episode 19: All About Sperm Episode 24: Controlling Your Weigh During IVF Episode 20: Stimulation Protocols Episode 21: All About Your Embryos in the lab Episode 33: All About Genetic Testing Episode 38: The Emotions of Infertility and How to Manage These Feelings ---------------------- Episodes about the Emotional Aspects of Infertility: Episode 12: WARRIOR STORY - The Infertility Journey of LuckyBabyLam AKA Annie at age 42 Episode 14 - ASK THE EXPERT - Grief, Trauma and Mother's Day Triggers with Dr. Wiyatta Fahnbulleh, PsyD Episode 26: WARRIOR STORY When a therapist is infertile. @Infertile_therapist_in_therapy shares her infertility struggle at 40, her experience with immunotherapy abroad, and struggling as a therapist Episode 28 - ASK THE EXPERT - The Emotions of Infertility and How to Manage Your Emotions and The Expectations of Yourself and Others with Miss Conception Coach AKA Chiemi Episode 30 - Infertility Man Jon Summers Talks Getting A Cancer Diagnosis, Dating While Going Through IVF with Male Factor Infertility, and Mindset in the Face of Your Medical Challenges. Episode 32 - WARRIOR STORY - Recurrent Pregnancy Loss, Endometriosis, Adenomyosis, Müllerian Anomaly and Finding Humor, Your Voice and Sanity During Infertility with @for_the_barreness - Meghan Faith Episode 37: WARRIOR STORY with Annie Kuo, DO - Integrative Medicine Physician discussing her 20 IVF Cycles Along with Endometriosis, Surrogacy, and Male Factor Infertility Episode 47: WARRIOR STORY with Dr. Dina - Unexplained Infertility, Infertility in 40s, Struggle AFTER IVF and Finding the Right Clinic -------------------------------------------------------- RESOURCES FROM THIS EPISODE Books mentioned in this episode and previously mentioned can be found here: www.amazon.com/shop/40andinfertile DONATE HERE: https://www.buymeacoffee.com/40andinfertile SPECIAL LISTENER OFFER FOR PRANAMAT: https://pranamat.com/af/ynkjmqzx?coupon=40andinfertile (CODE: 40andinfertile) -------------------------------------------------------- ON THIS EPISODE: Dr. Matthew Leonardi, MD Instagram: https://www.instagram.com/drmathewleonardi/ Website: https://mathewleonardi.com/ --- Support this podcast: https://podcasters.spotify.com/pod/show/40andinfertile/support
Today's conversation is a thoughtful and informative conversation with Dr. Lauren Fogel Mersy and it surrounds intimacy. Dr. Mersy is a psychologist and a sex therapist. We talk about what intimacy really means and how we deal with that in the world of infertility. I first had this thought when Monica of waitingforbabywunder posted about how no one talks about what infertility does to intimacy and your sex drive. I thought what a great way to discuss this than with a sex therapist. So, if you've been struggling with intimacy and your deep in infertility, know that you're not alone and know that there are different definitions of intimacy and ways we can deal with some of these struggles. Thank you Dr. Mersy for joining us and for sharing your expertise. As always, please share with people who may find value in our conversations and if the mood strikes you, please feel free to donate to the podcast or leave a review, so we can get more listeners to hear these stories and resources. I will have a link in the show notes along with the books that we discuss on this episode. They'll be linked in my Amazon shop. Your purchase with that link helps me offset the costs of running the podcast, so I would be so grateful if you opted to buy any of the books we discuss on the show, if you could please use the link. Thank you to everyone who is a part of the 40 and Infertile community! I am so grateful for all of you and I hope to continue bringing you more content that helps you on your quest to parenthood. —---------------------- To round out your IVF survival guide, I would recommend the following episodes before your first IVF cycle: Episode 23: What Happens to Your Fertility in your 20s, 30s, and 40s Episode 19: All About Sperm Episode 24: Controlling Your Weigh During IVF Episode 20: Stimulation Protocols Episode 21: All About Your Embryos in the lab Episode 33: All About Genetic Testing Episode 38: The Emotions of Infertility and How to Manage These Feelings ---------------------- Episodes about the Emotional Aspects of Infertility: Episode 12: WARRIOR STORY - The Infertility Journey of LuckyBabyLam AKA Annie at age 42 Episode 14 - ASK THE EXPERT - Grief, Trauma and Mother's Day Triggers with Dr. Wiyatta Fahnbulleh, PsyD Episode 26: WARRIOR STORY When a therapist is infertile. @Infertile_therapist_in_therapy shares her infertility struggle at 40, her experience with immunotherapy abroad, and struggling as a therapist Episode 28 - ASK THE EXPERT - The Emotions of Infertility and How to Manage Your Emotions and The Expectations of Yourself and Others with Miss Conception Coach AKA Chiemi Episode 30 - Infertility Man Jon Summers Talks Getting A Cancer Diagnosis, Dating While Going Through IVF with Male Factor Infertility, and Mindset in the Face of Your Medical Challenges. Episode 32 - WARRIOR STORY - Recurrent Pregnancy Loss, Endometriosis, Adenomyosis, Müllerian Anomaly and Finding Humor, Your Voice and Sanity During Infertility with @for_the_barreness - Meghan Faith Episode 37: WARRIOR STORY with Annie Kuo, DO - Integrative Medicine Physician discussing her 20 IVF Cycles Along with Endometriosis, Surrogacy, and Male Factor Infertility Episode 47: WARRIOR STORY with Dr. Dina - Unexplained Infertility, Infertility in 40s, Struggle AFTER IVF and Finding the Right Clinic -------------------------------------------------------- RESOURCES FROM THIS EPISODE Books mentioned in this episode and previously mentioned can be found here: www.amazon.com/shop/40andinfertile DONATE HERE: https://www.buymeacoffee.com/40andinfertile SPECIAL LISTENER OFFER FOR PRANAMAT: https://pranamat.com/af/ynkjmqzx?coupon=40andinfertile (CODE: 40andinfertile) ------------------------------------------------------- ON THIS EPISODE: Dr. Lauren Fogel Mersy, PsyD https://www.instagram.com/drlaurenfogelmersy/ About Dr. Mercy: https://drlaurenfogel.com/about/ Work with Dr. Mercy: https://drlaurenfogel.com/ --- Support this podcast: https://podcasters.spotify.com/pod/show/40andinfertile/support
In this podcast episode, Wendy K Laidlaw explains her absence over the past few months due to some unforeseen challenges. Wendy reminds listeners that a New Year brings NEW opportunities to focus on essential self-care, pay attention to the body's signs and signals, and to take responsibility for one's full health; mentally, emotionally, physically and spiritually. She also shares her plans to host more in-person events like EndoBoss® Mastermind retreats in 2024 for EndoBoss® Beginners, Advanced & Elite clients to provide more rich, niche and expert education, along with safe, female personal connections to empower women more securely emotionally for good. Throughout the podcast, Wendy's personal journey serves as a backdrop to convey the importance of self-awareness, empowerment, and resilience in the face of health challenges - to becoming an EndoBoss® for Life! To start your EndoBoss® journey join the 21 Day Unstoppable EndoBoss® Challenge at https://HealEndometriosisNaturally.com/Programs @WendyKLaidlaw #HealEndometriosisNaturally, #EndoBoss, #WendyKLaidlaw
Our guest this week is Karen Mannion, The Health Creator. Karen is a former PA who now helps women with hormone health issues confidently navigate peri-menopause. Karen is of Ghanaian heritage raised partly in Ghana and mostly in London, United Kingdom. Her trials, from reconnections with her biological family, to a diagnosis of Adenomyosis and Fibroids and the ensuing treatment by medical professionals, are harrowing. But Karens story is one of ultimate triumph and a testament to the woman she has become today, helping other women to feel supported and empowered. We discuss, Culture and being 'othered'. What good workplace support looks like Adenomyosis symtoms Fibroids and surgical menopause Bossing her hormones The power of dense nutrition And so much more! Notes: Benefits of Black strap molasses Karens' Hormone Harmony 30-Day Challenge. Starts 8.1.24 N.I.C.E guidelines. Menopause: Diagnosis and Management Consultation process ends 5th Jan '24. Please note: These episodes are conversations between humans discussing their own menopause experiences. They are no substitute for advice and consultation with a qualified health professional. No two menopause experiences are the same so do remember to do your own research. Don't forget to subscribe wherever you listen or hop over to YouTube for your visual fix , and recommend to a friend (or three) who you think would enjoy this episode. CONNECT · Karen Mannion on Instagram: · Karens Website: The Health Creator · Menopause Whilst Black on Instagram: Jiggle your bits to our Spotify Playlist Email the show: thekarenarthur@mail.com Places for The Joy Retreat Barbados, the worlds first retreat for Black women* in any stage of menopause are now available. April 29th - May 6th 2024. Three-month payment plan option ends 31.12.23. Like, subscribe, follow and rate Menopause whilst Black on Instagram, Facebook and YouTube. Karen Arthur is a menopause activist and campaigner and host of this podcast plus a new bi-weekly weekend radio show on Golddust radio'Can We Talk'. Listen to the latest episode on Soundcloud *We recognise that inclusive language is important in ensuring that ALL who experience menopause are seen and heard. The term ‘women' is used whilst mindful of this. Join our mailing list. Team MWB: Producer and Editor: Beyongolia Productions Digital design and communications: Yaa Studio Space
In this episode of Hope Natural Health, Dr. Erin gives advice about endometriosis vs. adenomyosis. During this episode you will learn about: Identifying endometriosis Identifying adenomyosis Who is affected by these conditions Link to Testing: https://hopenaturalhealth.wellproz.com/ Link to Period Planner: https://www.amazon.com/dp/B0BBYBRT5Q?ref_=pe_3052080_397514860 For more on Dr. Erin and Hope Natural Health: Take the Period Quiz: https://form.jotform.com/230368188751059 Check out my Hormone Reset Program: https://hopenaturalhealth.practicebetter.io/#/619ef36b398033103c7b6bf9/bookings?p=633b5cca8019b9e8d6c3518d&step=package Dr. Erin on Instagram: https://www.instagram.com/dr.erinellis/ Dr. Erin's Website: https://hopenaturalhealth.com/ Hope Natural Health on YouTube: https://www.youtube.com/channel/UChHYVmNEu5tKu91EATHhEiA Follow Hope Natural Health on FB: https://www.facebook.com/hopenaturalhealth
If you've heard of endometriosis, you may know of a similar condition: adenomyosis. Adenomyosis is the growth of endometrial-like tissue growing into the muscle of your uterus. Adeno can create symptoms that are even more severe and difficult to resolve like pelvic pain and pain with your period. In this episode, I dive into the root cause of adenomyosis and some treatment options. DUTCH Test: https://drbethwestie.com/dutch-hormone-testing/
What causes hot flashes and how can they be resolved? How do the new postpartum depression drugs work? Should women use testosterone pellets? Tune in to hear us discuss women's hormones from 30s to 50s and answer all of your burning questions. In this episode, we discuss the root causes of hot flashes and how sauna may actually help with menopause symptoms. We cover natural ways to boost progesterone and support postpartum mental health. Plus we troubleshoot long cycles, worsening PMS after babies, and discuss testosterone replacement for women. Also in this episode: Episode 360 From 30s-50s Women's Hormone Support Part 1 Women's Hormone Bundle Managing Hot FlashesEPA DHA Extra Super Turmeric The effect of oral capsule of curcumin and vitamin E on the hot flashes and anxiety in postmenopausal women: A triple blind randomised controlled trial Episode 252 From Fertility to Breezing through Menopause and beyond with guest Dr. Anna Cabeca Labrix Neurohormone Complete Plus Sauna for Hot Flashes?Nitric oxide-heat shock protein axis in menopausal hot flushes: neglected metabolic issues of chronic inflammatory diseases associated with deranged heat shock response Episode 244 Infrared Sauna, Is It Really Worth the Hype? With Sunlighten Sauna Sunlighten use code ALIMILLERRD for savings Postpartum Depression DrugsGabaCalm Calm and Clear MethylComplete Bio-C Plus Heavy Periods and Worsening PMSInflammazyme Herbal Immune Castor Oil Packs Episode 265 Uterine Health: Endometriosis and Adenomyosis and beyond Long CyclesBio-C Plus Maca Stress Manager Bundle Women and TestosteroneTesting:DHEA-s, Free Testosterone, Total Testosterone, SHBG Alcohol During PerimenopauseDetox Packs BroccoDetox Dry Farm Wines use code ALIMILLERRD Sponsors for this episode: This episode is sponsored by the Naturally Nourished supplement line: these pure, potent and effective formulas have been hand selected to deliver profound health benefits. We price our formulas 2-5% below market industry standard and competitors and guarantee that our products will always be third party assessed to ensure they are free of mold, toxins, contaminants, and contain the stated active ingredients in dosages noted. Use code ALI15 for 15% off your first Naturally Nourished Supplement Order!
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