Podcasts about clomid

What if the pill you were given to help you ovulate wasn't actually helping—or even making things worse—and no one was checking? In today's episode of Cycle Wisdom, Dr. Monica Minjeur reveals the often-overlooked truth about ovulation stimulation with medications like Clomid and Letrozole. You'll hear Hope's story—a 29-year-old nurse frustrated by impersonal care and harsh side effects—and how a personalized, restorative approach helped her conceive naturally.Dr. Minjeur explains how conventional care often relies on guesswork and outdated protocols, while restorative reproductive medicine uses real-time hormone data, follicular ultrasound tracking, and individualized care plans to optimize ovulation and minimize risk. If you've ever felt lost in the fertility process or pressured to "just take a pill," this episode is for you.✨ Learn more or book your free discovery call at radiantclinic.com

On this episode of The Wholesome Fertility Podcast, I am joined by Dr. Nirali Jain (eggspert_md), a board-certified OB/GYN and reproductive endocrinologist at Reproductive Medical Associates (RMA). Dr. Jain shares her expert insights on fertility preservation for individuals undergoing cancer treatment, a crucial yet often overlooked aspect of reproductive care. We explore what options are available for fertility preservation, including egg and sperm freezing, and why it's so important to initiate these discussions before starting chemotherapy or radiation. Dr. Jain also explains the difference between Letrozole and Clomid, the impact of estrogen-sensitive cancers on IVF treatments, and innovative approaches like random-start cycles and DuoStim protocols. Whether you're facing a cancer diagnosis or simply thinking proactively about your reproductive future, this conversation is filled with knowledge and reassurance. Key Takeaways: Why it's essential to discuss fertility before starting cancer treatment. The role of Letrozole in estrogen-sensitive cancers and fertility preservation. Differences between Letrozole and Clomid, and why Letrozole is often preferred. How new protocols like DuoStim and random-start cycles are improving outcomes. Why fertility preservation is important even for those without a cancer diagnosis. Guest Bio: Dr. Nirali Jain (@eggspert_md) is a board-certified OB/GYN and fertility specialist at Reproductive Medicine Associates (RMA) in Basking Ridge, New Jersey. She earned both her undergraduate degree in neurobiology (with a minor in dance!) and her medical degree from Northwestern University, before completing her residency at Weill Cornell/NYP, where she served as co-Chief Resident, and her fellowship in reproductive endocrinology and infertility at NYU Langone. Deeply passionate about women's health and fertility preservation, Dr. Jain blends the latest research and cutting-edge treatments with compassionate, patient-centered care. Her interests include third-party reproduction and oncofertility, and she is especially passionate about supporting patients navigating fertility preservation through a cancer diagnosis. Outside of the clinic, Dr. Jain is a trained dancer, a dedicated global traveler, and an adventurer working toward hiking all seven continents with her husband. Her diverse experiences, from international medical rotations to personal connections with friends and family navigating infertility, have shaped her into a warm, resourceful, and determined advocate for her patients. Links and Resources: Visit RMA websiteFollow Dr. Nirali Jain on Instagram For more information about Michelle, visit www.michelleoravitz.com To learn more about ancient wisdom and fertility, you can get Michelle's book at: https://www.michelleoravitz.com/thewayoffertility The Wholesome Fertility facebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/ Instagram: @thewholesomelotusfertility Facebook: https://www.facebook.com/thewholesomelotus/ Disclaimer: The information shared on this podcast is for educational and informational purposes only and is not intended as medical advice. Please consult with your healthcare provider before making any changes to your health or fertility care. --  Transcript:   # TWF-Jain-Nirali (Video) ​[00:00:00]  **Michelle Oravitz:** Welcome to the podcast Jain.  **Dr. Nirali Jain:** Thanks so much for having me **Michelle Oravitz:** Yeah, so. **Michelle Oravitz:** I'm very excited to talk about this topic, which, um, actually you don't really hear a lot of people talking about, which is how to preserve your fertility if you're going through a cancer diagnosis and if you have to go through treatments. 'cause obviously that can impact a lot on fertility. **Michelle Oravitz:** I have, um, seen actually like a colleague of mine go through. And she also preserved her fertility and, and now she has a baby boy. so it's really nice. **Michelle Oravitz:** to **riverside_nirali_jain_raw-video-cfr_michelle_oravitz's _0181:** so nice. **Michelle Oravitz:** So I'd love for you first to introduce yourself and kind Of give us a background on how you got into this work. **Dr. Nirali Jain:** Of course. Um, so I am Dr. Narly Jane. I am, um, an OB GYN by training, and then I did an additional, after completing four years of residency in OB GYN and getting board certified in that, I did an additional training in reproductive endocrinology and [00:01:00] infertility or otherwise known as REI. So now I'm a fertility specialist. **Dr. Nirali Jain:** Um, I trained at Northwestern in Chicago, so I went to undergrad and medical school there. And then, um, home has always been New Jersey for me, so I moved back out east to New Jersey. Um, I did all my training actually in New York City at Cornell for residency and NYU for fellowship. Um, and then moved to the suburbs. **Dr. Nirali Jain:** Um, and now I'm a fertility specialist in, in Basking Ridge at Reproductive Medical Associates.  **Michelle Oravitz:** Very impressive background. That's awesome.  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** I'd love to hear just really. About what your process is. If a person has been diagnosed with cancer, like what is the process? What are some of the things that you address if they are trying to preserve fertility, and what are some of the concerns going  **Dr. Nirali Jain:** yeah, yeah. All great questions. So, you know, there's a lot of us, uh, the Reis. Are a very small, [00:02:00] there's a very small number of us. So in terms of specializing in fertility preservation, technically we all are certified to treat patients with cancer and kind of move them through fertility preservation before starting chemotherapy. **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** Um, luckily we've been working closely with oncologists in the past several years just to establish some type of streamlined system because having a diagnosis of cancer and hearing all that information. Especially when you're young is so hard. So I think that's, that's where my interest started in terms of being able to speak to and counsel cancer patients. **Dr. Nirali Jain:** I think it is a very specific niche that you really have to be comfortable with in our field. Um, I. So I'll kind of walk you through, you know, what it, what does it look like, right? Um, you go into your oncologist's office suspecting that you have this, this lump. I'll take breast cancer, for example. It could really be any kind of cancer. **Dr. Nirali Jain:** Um, but breast cancer in a reproductive age patient or someone that's in those years where you're starting [00:03:00] to think about building a family, planning a family, um, or if you have kids at home, that's usually the type of patient that we see come in with a breast cancer diagnosis. So. Kinda just taking that, for example, um, the minute that you're diagnosed, it's really your oncologist's responsibility to counsel you on what treatment options are going to be offered to you. **Dr. Nirali Jain:** And then based off of the treatment options, it's important to know how that affects your reproduction. So how does it affect your ovaries in the short term, in the long term, um, in any way possible. So. Once a patient is initially referred from their oncologist to myself or any other fertility specialist, they come into my office and we just have a 30 minute conversation really talking about family planning goals. **Dr. Nirali Jain:** Any kids that they've had in the past either naturally conceived or through um, IVF, and then we talk about where they're at in their relationship. Are they married, are they not? Are they with a partner, [00:04:00] a male partner, a female partner, whatever it might be. It's important to know the social standpoint, um, especially in this sensitive phase of life. **Dr. Nirali Jain:** So patient patients usually spend anywhere from 30 minutes to an hour. Um, just kind of talking through where they're at, how they're feeling, what their ultimate childbearing goals are. And then from there we do an ultrasound and that's when I'm really able to see, you know, the, the reproductive status. **Dr. Nirali Jain:** So what do the ovaries look like? What does the uterus look like? Is there something that I need to be concerned about from a baseline GYN standpoint? Um, and all of those conversations are happening in real time. So. I think one of the things is patients come in and they're like, I'm already so overwhelmed with all this information from my oncologist, and now my fertility specialist is throwing all this information at me. **Dr. Nirali Jain:** Luckily, the way I like to frame it is you come in and you just let go. Like you let us do the work because in the background we're the ones talking to your oncologist. We're the [00:05:00] ones giving that feedback and creating a timeline with your oncologist. Um, and really I think just getting in the door is the hardest part. **Dr. Nirali Jain:** So once patients are here to see us, we go through the whole workup. We do anything that we would do for a normal patient that came in for fertility preservation. And then based off of where they're at in their journey, we talk about what makes sense for them, whether that means freezing embryos, freezing eggs, they're very similar in terms of the, the few weeks leading up to the egg retrievals. **Dr. Nirali Jain:** So I have that whole conversation just at the initial visit. And then from there we talk about the timeline behind the scenes and make sure that it works with their lives before moving forward. **Michelle Oravitz:** So for people listening to this, why, and this might be an obvious question, but to some it might not be,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** why would somebody want to preserve. eggs or sperm. 'cause I've had actually some couples  **Dr. Nirali Jain:** Yep. **Michelle Oravitz:** come to me where the husband preserved the sperm and they had to go through IVF just because he was going [00:06:00] through cancer treatments. So he had to preserve the sperm ahead of time.  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** people need to consider doing that before doing cancer treatments?  **Dr. Nirali Jain:** So there are certain cancer treatments that do affect the ovaries and the sperm health, and you know, for men and women, it affects your reproductive organs. In a similar way, um, depending on the type of chemotherapeutic agent, there are some that are more dangerous in terms of, um, being toxic to your ovaries or toxic to your sperm. **Dr. Nirali Jain:** And those are the instances where we are really thinking about what's the long-term impact because there's medications that oncologists do give patients, and our oncologists are amazing, the ones that we work with, Memorial Sloan Kettering from Reproductive Medical Associates through RMA, um, and. **Dr. Nirali Jain:** They're just so good at what they do and are so well-trained, so they know in the back of their mind, is this going to impact your ovaries or your sperm health or not? Um, and I [00:07:00] think that any chemotherapy, you know, your ovaries are these, these small organs that are constantly turning over follicles every month. **Dr. Nirali Jain:** So every month we're losing those eggs, and if they don't become. If an egg isn't ovulated, it doesn't become a baby, it's just gonna die off. So I counsel even patients that don't have cancer, I counsel them on fertility preservation as young as possible. You know, between the ages of 28 and 35, that's like the best time to preserve your fertility. **Dr. Nirali Jain:** So in cancer patients, there's an extra level added to that where even if they are a little bit younger, a little bit older. Your eggs are not gonna be the same quality. There's gonna be higher level of chromosomal errors, more DNA breakage, um, and, and bigger issues that lead to issues with conceiving naturally afterwards. **Dr. Nirali Jain:** So I think that it's important to consider how that chemotherapy is going to affect them or how surgery would affect them if it was, for example, a GYN cancer where [00:08:00] we're removing a whole ovary, you know, what, what do we have to do to preserve your fertility in that case? And those are important conversations to have. **Michelle Oravitz:** Yeah. for sure. I know that a lot of people are also concerned, you know, with going through the IVF process, you're taking in a lot of estrogen, a lot of hormones, and many cancers are actually estrogen sensitive. So I wanted to talk to you about that. 'cause I know that the data shows that it's. It's been fine, which some people might find surprising, but I wanted you to address that and just kind of **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** from your perspective.  **Dr. Nirali Jain:** That's so interesting that you asked that question because I actually, my whole I I graduated fellowship last year and my entire, like passion project in fellowship was looking at one of the drugs that we use to suppress the estrogen levels specifically in cancer patients. Um, and I had presented this at a few of our reproductive meetings. **Dr. Nirali Jain:** Um, A SRM is one of our annual meetings where all of the reiss get together. A lot of male fertility [00:09:00] specialists come and we kinda just talk about. Specific things and fertility preservation for cancer patients is, has been an ongoing topic of interest for all of us. Um, and it's important to know that there are different medications that we can offer. **Dr. Nirali Jain:** Letrozole is the one that I, um, have a particular love for and I, uh, you know, I use all the time for my patients, um, for different reasons, but it suppresses the exposure that your body has to estrogen. And there's mixed data, um, out there in terms of, you know, does Letrozole suppression actually impact, you know, does it help or. **Dr. Nirali Jain:** Or does it have no impact on your future risk of cancer after treatment? Um, and that honestly is still up for debate. But what we do know is that there's no increased risk of cancer recurrence in patients that have undergone fertility preservation with or without Letrozole. Um, Letrozole is one of those things that we can give, and the way it works is basically. **Dr. Nirali Jain:** It masks that [00:10:00] conversion. It, it doesn't allow for conversion from those androgens in the male hormones over to estrogen. Um, and so your body doesn't really see that estrogen exposure. It stays nice and low throughout your cycle, and it does help with actually ovarian maturation and getting mature eggs harvested and, um, helps a little bit with, with quality too. **Dr. Nirali Jain:** So I think that it's really nice in terms of having that available to us, but know that. It's not, it's not essential that you have it, really, the data showing plus minus. Um, but there are certain things that we can do to protect the ovaries, protect your exposure to estrogen. Um, and so that shouldn't be top of mind of concern when we're going through fertility preservation, even with an estrogen sensitive cancer. **Michelle Oravitz:** Actually, so, uh, on a different topic, kind of going back to that, so Letrozole versus Clomid, I, it's like a, the questions I personally feel just based on what I've heard and like my own research that Letrozole would be kind of like the more. [00:11:00] Um, the, it's, it's a little better, but I know that it really depends on the person as well.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** they might do better with Clom, but I'd love to hear your perspective and kind of pick your brain on this.  **Dr. Nirali Jain:** totally. You're choosing all the, all the right questions because these are all of my, my specific interests and niches. So  **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** Letrozole is basically, you know, we use Letrozole and Clomid in. Patients that don't have cancer and patients that come in for an intrauterine insemination, that's kind of the most common scenario where we're thinking about, you know, which medication is better? **Dr. Nirali Jain:** Letrozole or Clomid and Clomid used to be the, the most common medication that we use, we dose patients, you know, have 50 milligrams of Clomid, give them five days of the medication. It's an oral pill. Feels really easy and. The way it works is really, it recruits more than one follicle, so it really helps with the release of, um, more than one follicle growing more than one follicle in the ovary. **Dr. Nirali Jain:** Um, but it has a little bit [00:12:00] higher of a risk of twins because that's exactly what it's good at. Um, Clomid, not so much in the cancer. In the cancer front, it's not really used there because it's considered, from a scientific perspective, it's considered like a selective estrogen receptor modulator. So it doesn't necessarily suppress your estrogen levels in the same way that Letrozole does versus. **Dr. Nirali Jain:** Letrozole is an aromatase inhibitor, so it really blocks the chemical conversion of one drug or one hormone to the other hormone. Um, the reason we love Letrozole so much, and I don't mean to like gush over Letrozole, but um, it's a mono follicular agent, so it works really well at recruiting one follicle  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** you know, every OB-GYN's nightmare in a way is having multiples when you didn't intend on having multiples at all. **Michelle Oravitz:** so  **Dr. Nirali Jain:** Um. **Michelle Oravitz:** were saying that, um, there's more of a chance of twins, it's Clomid, not letrozole.  **Dr. Nirali Jain:** Yes, there's a higher chance with Clomid versus Letrozole. And I mean, don't get me wrong, there's a chance of twins with [00:13:00] any type of assisted reproductive technology. Even when we're doing single embryo transfers, there's a chance that it's gonna split. So, um, the chance is always there just like it is in the natural world. **Dr. Nirali Jain:** But we know for a fact that. CLO is really good at recruiting many follicles. It's good for certain patients that don't respond well to Letrozole. Um, but Letrozole is kind of our, our go-to drug these days just because of all the benefits that we've seen.  **Michelle Oravitz:** Awesome.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** These are all fun things to ask because I, I love talking to our eis 'cause there's so much information that I'm always  **Dr. Nirali Jain:** totally. **Michelle Oravitz:** learn a lot from my patients in my own research, but it's really cool. Picking your guys' brains. So another question I have, and I have actually talked to Dr. Andrea Elli, he's been on,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** and he does a lot of endometriosis and, and immune related work as well,  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** so. I'd love to know just from your perspective. One thing that I do know from, based on what I've heard is that the, [00:14:00] guess like you were just saying, that breast cancer or estrogen sensitive breast cancer doesn't seem to be affected by IVF cycles, however, and endometriosis lesions do get affected.  **Dr. Nirali Jain:** Yeah. **Dr. Nirali Jain:** that's a great question. So, you know, every, there are so many complex G mind diagnoses that the, that our patients come in with. Um, and endometriosis is a big one because there is clear data that endometriosis is linked to infertility. So we think about, you know, when a patient comes in with endometriosis, we really do think about the different treatment options and what are the short-term and long-term impacts of the hormones that we're giving 'em. **Dr. Nirali Jain:** Um, these days, again, kind of going back to Letrozole, we, letrozole is something that I give all of my endometriosis patients because it helps suppress their estrogen because we know.  **Michelle Oravitz:** interesting.  **Dr. Nirali Jain:** is very responsive to estrogen and leads to this dysfunctional regulation of all the endometrial tissue that can really flare in a, [00:15:00] in a cycle, or shortly after a cycle. **Dr. Nirali Jain:** I. So we really, for endometriosis patients, the, the best treatment is being on birth control because we don't see that hormonal fluctuation. The up and down of the estrogen and the progesterone, that's what leads to those flares. Um, so I really, I watch patients closely after their cycles too, because you definitely can have an endometriosis flare and we say the best treatment for endometriosis is pregnancy, right? **Dr. Nirali Jain:** That's when you're suppressed, that's when you're at your lowest. Um, and patients, my endo patients feel so good in pregnancy because they have. Hormones that are nice in that baseline, they're not getting periods of course. Um, and that's truly, truly the best treatment.  **Michelle Oravitz:** That's interesting.  **Dr. Nirali Jain:** But it is important to consider when you're going through infertility treatments. **Dr. Nirali Jain:** How does my endometriosis affect the short and long-term effects of the fertility medications? And really not to, not to say that they're bad in any way. I think a lot of endometriosis patients go through IVF and have success and do really, really well, and that's kind of the push that they need. [00:16:00] Um, but it's important to be mindful of the bigger picture here. **Dr. Nirali Jain:** It's not just, you're not just a number of. A patient with endo coming in, getting the same protocol. It's really individualized to the extent of your lesions, what symptoms you're having, what grade of endometriosis, where your lesions are. So we're the RAs are thinking about everything before we actually start your protocol. **Michelle Oravitz:** It's crazy how in depth it is, and it's, it, there's just so, it's so multifaceted,  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** when it's females  **Dr. Nirali Jain:** totally. **Michelle Oravitz:** are a little, I mean, they can, you know, there, there's definitely a number of things, but it's not as complicated and interconnected  **Dr. Nirali Jain:** Exactly. Exactly. That's so true. **Michelle Oravitz:** And so one question I actually have, this is kind of really off topic, but something that I was curious about. **Michelle Oravitz:** 'cause I heard about a while  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** a, a type of cancer treatment that was used. I'm not sure exactly what it was, but for some reason it actually caused follicles to grow, [00:17:00] or to multiply. And they were **Dr. Nirali Jain:** Interesting. **Michelle Oravitz:** this definitely. Puts, um, the whole idea of like a woman being born with all the follicles she'll ever have on its head, I thought that was really Interesting. **Michelle Oravitz:** Now I learned a little bit about it. I don't think it really went further than that,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** one of those things that they're like, Hmm, this is interesting. I don't know, it was kind of a random side effect of this chemo drug. I dunno if it was a chemo drug or a cancer drug.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** ever heard of that. **Michelle Oravitz:** So I was just **Dr. Nirali Jain:** I haven't, I mean, that's interesting. I feel like I'd have to look into that because that would be definitely a point of interest for a lot of Reis. But it kind of does go back to the point of, you know, women are really born with all the eggs we're ever gonna have. So it's about a million, and then it just goes down from there. **Dr. Nirali Jain:** And the, by the time you start having periods, I like to kind of show my patients a chart, but you have a couple hundred thousand eggs and you ovulate one egg a month. That's, you know. Able to [00:18:00] progress into a fertilized egg and then into a, an embryo into a baby, um, if that's your goal. But otherwise, patients that are having periods and not trying to actually get pregnant, we're losing hundreds of eggs a month. **Dr. Nirali Jain:** So.  **Michelle Oravitz:** Mm.  **Dr. Nirali Jain:** It's important to kind of think about that decline, and it's important to know that that rate can be faster in patients with cancer, patients with low ovarian reserve. And sometimes when you have the two compounded, that's when a fertility specialist is definitely, you know, in the queue to, to have a discussion with you in terms of what that means and how you can reach your family building goals despite being faced with that, with that challenge. **Michelle Oravitz:** Yeah. **Michelle Oravitz:** I mean, 'cause we know oxidative stress is one of the things that can cause, uh,  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** quality eggs, but it's also can cause cancer. **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** um, similar, you know, like things that really deplete the body could definitely impact. Um, and then what are your thoughts? I know I'm asking you all kinds of random questions, **Dr. Nirali Jain:** I love it. **Michelle Oravitz:** are your thoughts about doing low simulation in certain [00:19:00] circumstances versus high stem? **Michelle Oravitz:** Sometimes people don't respond as well to higher stems.  **Dr. Nirali Jain:** Yeah, that's a great point. I think that it kind of all goes back to creating an individualized protocol. If. A patient's going to a practice and basically just getting a protocol saying, this is our standard. We start with our standard of, you know, I, I think about the standard, which is 300 of the FSH or that pen that you dial up, and then 150 units of that powder vial. **Dr. Nirali Jain:** And we have patients mixing powders all the time, and that's kind of our blanket protocol that we give patients. But that's not really what's happening behind the scenes. And if you're given a protocol that's, and being told, you know, this is kind of what we give to everyone, it's probably not the right fit for you. **Michelle Oravitz:** Yeah, I  **Dr. Nirali Jain:** Um, there are certain patients that respond to a much lower dose and do really, really well, and then some patients that need a much higher dose. Um, and I think it's, that's kind of like the fun part of being an REI of being able to individualize the [00:20:00] protocol to the patient. Um, and I know for a fact there are so many, luckily, you know, we have so many leaders in REI that have been. **Dr. Nirali Jain:** Have dedicated their entire careers to researching these different protocols and how they can help different patients. Um, patients with lower a MH, you know, might benefit from a duo stim protocol, for example. That's kind of the first one that comes to mind, but a protocol where we're using those follicles from the second half of a cycle. **Dr. Nirali Jain:** I would've never thought that those were the follicles that  **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** would be better than the first half of the cycle,  **Michelle Oravitz:** Wait,  **Dr. Nirali Jain:** but, **Michelle Oravitz:** that. Explain that. Um, because I think that that's kind of a unique  **Dr. Nirali Jain:** mm-hmm.  **Michelle Oravitz:** that I haven't heard of.  **Dr. Nirali Jain:** Yeah, so there's this new day. It's still kind of developing, but um, kind of going back to, you know, what's an individualized protocol? Duo STEM is one of the newer protocols that we've started using. I, I've used it once or twice in patients. Um, but it goes back to the research that shows that you might actually have two different periods of time in a menstrual cycle where you could potentially recruit [00:21:00] follicles. **Dr. Nirali Jain:** You could have a follicular phase where there's a certain cohort of follicles recruited, and then you have a follicle that forms creates a corpus glut.  **Michelle Oravitz:** um, protocols  **Dr. Nirali Jain:** Yep. And then you basically go through the follicular protocol and then a few days after a retrieval, instead of waiting for a new follicular cohort or follicular recruitment from the first half of your menstrual cycle, you actually use the luteal phase and you recruit those follicles that would've actually died off or have been prematurely recruited in a prior cycle. **Dr. Nirali Jain:** So **Michelle Oravitz:** that's So  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** you just do a similar, I guess, um, medicine,  **Dr. Nirali Jain:** go right back into it.  **Michelle Oravitz:** do the same exact thing, but right after ovulation.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** Fascinating. That's really interesting.  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** has been your experience with that?  **Dr. Nirali Jain:** I think it's, honestly, it's mixed. Um, so far, you know, our data from fertility and sterility and A SRM, it, it shows support for these DUO STEM [00:22:00] protocols, saying that if patients don't have that great quality of eggs or if they have a very low number, maybe they'd benefit from starting the meds earlier and recruiting follicles. **Dr. Nirali Jain:** A little bit earlier. Um, so we've seen positive results so far. A lot of work to be done in terms of really understanding it. Um, and of course, as a new attending, I have a lot more experience to kind of build on. Um, but I, I have seen success from it. **Michelle Oravitz:** That's fascinating. Are there any other new technologies, like new add-ons, um, that you've seen, that you've found to be really cool or interesting?  **Dr. Nirali Jain:** I think the biggest thing, actually, kind of going back to our whole topic for today is fertility preservation cancer patients. One of the biggest things that I've learned recently is that we used to start fertility, um, patients. You know, only in the beginning of the cycle days, two or three is technically like when most. **Dr. Nirali Jain:** Most clinics, um, start patients, but for our cancer patients, sometimes you don't have that time. You don't wanna wait a full month to [00:23:00] restart, um, your, you know, your menstrual cycle and then do the fertility preservation and then delay chemotherapy a full month. So we started doing what we call random starts. **Dr. Nirali Jain:** So you basically start a patient whenever they come in. You know, it could be the day after your consultation, the day of your consultation. I've kind of seen all of the above. Um, and we've seen really good success with random starts, per se. Um, and we've been doing a lot more of that, where it's not as dependent on where you're at in your cycle. **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** Um, obviously there's a difference in outcomes. You might not be a great candidate for it, so definitely it's worth talking to your doctor about it. But it kind of gives relief to our cancer patients where if you have a new cancer diagnosis and you're like, oh, I just finished my period, like, I can't even start a cycle until next month. **Dr. Nirali Jain:** That's not always true. Um, so it's always worth it to go into see a fertility specialist and just get, you know, get the data that you need right away, and then you can make a decision later on. **Michelle Oravitz:** For sure. Um, Yeah. **Michelle Oravitz:** and I wanted to kind of cover a lot of different topics 'cause I know that [00:24:00] some people are gonna wanna hear what you have to say that don't necessarily, or, uh, have cancer. But it is important. I, I think that, you know, if you get to thirties and you haven't gotten married or you don't have a partner, I think it's really important to preserve your fertility in general.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** important thing. And then if you were going through a cancer diagnosis and you decided to preserve your fertility, um, guess more for women because they're eventually going to be thinking about transfers after they go through treatment. So what are some of the things that they would need to consider as far as that goes? **Michelle Oravitz:** Like after the  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** then they go through the cancer treatments. Um, and then what, how long should they  **Dr. Nirali Jain:** yeah. Like what does it look like? So I've had patients that come back, you know, in my fellowship training I did a, a couple research projects on patients that came back to pursue an embryo transfer, um, after chemotherapy agent. And basically compared them to how they did, um, [00:25:00] compared to patients that didn't have cancer and just froze their embryos or froze their eggs and then came back to pursue a transfer and. **Dr. Nirali Jain:** I think the, the most reassuring thing from the preliminary data that we have is saying that there's no difference in pregnancy rates and no difference in life birth,  **Michelle Oravitz:** Awesome.  **Dr. Nirali Jain:** of whether they had chemotherapy or not. After freezing those eggs and going through fertility preservation.  **Michelle Oravitz:** Amazing.  **Dr. Nirali Jain:** Um, in terms of where your body needs to be, I think the oncologist, we, we wait for their green light. **Dr. Nirali Jain:** We wait for their signal to say, you know, she's safe to carry a pregnancy.  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** And then once we do that, we basically treat you like any other patient. So if you're coming in for a cycle, if you're having periods, then it's reasonable to try a natural cycle protocol, wait for your body to naturally ovulate an egg. **Dr. Nirali Jain:** And instead of obviously hoping that egg will fertilize, we, um, use a corpus luteum. We use the progesterone from the corpus luteum to really support this embryo being implanted into the uterus. Um. Yeah. [00:26:00] And then there's also another side. I mean, some patients don't get their periods back and they always ask like, what if I never get my period back? **Dr. Nirali Jain:** What if I'm just like in menopause because of the chemotherapy agents? And for that, we can start you on a synthetic protocol or basically an estrogen dependent protocol where you take an estrogen pill for a certain number of days. We monitor your lining, then we start progesterone, um, to support your hormones from that perspective instead of relying on your ovaries to release the progesterone that they need, um, and then doing the embryo transfer a few, few days after progesterone starts. **Dr. Nirali Jain:** So there's definitely different protocols depending on where your menstrual health is at after the chemotherapy or after the cancer treatment. Um, but it's important to kind of just know that. That there's options. It doesn't mean that it's the end of the road if you all of a sudden stop getting your period. **Michelle Oravitz:** Yeah, for sure. I mean, 'cause you, technically speaking, you can really control a lot of that. More so for transfers  **Dr. Nirali Jain:** Yep. **Michelle Oravitz:** Retrievals really is kind of like what [00:27:00] eggs you have, what the quality is. But people can be in complete menopause and you guys can still control their cycles for transfer, which is kind of. A huge difference  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** in the  **Dr. Nirali Jain:** exactly. That's exactly right. Yeah. **Michelle Oravitz:** interesting. Any other, um, new, new things that you're, you guys are excited about? I always like to hear about like the new and upcoming things  **Dr. Nirali Jain:** Of course.  **Michelle Oravitz:** actually before, which I thought was fascinating. Yeah.  **Dr. Nirali Jain:** I feel like there's always like updates and, and new data and things like that coming out, but just know, I think it's important for patients to know, like we're constantly, we're, the reason I chose to even pursue this field was because it's new. Right. There's something that we are discovering every day, every year, and that's what makes our, our conferences so important to attend, um, to really just stay up to date. **Dr. Nirali Jain:** Um, but we are, uh, constantly updating our embryology standards, the way we thaw our eggs, and the success rate associated with a thaw and [00:28:00] how we treat our embryos and the media that we use, right? Like, so we're really thinking about the basic science perspective every single day, and that's what makes this field so unique. **Michelle Oravitz:** It is really awesome. And so do you guys specialize specifically on, um. Egg freezing and, and I mean specific fertility preservation in patients that do that have cancer that are going through treatments, do you guys specialize specifically in that? I mean, I know you do range  **Dr. Nirali Jain:** Yeah. Yeah, because it's such a small community, we all have our own niches and we all kind of have our own interests and  **Michelle Oravitz:** Yeah.  **Dr. Nirali Jain:** no like specific training. There are a couple courses that you take that I took in in training as well, just to kind of understand what it sounds like to, I. Council of fertility preservation, patient with and without cancer. **Dr. Nirali Jain:** Um, and then, you know, you kind of just learn by experience and you form a niche for something that you're passionate about. 'cause that's what makes you, you know, really thorough in, in your treatment. [00:29:00] So that's one of my interests. Um, and, but I would say,  **Michelle Oravitz:** training for that. It's just like  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** just know how to treat that in  **Dr. Nirali Jain:** exactly.  **Michelle Oravitz:** especially if you're interested in doing that.  **Dr. Nirali Jain:** Exactly. That's exactly right. It's kind of, it just comes with the experience comes with your mentors and who you're surrounded by, and everyone kind of helps each other get to that point. But there are several specialists in our practice at RMA that specialize specifically in fertility preservation in cancer patients. **Dr. Nirali Jain:** So we have a close communication with our oncologist and they know who to refer to within the practice because everyone has their own little interests.  **Michelle Oravitz:** Amazing.  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** Um, definitely. I, like I said, I really enjoy picking your brain because it's a lot of fun for me. I, I do  **Dr. Nirali Jain:** Totally.  **Michelle Oravitz:** acupuncture, so  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** and I, I think that it's just so crazy that our fields don't work together. I mean, we kind of do, but I think, I just feel like it would be so great  **Dr. Nirali Jain:** exactly.[00:30:00]  **Michelle Oravitz:** the expertise because you guys have immense. Benefits like in, in, uh, technology and incredible innovations and, and then the natural aspect of really understanding the, the body. And I, I just think that it would work so amazing together if it was more of like a thing. 'cause it, I know in China they actually combine the two  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** eastern.  **Dr. Nirali Jain:** Yeah, I mean I think that that's so important and there is data that shows, you know, there's actually a recent study that came out just a few weeks ago on the benefits of acupuncture for fertility patients. And we know that, I mean, I recommend it to all of my patients, specifically the day of the embryo transfer. **Dr. Nirali Jain:** We, luckily, we offer it on site at RMA and we have acupuncturists that come in and, and do a session before and after the embryo transfer, and I think. A lot of that is targeted towards stress relief. But I also think that holistically it's important to feel at your best when we're doing something that's so crucial to your, to your health. **Dr. Nirali Jain:** So to really focus on the diet, focus on stress relief, [00:31:00] focus on meditation, yoga, whatever it takes to get to your best wellbeing when you're going through fertility treatments, um, is so important. So I appreciate  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** like you that really specialize in the other side of. Of this, because I do consider it still part of the holistic medicine that we need to really maximize success for our patients. **Michelle Oravitz:** Awesome. Well,  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** Jane, this is such a pleasure Of talking to you. You've given us some, so much great information and we've definitely dived into a, do a topic that I don't typically, I haven't yet spoken about. But, um, that being said, it's such an important topic to talk about. And thank you so much for coming on today. **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** course. **Michelle Oravitz:** I get off, how can people find you?  **Dr. Nirali Jain:** That's a great question. So I have, um, a social media page. I, it's called Expert nc. So like EGG,  **Michelle Oravitz:** I  **Dr. Nirali Jain:** um, expert nc. Try, tried to make it a little bit humorous. Um, but I'm all over social [00:32:00] media and would love to hear from anyone that is listening. I, you know, every, every day I get different, um, dms and I'm happy to respond. **Dr. Nirali Jain:** I love hearing about everyone else's. Stories and things like that. Um, so that is kind of my main, main social media platform. Um, and then through like RMA and Reproductive Medical Associates, we also have a YouTube channel. We have an Instagram page, um, of our office available, um, as well that is public. **Dr. Nirali Jain:** So you can find us pretty easily if you just kind of hit Google. But um, yeah, I'm kind of developing my social media platform as the expert and I hope it grows.  **Michelle Oravitz:** Love it. Great.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** was such a pleasure talking to you. Thank you. so much **Dr. Nirali Jain:** Thank you. **Michelle Oravitz:** today.  **Dr. Nirali Jain:** Of course. Thank you so much for having me.  [00:33:00]   

If you want to get leaner and live longer, check out https://milliondollarbodylabs.com/   What if your low energy, brain fog, or poor sleep had more to do with your hormones than you realize?   In this episode, I sat down with Patricia Zamora, a nurse practitioner who helps men improve their health through hormone balance. We talked about how to raise testosterone naturally, when TRT might be a good option, and why some men still don't feel great even if their lab numbers look normal.   Patricia shared why cardio is key for overall health, especially if you're on testosterone. We also covered how medications like Clomid and Enclomiphene work, and why many regular doctors aren't fully trained in hormone therapy.   We wrapped up with simple habits that can make a big difference, like walking more and slowing down with breathing or mindfulness. If you've been feeling off and want to get back to feeling like yourself, this episode is a great place to start.   Key Takeaways:    TRT Isn't Always the First Step.   Most doctors aren't trained in hormone therapy. Don't assume your GP is an expert.   Hormone issues affect both partners. Couples should learn and work through it together.   Resources:    Patricia Zamora is a men's health nurse practitioner who focuses on hormone optimization, testosterone therapy, and sexual wellness. With a passion for education and practical solutions, she helps men understand how lifestyle, stress, and medical care affect their hormones and overall health. Patricia also emphasizes the importance of cardio, mindfulness, and clear communication in relationships for long-term well-being.   Patricia Zamora's Website thepatriciazamora.com   @themenshealthnp (IG)  https://www.instagram.com/themenshealthnp    YouTube Channel https://www.youtube.com/@themenshealthnp  _________________________________________ Host Nate Palmer The founder of The Million Dollar Body and Author of "The Million Dollar Body Method", Nate has been in the industry of coaching over 15 years and has worked with over 1000 clients personally. Nate Palmer's Website: https://milliondollarbodylabs.com/    "The Million Dollar Body Method" by Nate Palmer: http://getnatesbook.com   Lean Energy Stack: https://milliondollarbodylabs.com/pages/lean   @_milliondollarbody (IG) https://www.instagram.com/_milliondollarbody

Dr. Natalie Crawford answers your fertility questions called into the voicemail. Questions Answered: -What happens if you lose your period after stopping birth control? -Is it normal to have low basal body temperatures during the luteal phase? -Should someone with regular cycles but a potentially short luteal phase consider taking Clomid? -How significant is a drop in AMH and increase in FSH between ages 29 and 31? -Can a past chlamydia infection cause long-term fertility difficulties? -Is it safe to have a colonoscopy while starting IVF or during breastfeeding? -Can women with PCOS donate their uterus or become surrogates? - What physical activities are recommended or restricted after an IUI? Want to receive my weekly newsletter? Sign up at ⁠nataliecrawfordmd.com/newsletter⁠ to receive updates, Q&A, special content and my FREE TTC Starter Kit! Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page ⁠@nataliecrawfordmd.⁠ You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today!     Thanks to our amazing sponsors! Check out these deals just for you: Quince- Go to ⁠Quince.com/aaw ⁠for free shipping on your order and 365-day returns Ritual-Go to ⁠ritual.com/aaw⁠ to start Ritual or add Essential For Women 18+ to your subscription today. Calm - Go to ⁠calm.com/aaw⁠ for 40% off unlimited access to Calm's entire library. AquaTru - Go to ⁠aquatru.com⁠ and use code AAW for 20% off! If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram ⁠@nataliecrawfordmd,⁠ check out ⁠Natalie's YouTube channel Natalie Crawford MD⁠, and if you're interested in becoming a patient, check out ⁠Fora Fertility. Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us a textIn this episode, I'm walking you through my full story — the highs, the heartbreaks, the hospital rooms, the quiet breakdowns, the Clomid, the IUIs, the IVF, the separation, all the decisions… all of it.You'll hear about Jade, Angel, and Hope...the daughters we lost.You'll hear how we almost gave up.And you'll see how Dane and Kyle came into this world in a way I never imagined, but wouldn't change for a second.If you're walking through infertility, loss, or the brutal in-between where your life doesn't look how you thought it would… this one's for you.It's raw. It's unfiltered. And it's the story I've never fully told — until now.#TheKeriCroftShow #InfertilitySeries #InfertilityAwarenessMonth #1in6  #InfertilityJourney #YouAreNotAlone #PregnancyLoss #realtalk To learn more about Keri's Dream Surrogate Workshop go to: https://kericroft.com/surrogacy-workshop-----Use promo code KERI for 20% your first order at Fluff! www.thefullapp.coMention KERI for $100 off your first treatment at Donaldson. Use code CROFT for $25 off your first visit at Boss Gal Beauty Bar.Book your appointment at Headspace by Mia Santiago today at https://miasantiago.glossgenius.com/

Welcome to another heartfelt episode of the Fertility in Focus Podcast with your host, Dr. Christina Burns.In this episode, Dr. Christina is joined by Michelle Villatoro, a hospitality strategist and founder of Just Think Hospitality, who courageously shares her deeply personal and emotional fertility journey. Together, they explore the emotional highs and lows of trying to conceive, how she struggled with a very low ovarian reserve, multiple IVFs, an ectopic pregnancy, and more. They talk through the suggestions on how to speak to someone going through a fertility challenge and the effects of the medications and process on the mental health of the patient.  As always Dr. Christina is solutions focused and so covers ways to find peace and power in the process. The conversation explores everything from logistical aspects of the fertility journey such as self advocacy and the deeper, very powerful effects of spirituality and manifestation. Michelle happens to have a great sense of humor and brings a lightness to the conversation with her hilarious anecdotes. Whether you're going through fertility treatments or supporting someone who is, this episode offers a powerful mix of vulnerability, wisdom, and inspiration.In this episode, you will learn:How Michelle's fertility experience shaped her work in improving patient careThe emotional impact of IUI, IVF, pregnancy loss, ectopic pregnancy and hormone treatmentsWhy compassion and validation matter in fertility treatmentThe power of mindset, self-advocacy, and community in fertility journeysMichelle's inspiring story of becoming a mom—and the unexpected miracle that followedTimestamps:[0:26] Meet Michelle and her work in hospitality and patient experience[2:17] Empathy gaps in fertility care and what to say instead of “I know how you feel”[8:45] Michelle's fertility journey begins and her first pregnancy loss[15:04] IUI struggles, Clomid side effects, and switching to Letrozole[18:25] Going all in with IVF and lifestyle changes[23:12] Embryo loss, emotional lows, and staying committed[26:41] The B embryo transfer—and the long wait[28:35] The call that changed everythingMichelle's info:https://www.instagram.com/mc_szmajda/?next=%2Fhttps://www.linkedin.com/in/michelleszmajda/https://justthinkhospitality.com/

On today's episode, Ali talks to Intended Parent, Maggie, and Surrogate, Jessie, about working with ConceiveAbilities, a leading egg donor and surrogacy agency. Maggie explains how she and her husband, Matt, started trying to conceive more than five years ago. She talks about seven rounds of Clomid, multiple miscarriages, and moving on to IVF. When that wasn't successful, she pivoted to surrogacy, after she and Matt were matched with Jessie. Jessie talks about being a nurse, why there are so many nurses who become surrogates, and why she decided to become a surrogate in the first place. "My heart just ached for women who couldn't have babies," Jessie says. "I love my babies so much. I feel so deeply passionate about making sure that another woman has a chance to love a baby, because it's just the greatest gift." Maggie and Jessie talk about meeting for lunch before the transfer, their deep bond, the difficulties of her pregnancy, and finally, how Maggie's daughter, Josie, entered the world. Maggie also talks about where she and Matt are now. Make sure to stay tuned to the end!Find out more about ConceiveAbilities on IG: https://www.instagram.com/conceiveabilities/For more information on ConceiveAbilities Empower Nurse Campaign click on this link:https://share.conceiveabilities.com/apratoncFor more information on surrogacy or becoming a surrogate click on this link:https://share.conceiveabilities.com/apratorafTOPICS COVERED IN THIS EPISODE: Infertility; TTC; miscarriage; Clomid; IUI; IVF; egg retrieval; immunotherapy drugs; surrogacy; IVF success; surrogacy successEPISODE SPONSORS: WORK OF ARTAli's Children's Book about IVF and Assisted Reproductive Technologyhttps://www.infertileafgroup.com/booksDo not miss Ali's children's book about IVF! It's been getting rave reviews. “Work of ART” is the story of an IVF kiddo the day he learns he is a “work of ART” (born via IVF and ART). For young readers 4-8. Hardcover. Written by Ali Prato; Illustrated by Federico Bonifacini.Personalized and non-personalized versions are available. Order yours now at https://www.infertileafgroup.com/booksFor bulk orders of 10 or more books at 20% off, go to https://www.infertileafgroup.com/bulk-order-requestFERTILITY RALLYIG: @fertilityrallywww.fertilityrally.comNo one should go through infertility alone. Join the Worst Club with the Best Members at fertilityrally.com. We offer 5 to 6 support groups per week, three private Facebook groups, tons of curated IRL and virtual events, and an entire community of more than 500 women available to support you, no matter where you are in your journey.Join today at link in bio on IG @fertilityrally or at www.fertilityrally.com/membershipEMBRYO SOLUTIONIf you're navigating infertility, have you ever thought about embryo donation as a family building solution? Embryo donation is when one family that has gone through IVF donates their embryos to support the family-building efforts of another family. Embryo Solution is an agency with an important mission: to fill the gap between infertility and excess embryos by connecting all parties involved. Whether you're looking to build your family or you've gone through IVF and you have embryos in storage that you're not sure what to do with, Embryo Solution can help. To find out more go to www.embryosolution.com Advertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacySupport this podcast at https://redcircle.com/infertile-af/donationsSupport this podcast at — https://redcircle.com/infertile-af/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Dr. Natalie Crawford discusses PCOS treatment options, emphasizing the importance of understanding the normal ovulation process. Letrozole is a common treatment for PCOS, working by reducing estrogen levels to stimulate FSH production. She advises monitoring with ultrasounds and progesterone levels. For those not responding to Letrozole, Clomid may be considered. Dr. Crawford also highlights the role of lifestyle changes, including diet, exercise, and stress reduction, in managing PCOS. She mentions the potential benefits of GLP-1 agonists for weight loss and insulin resistance, though they should be discontinued before attempting pregnancy. Want to receive my weekly newsletter? Sign up at nataliecrawfordmd.com/newsletter to receive updates, Q&A, special content and my FREE TTC Starter Kit and Vegan Starter Guide! Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page @nataliecrawfordmd. You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today!      Thanks to our amazing sponsors! Check out these deals just for you: Quince- Go to Quince.com/aaw for free shipping on your order and 365-day returns Ritual-Go to ritual.com/aaw to start Ritual or add Essential For Women 18+ to your subscription today. Rula - Go to Rula.com/aaw and take the first step towards better mental health today. Aquatru - Go to aquatru.com and use the code AAW for 20% OFF any AquaTru purifier! If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram @nataliecrawfordmd, check out Natalie's YouTube channel Natalie Crawford MD, and if you're interested in becoming a patient, check out Fora Fertility. Learn more about your ad choices. Visit megaphone.fm/adchoices

Subscribe to our channel: https://www.youtube.com/@optispanIs testosterone therapy right for you? In this episode, Matt Kaeberlein & Kevin White explore the benefits, risks, and misconceptions of testosterone replacement therapy (TRT). Learn about low testosterone symptoms, when to get tested, and the differences between primary and secondary hypogonadism. We also cover treatment options like injections, creams, and Clomid, plus the impact on heart health, longevity, and mental well-being.0:00 - Introduction to Testosterone Therapy1:25 - The Gradual Decline of Testosterone in Men3:35 - Symptoms and When to Get Tested6:00 - Primary vs. Secondary Hypogonadism Explained10:34 - Common Misconceptions About Testosterone Therapy19:07 - Different Treatment Options: Injections, Creams, and More24:41 - Addressing Risks: Cancer, Mood, and Heart Health32:20 - Can Testosterone Therapy Improve Longevity?39:02 - Mental Health & Quality of Life Benefits51:14 - How Many Men Actually Need Testosterone Therapy?Producers: Tara Mei, Nicholas ArapisVideo Editor: Jacob KeliikoaDISCLAIMER: The information provided on the Optispan podcast is intended solely for general educational purposes and is not meant to be, nor should it be construed as, personalized medical advice. No doctor-patient relationship is established by your use of this channel. The information and materials presented are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. We strongly advise that you consult with a licensed healthcare professional for all matters concerning your health, especially before undertaking any changes based on content provided by this channel. The hosts and guests on this channel are not liable for any direct, indirect, or other damages or adverse effects that may arise from the application of the information discussed. Medical knowledge is constantly evolving; therefore, the information provided should be verified against current medical standards and practices.More places to find us:Twitter: https://twitter.com/optispanpodcastTwitter: https://twitter.com/optispanTwitter: https://twitter.com/mkaeberleinLinkedin: https://www.linkedin.com/company/optispanInstagram: https://www.instagram.com/optispanpodcast/TikTok: https://www.tiktok.com/@optispanhttps://www.optispan.life/Hi, I'm Matt Kaeberlein. I spent the first few decades of my career doing scientific research into the biology of aging, trying to understand the finer details of how humans age in order to facilitate translational interventions that promote healthspan and improve quality of life. Now I want to take some of that knowledge out of the lab and into the hands of people who can really use it.On this podcast I talk about all things aging and healthspan, from supplements and nutrition to the latest discoveries in longevity research. My goal is to lift the veil on the geroscience and longevity world and help you apply what we know to your own personal health trajectory. I care about quality science and will always be honest about what I don't know. I hope you'll find these episodes helpful!

 "Als je PCOShebt en zwanger wilt worden, heb je waarschijnlijk al gemerkt dat het nietaltijd vanzelf gaat. Misschien heb je een onregelmatige cyclus, geen ovulatieof twijfel je of jouw voeding en leefstijl wel bijdragen aan je vruchtbaarheid.Veel vrouwen krijgen direct te horen dat ze medicatie nodig hebben, zoals letrozol,Clomid of Metformine. Maar wist je dat je met de juiste aanpassingen je kansenop een natuurlijke zwangerschap aanzienlijk kunt verhogen?"

In this episode of The Wholesome Fertility Podcast, Dr. Amelia Kelley @drameliakelley , a trauma-informed therapist, discusses her journey and insights into high sensitivity, coping mechanisms, and the impact of trauma on mental health. She explores the differences between empathy and compassion, the importance of understanding one's nervous system, and shares her personal fertility journey, highlighting the integration of holistic approaches such as acupuncture and herbal medicine. In this conversation, Dr. Amelia Kelley and Michelle explore the complexities of pregnancy loss, trauma, and the role of the nervous system in fertility. They discuss the importance of letting go of control and embracing spirituality, as well as the dynamics of being a highly sensitive person (HSP). The conversation delves into the benefits of body awareness and how it can aid in healing, while also addressing the challenges HSPs face in relationships and daily life. Ultimately, they highlight the adaptive nature of high sensitivity and its prevalence in the population, encouraging listeners to embrace their sensitivity as a gift rather than a burden.   Takeaways   Coping skills should be viewed as a lifestyle. High sensitivity is a genetic trait, not a flaw. Empathy can have negative health effects. Highly sensitive people require more alone time for regulation. Generational trauma can impact reproductive health. Understanding one's nervous system is crucial for coping. Holistic approaches can aid in fertility journeys. Stress and nervous system balance are crucial for fertility. Highly sensitive people (HSPs) experience the world differently. Body awareness can enhance healing processes. HSPs often respond more positively to therapeutic interventions. High sensitivity is an adaptive trait found in many individuals. Embracing sensitivity can lead to greater self-awareness and compassion.   Guest Bio:   Dr. Amelia Kelley is a trauma-informed therapist, author, co-host of The Sensitivity Doctor's Podcast, researcher, and certified meditation and yoga instructor. Her specialties include art therapy, internal family systems (IFS), EMDR, and brainspotting. Her work focuses on women's issues, empowering survivors of abuse and relationship trauma, highly sensitive persons, motivation, healthy living, and adult ADHD.    She is currently a psychology professor at Yorkville University and a nationally recognized relationship expert featured on SiriusXM Doctor Radio's The Psychiatry Show as well as NPR's The Measure of Everyday Life. Her private practice is part of the Traumatic Stress Research Consortium at the Kinsey Institute.    She is the author of Powered by ADHD: Strategies and Exercises for Women to Harness their Untapped Gifts (whichhas a corresponding online support group!), Gaslighting Recovery for Women: The Complete Guide to Recognizing Manipulation and Achieving Freedom from Emotional Abuse, coauthor of What I Wish I Knew: Surviving and Thriving After an Abusive Relationship, as well as Surviving Suicidal Ideation: From Therapy to Spirituality and the Lived Experience, and a contributing author for Psychology Today, ADDitude Magazine, as well as Highly Sensitive Refuge, the world's largest blog for HSPs. Her work has been featured in Teen Vogue, Yahoo News, Lifehacker, Well + Good and Insider.   You can find out more about her work at https://www.ameliakelley.com.   Follow her on Instagram @drameliakelley   https://www.instagram.com/drameliakelley/   https://www.facebook.com/DrAmeliaKelley   https://www.linkedin.com/in/drameliakelley/   https://www.psychologytoday.com/us/blog/in-your-corner       For more information about Michelle, visit: www.michelleoravitz.com   Check out Michelle's Latest Book: The Way of Fertility! https://www.michelleoravitz.com/thewayoffertility   The Wholesome FertilityFacebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/   Instagram: @thewholesomelotusfertility   Facebook: https://www.facebook.com/thewholesomelotus/     Transcript:     Michelle (00:00) Welcome to the podcast Amelia.   Dr. Amelia Kelley (00:02) Thank you for having me. It's good to see you again.   Michelle (00:04) It's so good to see you. So Amelia's had me on her podcast, the sensitivity doctors in the past, and I would love for you to share your background. I am really interested and very intrigued by what you do because it's something that we spoke about. I totally relate to. I love the fact that you've authored so many books and have such an interesting background. So I would love to have the.   Dr. Amelia Kelley (00:26) Hehehe   Michelle (00:30) audience hear you.   Dr. Amelia Kelley (00:32) Sure. Well, I'm currently in my office. So I'm a trauma informed therapist, professor, and podcaster, which is how you and I met. And I've been in the field for 20 years now. I primarily work with trauma of various forms, but a lot of it is interpersonal trauma, relationship trauma, some issues with sexual abuse, some instances where I also work with per...   a lot of first responders, so cops, doctors, and also folks from the military. So I'd say that my work is kind of an intersection. I sometimes call myself an integrative therapist because just before our session, I was doing a yoga therapy session. I do everything from EMDR, brain spotting, yoga therapy, art therapy is actually my background, sand play therapy.   Michelle (01:02) Mm-hmm.   Dr. Amelia Kelley (01:27) I'm so into the brain too. I mean, I'm not, I would not say that my practice is comprehensive in neurofeedback. We do some minor interventions, but I love referring my clients to practitioners in the area to make sure that their brain health is on par too. And I also love referring to Carolina Clinic of Natural Medicine is my favorite in the area, but they do things like acupuncture and.   Michelle (01:40) Hmm.   Mm.   Dr. Amelia Kelley (01:54) kind of holistic health, which I know really aligns with what you do. So, yeah.   Michelle (01:59) it's interesting because as you start to do anything, you start to find out how many different layers and different ways and methodologies that certain people respond to better than others. there's just so many different methods. And I think that some people just respond better to some.   Dr. Amelia Kelley (02:10) Right.   Right.   yeah. I think that's a great thing about coping skills. First and foremost, I love the idea of obliterating this idea that a coping skill is like work or that it's something that you only do when you're struggling. I think it's more of a lifestyle. And everyone is going to respond differently. Like I know I personally...   Michelle (02:35) Yes.   Dr. Amelia Kelley (02:41) water is very big for me. Like if I'm really stressed or I'm dysregulated, getting in hot water or cold water is very regulating for my nervous system. Whereas I have clients who the last thing they want to do when they're stressed or dysregulated is shower or get in water. It's actually one of the first things that they stop wanting to do.   Michelle (02:51) Mm-hmm.   Dr. Amelia Kelley (03:04) So it's so interesting seeing how we all respond differently, I think, in our own unique nervous system when we're under stress.   Michelle (03:11) Yeah, definitely. I find that also with my patients. mean, some people, be much more open to like things like meditation, other people, there's other ways to self soothing, which I call it, because ultimately, that's really what it is. So yeah, it definitely isn't work. sounds like work.   Dr. Amelia Kelley (03:20) Mm   Mm-hmm.   Right.   Michelle (03:30) but it's not work. think the biggest work is really the strategy and kind of figuring it out. But ultimately it's really there to soothe you at times that you feel overwhelmed.   Dr. Amelia Kelley (03:35) Mm-hmm.   Absolutely. I couldn't agree more.   Michelle (03:44) So let's talk about the sensitive person because I've always felt that that was something that I can describe myself as when I was younger. It was something that I felt I found myself more overwhelmed by noises, by certain people's energy than other people. And people would just be like, you're too sensitive or you focus on things too much. And   Dr. Amelia Kelley (03:52) Mm   Okay.   Michelle (04:08) It was something that I realized, as I met other people like me. I was like, wait, this is kind of a thing. And then when I learned about it, that it really is a thing, I found it really interesting. And it also, I found it very comforting. So it's like, okay, I'm like, I'm not abnormal. Like this isn't crazy. Yeah. So I would love for you to talk about that. So I feel like a lot of people can relate.   Dr. Amelia Kelley (04:14) Mm-hmm.   Mm-hmm.   Mm-hmm.   Right, Mm-hmm.   Definitely, and I know my aha moment was a big deal to me. It was years ago now. I stumbled upon Dr. Elaine Aaron, who is kind of the pioneer of some of the modern research on high sensitivity on her documentary, Sensitive, the Untold Story.   And it was one of those light bulb aha moments that made so much of my life make sense. Interestingly though, when I dug a little deeper, she was not the of the originator of this. It was actually research done in the 80s on babies and their responses to different stimuli. Things like they had...   Michelle (04:59) you   Mm.   Dr. Amelia Kelley (05:17) auditory stimulation with like a creepy face making sound. had light stimulation, physical stimulation. And what they found was that the babies who were more reactive, they were calling high reactive babies, you know, which down the road became high sensitivity. But the really interesting thing is that the researchers went and followed up with these babies who are now in their midlife, you know, they're in their   I'd say probably 40s at this point, 30s and 40s. And they're finding that those high reactive babies still are more reactive adults. And so this doesn't mean someone who's highly emotional or can't control their temper when we think of reactivity. It's more, what is your reaction to sensory input? And certain brains, it is genetic.   Michelle (06:07) Mm-hmm.   Dr. Amelia Kelley (06:10) So it's a predisposition. It is a genetic trait. It is not a diagnosis. It is not something to fix. It is rather something to learn from and grow with and manage and live life in that way. And so it's highly genetic. And for that reason, I'm not surprised I have kids who are definitely highly sensitive. And high sensitivity can express in so many different ways. It can look like   Michelle (06:10) you   Mm-hmm.   Mm-hmm.   Dr. Amelia Kelley (06:39) hypersensitivity to medication, sensitivity to light, to sound, to being rushed to other people's emotions. That's a big part. The empathy piece is very strong. I think it's really important to understand the difference between empathy and compassion when we consider highly sensitive people. you, like when I say that, does that make sense to you? Do you want me to unpack that?   Michelle (06:52) Mm-hmm.   It does. mean, so what I'm perceiving in that is that empathy is kind of like almost giving more of your own personal energy to something versus just feeling compassion and understanding that another person's emotions or perspectives without almost taking it on. I'm not sure if I'm on or not.   Dr. Amelia Kelley (07:08) Mm-hmm.   Well, mean, I think that's we can all define it differently, but I guess if I was going to scientifically define compassion and empathy. So empathy is our ability to feel what someone else is feeling. We all tend to know that definition. However, the interesting thing is that empathy has a negative impact on your immune health and it increases inflammation. Right. And so when we consider the fact that highly sensitive people   Michelle (07:34) Mm-hmm.   Mm-hmm.   Well, that's interesting.   Dr. Amelia Kelley (07:56) have more active mirror neurons, which means the areas of their brain designed to plan social interactions, problem solving around social interactions, and even something as simple as, as a highly sensitive person, one of my ways to decompress is to watch like trashy reality TV at night. And so I will find myself as I'm watching these dating shows, smiling with the contestants.   Michelle (08:15) Yeah   Mm-hmm.   Dr. Amelia Kelley (08:23) or frowning with them. Sometimes I kind of laugh when I catch myself doing it. As a highly sensitive person, those areas of the brain are so much more active. And so it does make us have higher levels of empathy. But when you consider the fact that that can negatively impact your body, if you don't have enough boundaries around them, empathy is pro-social. It helps us get along, but also too much can be draining.   Michelle (08:32) Mm-hmm.   Mm-hmm.   Dr. Amelia Kelley (08:50) And so compassion is actually kind of the anecdote to empathy because compassion is centered around the desire to act or help. And so this, when we think of self-compassion, the act of speaking to yourself kindly is an act. So you empathize for yourself, I feel bad today because I made a mistake. Just thinking of an example. The compassion is,   Michelle (08:50) Right.   Mm-hmm.   Dr. Amelia Kelley (09:18) I'm going to choose to speak to myself kindly and with love because that will be curative for me. Whereas if you stay in an empathy response, you just continue to feel bad about whatever mistake you made, right? And so for highly sensitive people, it's exponentially important to lean into compassion and we can't all go out and save the world all the time. So sometimes this looks like well-wishing meditation.   Michelle (09:24) Done it.   Got it.   Mm-hmm.   Dr. Amelia Kelley (09:46) processing with other like-minded people, those can be ways to express compassion that doesn't all have to be going out. And I remember, do you remember the movie Free Willy?   Michelle (09:58) yeah, but I don't remember if I saw it or I don't remember the actual movie. wait, though. It was the one with the whale, right? Yes. Yeah.   Dr. Amelia Kelley (10:06) Right, it was fiction, obviously, but as an HSP or an HSC at the time, a highly sensitive child, when that movie was over, I was destroyed at the thought of all these whales in the world who need help. And so my gracious parents who encouraged my sensitivity helped me find an organization where could adopt a whale. So it's like, and I mean, who knows what's happening. We probably paid $20 and...   Michelle (10:29) that's cute.   Dr. Amelia Kelley (10:34) I've adopted a whale, who knows, but it was the act of taking my empathy response and putting it into action with compassion that was curative for my little highly sensitive child heart.   Michelle (10:34) Yeah.   Hmm.   That's beautiful. actually really love that. And it also makes you feel like there's more purpose in the feelings that you're having. You're kind of taking the feelings and creating purpose with it.   Dr. Amelia Kelley (10:57) Absolutely. That's such a way of putting it.   Michelle (11:01) And one thing too, that I was thinking about when you were talking about being highly sensitive, which I could tell you right now, I 100 % am self-diagnosed. The nervous system, I think to myself about the nervous system and possibly that having something to do with it, just having a more heightened sensitive nervous system.   Dr. Amelia Kelley (11:09) Mm-hmm   Mm-hmm.   Michelle (11:22) Besides obviously the antidote and kind of like using or acting or doing, to translate the empathy, but as one part of regulating the nervous system, learning to manage the nervous system, doing things like you said, like when you get home, take a shower, do something that really connects with your nervous system, I feel like is a really great tool. And figuring out what that is, is that something that you often look into?   Dr. Amelia Kelley (11:49) Absolutely. Because if you think about just a handful of the questions that I was posing that help you identify if you're highly sensitive, a lot of them have to do with nervous system response. highly sensitives are more responsive to caffeine, drugs and alcohol, pain tolerance, hunger cues even, are more, you know, felt more intensely. So with HSPs, the nervous system, specifically the limbic   system is more active. And this is something that can be seen on actual scans of HSP brains. It is. It's wild. so I was having a really interesting conversation with Michael Allison, who is one of the instructors for the Polyvagal Institute. And he was talking about, I don't think if he really fully bought into the HSP thing, I think he sees everything through the Polyvagal world.   Michelle (12:20) Mm-hmm.   That's so interesting.   Mm-hmm.   Dr. Amelia Kelley (12:48) And which I totally appreciate. There's different ways to look at our nervous systems. But he said something when we were talking about highly sensitive that really struck a chord to your point about the nervous system. He was saying when our nervous system alerts danger and for him that means the vagal break is off and the vagus nerve is overactive, the heart rate is up, fight flight. When we're not feeling safe.   It's usually because we're attending to something we think we need to attend to because it's out of sorts. And so the highly sensitive person, a look on your face could alert danger to me. Like someone seeming off or upset or concerned could signal that. And so for the highly sensitive person,   Michelle (13:23) Mm-hmm.   Mm-hmm.   Mm-hmm.   Dr. Amelia Kelley (13:42) They need more time and research has shown up to two hours of unstructured alone time per day is most quote prescribed for highly sensitive. And so the reason being is that our baseline is higher all the time. And so we need more things to regulate the nervous system so that sounds and things and emotions aren't pulling us out of our safety zone so quickly.   Michelle (13:49) Mm-hmm.   Right.   Mm-hmm.   my God, that makes sense on so many levels. I always felt like I needed, I need alone time. Like after a while, I just need to be by myself. need quiet. I need peace. And I totally understand what you're saying. And then also what's interesting is I remember when I was younger, always being afraid, like if somebody was mad at me or like, I would kind of feel a tone of like, my God, are they mad at me? And I get like really upset. And now I had to like learn to   Dr. Amelia Kelley (14:19) Mm-hmm.   Mm-hmm.   Yes.   Michelle (14:42) just be like, okay, it's not that big of a deal. Maybe they were having a bad day, you know, sort of speak to myself on that, but that makes sense. And then I noticed that with my daughter, if sometimes I'll be busy and I won't respond with like a, you know, a full response, I'll be like, okay, okay, we'll talk later or whatever. Are you mad at me? And I always tell her, believe me, I would tell you I'm pretty clear about like what I'm happy about and not happy, you know.   Dr. Amelia Kelley (14:52) Mmm.   Hmm.   Right.   Michelle (15:07) And, but it's interesting. She'll kind of read between the lines with me. And she's like me, she just took after me. So it's kind of, yeah, so she's 19.   Dr. Amelia Kelley (15:12) Mm   How old is she, I ask? OK, so she's older. I was going to say, I know a great workbook, but it's for younger kids. yeah, she definitely, especially if you are too, it wouldn't surprise me that she would also be highly sensitive because it is so genetic.   Michelle (15:23) Yeah.   And she got like that more as she got older when she went to college than even before, for some reason. I don't know if maybe because she has a lot more going on or, she's starting to regulate on a different level, her nervous system. Cause I think that coming from home, things shift and change.   Dr. Amelia Kelley (15:39) Mm-hmm.   Right.   Totally. mean, think it's research has shown that some high sensitivity traits, you know, can be very present in childhood, but then there's other different types of traits that become more expressed later in life. But   Michelle (16:04) Mm-hmm. Yeah.   Dr. Amelia Kelley (16:06) I also beg to say, let's look at the external factors. You look at someone who is a highly sensitive child who didn't have to raise children, work a job, manage a home. So when you just keep adding more to your exactly, that can make those traits become more expressed too, I believe.   Michelle (16:16) Yeah, right.   Yep, responsibility. Yeah, for sure.   So I want to actually take this into your own journey, because I know you've had your fertility journey, because a lot of listeners, are going through the fertility journey. And I know a lot of people just based on my own clients and patients that are very sensitive and highly sensitive as well.   Dr. Amelia Kelley (16:38) Mm-hmm.   Mm-hmm.   Michelle (16:48) I work a lot with them on, I don't know if you've ever heard of the NADA protocol. It's really good for PTSD. NADA, it's used, it's, yeah, yeah. So NADA, and it's a protocol that they use on the ears. it's like a, it's a series of ear points that we use like altogether.   Dr. Amelia Kelley (16:54) No. I love learning new things. Tell me. NADA. I have nothing to write on. Okay.   Michelle (17:12) And it works on regulating the nervous system. And it actually works amazing on it's even had published studies on working with vets, people with PTSD, like really major PTSD. Yeah. Yeah, I know. It's, it's really, really interesting. And, and also interestingly enough,   Dr. Amelia Kelley (17:23) I need a pen. Let me just grab one.   Do you use the mustard seeds or is it actual needles?   Michelle (17:33) So you could use the seeds. I use needles. I use needles. then some people, no, no, they're not mustard seeds, but they're seeds. And then some of the studies that were published, I think they even added electric stimulation. And what's interesting is it's not just really great for   Dr. Amelia Kelley (17:36) They're probably not called mustard seeds. I forgot what are they actually.   Mm-hmm.   cool.   Thank   Michelle (17:51) PTSD, but it's also really good for addiction. And interesting, if you think about the two, like what do they have in common? They're kind of like, it runs, they run on a loop. You know, it's this repeated either thoughts or behaviors. And it seems to kind of have that in common. Obviously it's two different things, but sometimes can cross over.   Dr. Amelia Kelley (17:56) wow.   Mm-hmm.   Mm-hmm.   I love that. It's funny. It looks like you're on my podcast right now. So I'm like, let me take notes on what you're saying. You're so smart and knowledgeable in these areas. I love it. I will definitely check that out. I would be so curious if that's something that there are, like I said, a lot of veterans and addicts that I work with. And so I'm definitely going to look into that.   Michelle (18:16) So.   No, no, I know. It will...   I feel the same about you. it makes for a great conversation.   Yeah, definitely look into the studies. I think that that's, seeing the studies and seeing the numbers really makes a difference. And so that aspect of it is amazing. And also Joe dispense does work a lot of what he does helps tons of people with PTSD, like, they do scans and study the brains. It's pretty impactful. Yeah. Yeah. So back to you though, I would love to talk to you about how you feel, your nervous system.   Dr. Amelia Kelley (18:47) Mm-hmm.   That's really neat.   Michelle (19:10) Like how were you able to figure out a way to balance yourself through the journey, knowing what you know, and how do you think it's impacted you on that nervous system level and like the trauma, because I know that it can be very traumatic, even though people don't often talk about it like that. It should be, it should be highlighted in that way so that more people have awareness around it because it really is a very difficult process.   Dr. Amelia Kelley (19:16) Right.   Mm-hmm.   Mm-hmm.   Mm-hmm.   Mm-hmm.   Michelle (19:37) has even been compared to a cancer diagnosis. It's really significant.   Dr. Amelia Kelley (19:41) Wow. Well, and I actually have something about my story that integrates the two. So I think when I really look now and I understand my nervous system better, I think that the generational trauma that I was carrying with me into my reproductive years that I didn't understand that I didn't understand my high sensitivity. I didn't have a name for it. I didn't realize that that's what that was. I just thought.   I just felt too much all the time. What I think that was doing was that when I was ready to try to start having a family is that I had been in flight mode. And when people think of flight mode, they think of like running the coop. I had been in flight mode being overly productive. And I laugh because I'm still overly productive, but it's in a different energy now. It's in a completely different energy than it was then. But.   Michelle (20:34) Yeah.   Dr. Amelia Kelley (20:39) This flight mode, think what it was doing is it was putting my nervous system in a state, like you said on my podcast, where it was never able to rest. It was never able to replenish. so my cycle was totally dysregulated. I ended up, I don't know how detailed you want me to get, but I'm happy to share. OK, OK. So I started off, we had tried to get pregnant for a couple of years and it wasn't working. And at the time, I think about it,   Michelle (20:58) you can get as detailed as you need.   Dr. Amelia Kelley (21:09) I was in my doctoral program. I was working at a women's clinic and the methadone clinic and trying to start my practice all at the same time and just live life and be like a normal adult. And so we went the route of Western medicine at first. I love my doctor and he worked with me through the whole journey, but we tried Clomid and I got pregnant. But I think now that I know what I know about egg quality, thank you, Rebecca Fett. She's amazing.   Michelle (21:19) Bye.   Yeah, she's phenomenal. I know I've tried, but she like, she wasn't really doing them. Maybe she is now, but let me know if you get her. She's great. Yes.   Dr. Amelia Kelley (21:40) my gosh, I need to get her on my podcast. Let's like.   We're going to like, we'll just go not tap, tap, tap. Come on. now that I understand what I know now about egg quality, I think that the clomid forced an egg that really wasn't ready to be fertilized. And so we miscarried that baby. And that was the first miscarriage and definitely the most shocking and painful miscarriage. From there, did my, one of my, I think healthier   trauma coping mechanisms is research. And so I just dug in and I created this kind of like wellness plan for my husband and I had like printouts. What I didn't realize is that I was basically creating what Rebecca Fett recommends without realizing what in the world I was doing. And so I had us on a laundry list of vitamins and supplements and all these things. We got pregnant again, very.   Michelle (22:33) and   Mm-hmm.   Dr. Amelia Kelley (22:45) very luckily with our daughter, who is now nine. And then that was the end of that. was like, OK, that went OK. Maybe it was just like that first miscarriage. Lots of people have it, statistically speaking. Then we were trying for our second child. And I feel like that's when I really got introduced to the world that you're in, which is the Chinese herbal medicine and acupuncture, because we   I think I had already started working with my acupunctures at that time. again, we were having a hard time getting pregnant. And so they put me on like the most disgusting tea, but it was some sort of tea regimen and these herbs. And I was doing really cool acupuncture to your point with like the little electrodes and all of that. And I did get pregnant again, but that time ended up being a molar pregnancy.   Michelle (23:26) Yeah.   Mm-hmm.   Mm-hmm.   Dr. Amelia Kelley (23:42) which you know what those are assume or I don't know if you're listeners.   Michelle (23:46) Yes, I remember learning about it. haven't had any of my patients have that, but I remember learning about it actually in school.   Dr. Amelia Kelley (23:54) Right. So the trauma of the first miscarriage was, would almost call that like acute trauma, whereas the trauma with the molar pregnancy. So a molar pregnancy, for anyone listening who doesn't know, is when the sperm and the egg join and the DNA markers are not turned on. So no actual baby starts forming, but a mass starts to form. And your body thinks you're pregnant, and so it spikes your HCG actually above kind of average levels.   I thought I was pregnant with twins. was so sick. So I go in and I'm, I want to say eight, seven, eight weeks at that point that I thought and they scanned and there's no baby, which felt like a miscarriage, but it wasn't. But what happened after it was that I still had to do a DNC and then I had to do monthly HCG tests to make sure that my levels were dropping because if your levels of HCG go up at any point, have to   Michelle (24:26) Mm-hmm.   Right.   Dr. Amelia Kelley (24:52) do chemo. So this was this chronic six month period where we couldn't try again. And every month I was going in afraid for my health.   Michelle (25:00) Mm-hmm.   my gosh.   Dr. Amelia Kelley (25:05) Right. So that was a totally different type of trauma. And then we got pregnant again. And that one we lost at 10 weeks because it was a little boy with downs. And then we finally got pregnant with our son that we have now. But I would say during that journey of those miscarriages, that was when I really dug deep into   Things like I was saying, like really taking everything serious with Chinese herbalism, looking at what I was putting in my body, looking at what was around me, my stress level, mean, meditation, really anything I could to balance my nervous system. And to your point, I think the nervous system played a role finally in us getting pregnant with our son because I think when you were on my podcast, I told you that   Michelle (25:47) Yeah.   Dr. Amelia Kelley (25:58) I was doing all these things, it wasn't working, and then finally I did that, quite essential, fine, I give up. I'm not doing this anymore. I went to my acupuncturist and I said, just do stress this time. Don't do any of the fertility treatments, please. I just don't want to even think about it anymore. And then it's so obnoxious to say, but three weeks later we got pregnant.   Michelle (26:04) Mm-hmm.   It's not, it is, it's something that I'm, well, I'm not just, know why you're saying that because people are like, what the heck? Like, it's kind of like the just relax kind of thing. saying just relax is not helpful. That's why people are like, okay, well then how, you know, that's the how, like, how do I relax? so actually let's talk about that. Cause that, that is a big thing. That's a big thing.   Dr. Amelia Kelley (26:32) Right, right.   Right. Well, I I let go of the outcome. Yeah, I think for me, it was letting go of the outcome. And I think that allowed my nervous system to get back to a safer baseline. To your point about asking about high sensitivity, I think what used to be the stress was work and school. The stressor became the goal.   Michelle (26:52) Yeah.   Yes. You know, I just hadn't, an aha, but if you want to continue, I did, I just had an aha. It's like you're taking on the responsibility of the goal. You think that it's all up to you and you're taking that weight on your shoulders. And I think that that's what it is is, and, I'm kind of thinking back cause I had Dr. Lisa Miller. I don't know if you've heard of her. She's yeah, she's amazing. You would love her. And I think she would be great on your podcast. So put her down as a   Dr. Amelia Kelley (27:06) Which, what? Ooh, no, I wanna hear it.   Mmm.   Mm-hmm.   I've heard that name.   and a jotter down.   Michelle (27:32) as an option or somebody. She went through the fertility journey, but separately from that, she's also a professor in Columbia. I think you would love talking to her because you're a professor as well. And she's a psychotherapist and she is studying spirituality in the brain.   Dr. Amelia Kelley (27:41) good. Yeah.   that's interesting. Okay.   Michelle (27:50) It's fascinating. And so they found looking at, scans of brains and how they're functioning, where they're lit up, that spiritual people who are spiritual have different brains, their brains look different. And this could be the same brain of somebody who used to not be spiritual and then became spiritual. It doesn't matter. And what's interesting is, so this is my, as you were talking, not to interrupt, hopefully you're trained a thought, but   Dr. Amelia Kelley (28:05) Interesting.   Mm-hmm.   Michelle (28:18) can come at life taking on the responsibility of every single part of our outcome and like fully micromanaging ourselves and bearing that weight or when we're spiritual, that means that we believe in a higher power or some kind of higher intelligence. We're relying on something else and not carrying all the weight. So we're just basically giving our intention out there, but, but also feeling safe enough. Like you said, safe, word safe.   Dr. Amelia Kelley (28:28) Thank   Mm-hmm.   Yes.   Michelle (28:46) to let go. So that was kind of my heart just came out.   Dr. Amelia Kelley (28:48) Hmm, absolutely. No, I love it. mean, the connection makes so much sense because and it kind of makes me think of why it doesn't have to be quote religion that someone leans into. It doesn't. It can literally be if you're someone listening who is an atheist and staunchly does not believe in a higher power, it could be energy. I mean, we can't there's no denying scientifically there's energy. mean, even   Michelle (29:01) Mm-hmm. No, no, it doesn't have to be religion.   Right?   True.   Dr. Amelia Kelley (29:18) plants have been proven to grow better when we speak to them because of the energy and probably the carbon monoxide, but like you're a carbon dioxide, but not monoxide. I'm not breathing carbon monoxide, but you can't deny energy. even if someone is not religious or I would say, I would want to ask her actually, does this hold true for someone who's not quote spiritual, but   Michelle (29:25) Yeah, yeah, yeah, dioxide. Totally. understood. Yeah.   Mm-hmm.   Dr. Amelia Kelley (29:44) who gives up things to the idea of energy. I want to ask her that.   Michelle (29:48) That's a great question. when you do have her on, let me know, because I'll be listening to the podcast.   Dr. Amelia Kelley (29:53) for sure. For sure. Thanks for the tip for the, I'll definitely check her out and reach out.   Michelle (29:57) Yeah, but it's fascinating. And I think to myself, I think that that might be that trusting in something else, trusting in an outcome or kind of releasing or relinquishing that burden and that responsibility. And that I guess that that was the aha is like taking on that responsibility of really trying to, take on the outcome, like as if you really have all of the responsibility and how it turns out and that burden and that feeling and that blame.   Dr. Amelia Kelley (30:06) Mm-hmm.   Mm-hmm.   Now I'm having an aha. Well, yes, I'm having an aha because high sensitivity. So I was talking about the mirror neurons earlier and the empathy overload with highly sensitives. Highly sensitive people, we do tend to naturally take on the responsibility of other people's emotions. And we also, even one of the questions that Dr. Aaron poses is,   Michelle (30:29) Tell me. This is great. We bounce off each other really well.   Dr. Amelia Kelley (30:54) Do you know how to make people comfortable in a room? Like things like changing the lighting and the volume and the temperature in the room. I think even as a highly sensitive person, we kind of naturally take on the responsibility of the environment. And that's why some HSPs who are not high sensation seekers, who are just, you know, kind of more of the traditional introverted expression of it, they really get overwhelmed in social settings and they don't love hosting.   Michelle (31:19) Mm-hmm.   Dr. Amelia Kelley (31:23) because it's too much to micromanage. I'm a high sensation seeking HSP, so I do enjoy hosting and having people over at my home. However, the hours leading up to the event, I need quiet and calm. I've got like a hairpin trigger nervous system leading up to inviting people in my space, even though I love it. It's like this weird.   Michelle (31:24) you   Mm-hmm.   Hmm.   Dr. Amelia Kelley (31:52) dichotomy. yeah, letting go of responsibility, think, releases the nervous system of a highly sensitive person as well.   Michelle (32:00) Yeah. And it's so interesting that you're saying that because like, I look back at my childhood, I was a really good imitator. And that just makes sense because you pick up on the little details of people's behavior and energy and you mirror that like literally.   Dr. Amelia Kelley (32:09) Mmm. Mm-hmm.   Mm-hmm.   Mm-hmm. Mm-hmm. Mm-hmm. I'm so curious and envious because I'm terrible at accents. Like, terrible. Really? Mm-hmm.   Michelle (32:26) Yeah, I used to, I would do it even when I wasn't trying. I would start to take on like, I would do it on purpose and when I wasn't trying, like I would just pick up on like certain behaviors or certain like tones and things. And I would kind of like take on like the energy of friends that would have very specific ways of talking. And I would almost be like, like I would catch myself. like, that's weird. I don't want to do that.   Dr. Amelia Kelley (32:35) Mm-hmm.   Mm-hmm.   You're like, I don't want to look like I'm really imitating them. This might get awkward.   Michelle (32:55) For sure. But it's just so fascinating. and then you're talking also highly sensitive persons that they could also have glucose sensitivity. You were saying you were talking about the physical sensitivity, right? Like that sometimes it could be allergies or other things and it's not just emotional.   Dr. Amelia Kelley (33:06) Mmm.   Mm-hmm. Well, so if you think about, it's not that they're going to have more unstable blood sugar from a technical medical stance. It's that the highly sensitive nervous system can sense peaks and valleys more than someone who is not highly sensitive. So they might respond more to hunger cues and may feel more   Michelle (33:29) Mm.   Mm-hmm.   Dr. Amelia Kelley (33:39) panic or anxiety or stress in the state of hunger. So they may be more likely to be the person that reaches for something to re-stabilize glucose. But then you can see how depending on someone's metabolic health, that might not fit well into whatever their health goals are. So I think of my non- he's actually quite highly sensitive now, but my husband- I'm going grab water.   Michelle (33:43) Mm-hmm.   Mm-hmm.   Got it.   Dr. Amelia Kelley (34:08) Sorry. My husband, who is a little bit less sensitive and has a more stable metabolic system, when he's hungry, it doesn't cause as much distress.   Michelle (34:08) Sure.   Got it.   Dr. Amelia Kelley (34:20) If that makes sense.   Michelle (34:21) a body awareness thing. because HSPs are probably much more aware of how their bodies feel because a, immediately feel it. And then that impacts their emotions or how they feel mentally. Cause a lot of emotions get processed and they're really felt in the body. think, a lot of times people don't realize that it's why somatic.   Dr. Amelia Kelley (34:39) Mm-hmm.   Michelle (34:43) work can be so beneficial. Have you looked into somatic work?   Dr. Amelia Kelley (34:48) I do offer some forms of somatic work. I am not a somatic-experiencing practitioner. That takes a full, it's almost like a whole separate degree. But I actually find what you're saying very important to highlight, too, because HSPs, while anyone listening might think, goodness, OK, I'm highly sensitive. Now what? Does this just mean that I'm in for it? Everything's going to be harder?   Michelle (34:57) wow.   Dr. Amelia Kelley (35:14) The good thing, the hopeful thing is that HSPs also respond more to positives. So they feel more positive sensation from things like a massage or acupuncture or homeopathy or different aromatherapies. They're really going to benefit from it. I think that's why   Michelle (35:20) Mm-hmm.   Dr. Amelia Kelley (35:39) My HSPs tend to stay in therapy longer. So HSPs are kind of a stronger ratio in therapy, not only because the world can feel more traumatizing at some points for HSPs, but because they just get so much out of it. I think it also leads to things like food can taste even better. Music can sound even more beautiful. Movies can be even more moving. So there's these...   Michelle (35:58) Mm-hmm.   There's benefits.   Dr. Amelia Kelley (36:09) Yeah, there's this, I wouldn't give it up. I wouldn't want to be less sensitive just because it would make me a little bit less likely to reach for a snack in the afternoon. So there's this yin and yang to it.   Michelle (36:14) brain.   Yes.   For sure. I actually like just from my own journey based on that, what I offer a lot of my patients and I always talk to them about it when I perceive that they get overwhelmed by stimulation. That was really how I saw it. I would say that it's not about changing that it's a gift actually, cause it could also teach you to be very aware of other people's feelings and   Dr. Amelia Kelley (36:40) Mm-hmm.   Mm-hmm. Mm-hmm.   Right.   Michelle (36:50) And that can be a great thing for healers, to be honest, because you're a lot more likely to be able to understand the people that you're working with. It's not about changing. It's more about managing, kind of figuring out ways to stabilize so that it works for you.   Dr. Amelia Kelley (36:53) Mm-hmm.   Right.   Mm-hmm. Mm-hmm.   Right.   Absolutely. And I think that's the whole key of identifying whether or not you're one and why it's important. I've had clients who come in with a laundry list of diagnoses from other practitioners, usually because what's going on is trauma and it's being misdiagnosed as many other things, just my clinical opinion. But when I say maybe you're also highly sensitive, sometimes they just throw their arms up like another thing. And it's like, no, no.   Michelle (37:36) Mm-hmm.   Dr. Amelia Kelley (37:37) This is a key. This is a huge level of insight that can inform everything from your fertility journey for people listening, from trauma, from navigating. Anytime something stands in your way of getting where you want to be, if you know, well, I'm highly sensitive, so I will be more likely to succeed at this thing or accomplish this thing or feel better about this thing if I take my sensitivity into account.   Michelle (38:01) Mm-hmm.   Dr. Amelia Kelley (38:07) Perfect example, I had a very heavy day yesterday. had, I think, eight clients, a podcast, an interview, and a class. It was too much. It was a heavy, heavy day. I get home and my husband had managed to fix the voice-changing microphone toy that my kids have that had been broken that I wasn't rushing to fix. so I come in the house. They run to me. They're so excited to see me, so I'm excited to see them.   Michelle (38:17) Mm-hmm.   Mm-hmm.   Ha ha ha!   Dr. Amelia Kelley (38:35) and then they start in on this microphone. The last thing I wanted was to hear that microphone. But I know I didn't want to ruin their fun. So I know about me that I am going to be sensitive to sound when I'm overstimulated. So I went into my bag. I got my loop earbuds. If no one's ever heard of them, they're great for dampening noise around you, but you can still hear people. Popped my earbuds in. I didn't feel like I had to mask the issue of being sensitive to the noise.   Michelle (38:56) Mm-hmm.   Dr. Amelia Kelley (39:03) My family knows this about me. It wasn't anything against my kids. It was just, I'm going to pop these in so you can still have fun, but I can feel peaceful. And that's, think, a compassionate way to care for yourself is when you know these things about yourself, you can do things to help you still integrate and feel happy and peaceful in your life, but not have to push away what really is true.   Michelle (39:17) Mm-hmm.   I love that. actually really love that. It actually, the idea of highly sensitive, I don't mind it. Although I do think that there's definitely a lot of labels. I don't see this as one because the reason why I'm saying this, it reminds me of human design where you find out your strengths and sensitivities.   Dr. Amelia Kelley (39:42) Yes.   Michelle (39:47) and I think that once you know those, so it's not like a disorder, you know, cause we, think we hear all these different labels. think of it as like all these disorders. It's not no. And so that's the thing with this. I feel like it brings a lot of clarity. I, as a sensitive person   Dr. Amelia Kelley (39:54) Mm-hmm. It's not even a diagnosis.   Michelle (40:05) it really makes me understand myself more and manage it more. Just like you said, and I think that that is the key rather than getting frustrated with my husband who likes to really over explain. And sometimes I'm like, okay, my brain is like just on fire right now. And I have to explain that to, like, I know to explain that to him, like, it's not you, it's just me. He like right now I'm overloaded with information. I need a little quiet.   Dr. Amelia Kelley (40:10) Mm hmm.   Mm-hmm.   my gosh.   Yes.   Right.   Mm-hmm.   Michelle (40:33) So I think that when you do that, you'll also come at explaining things in a way that's more compassionate and easier to communicate rather than getting frustrated because you'll understand yourself better. And you understand sort of the situation that somebody else might not have that level of sensitivity and you do so they may not realize it. And I just feel like it really puts so much clarity to the situation.   Dr. Amelia Kelley (40:41) Right.   Right.   Right.   absolutely. if you happen to have kids or if you're on this fertility journey and in the future you're blessed with kids, the likelihood of them maybe being sensitive is quite high. And so you will be able to model for them. I joke one day, my daughter was probably three or four at the time, and she kept asking me for things in the bathroom. like, what is she doing? I walked in and she was laying in the tub with a book and a cup.   Michelle (41:17) Yes.   Dr. Amelia Kelley (41:30) and a towel over her face. And I'm like, what are you doing? She goes, I'm being mommy. I know, but it made me really proud too, because I'm like, OK, great. So this has been modeled for her. And you know, one thing we didn't even mention that we probably should have mentioned at the very beginning, high sensitivity is not abnormal. It's an adaptive trait. And it is a third. Up to a third of the human population is highly sensitive.   Michelle (41:35) That's really cute.   Yeah.   you   Mm-hmm.   Dr. Amelia Kelley (41:59) And there are ranges. So you have high sensitivity, medium sensitivity, and there are actually people who are low sensitive as well. Like their nervous system takes a lot of stimulation to be activated. And you might notice if you start learning this about yourself, you'll be able to start reflecting on people in your life and how you respond to them. And there might be people you can get to depth with a little bit more easily. Those might be your other co-HSPs.   Michelle (42:12) Mm-hmm.   Mm-hmm.   Dr. Amelia Kelley (42:29) And this is not just humans. The research shows this is in hundreds of animal species, even bugs. So it's everywhere. It's part of nature. It's part of nature, essentially.   Michelle (42:38) Wow, that's fascinating. That's so interesting. It's wild. You know, and I think to myself, like one of the things that I noticed, and it's so interesting that you said this, because I noticed that my patients, One of the things that I really observe is how they respond to treatments. Not everybody responds as quick.   Dr. Amelia Kelley (42:52) Mm-hmm. Mm-hmm. Mm-hmm. Mm-hmm.   Michelle (42:58) Some people take a little longer. so I can come up with like my first protocol, but then I realized I need to shift it a little bit, depending on how they do, or sometimes I'll even use baby needles on people who are very, very sensitive. Cause I don't want to overdo it with their nervous system. They don't need the strong needles. They don't need the strong stimulation cause they feel it already. And the people that have that body awareness   Dr. Amelia Kelley (43:04) Mm-hmm. Mm-hmm.   Mmm.   Right.   Right.   Michelle (43:22) is that when they have that body awareness, I feel like they respond to treatment a lot faster.   Dr. Amelia Kelley (43:28) Mm hmm. Yep. You're right. Just like we were saying that you'll get more good out of the good.   Michelle (43:31) Yeah. Yeah. Interesting. So interesting. I can talk to you for hours. I really enjoy our conversations. It's a lot of fun. I'll come back and then I'll have you back because I'm sure we can come up with like all kinds of things to talk about.   Dr. Amelia Kelley (43:37) I know I have to have you back now.   Well, and you know the funny thing, so I'll tell your listeners my podcast is The Sensitivity Doctor, and I have folks on all the time to talk about different topics around sensitivity. Do you know I have not had an episode literally just talking about what it means to be a highly sensitive person? I would love to have you on to have a chat about what it means to another highly sensitive person, and we can just unpack it. Because we talk about it extraneously around it, but I'm like,   Michelle (44:04) really?   Let's do it. Let's do it.   Dr. Amelia Kelley (44:16) Yeah, we should just unpack what that means. So I would love to have you back.   Michelle (44:20) That would be great. I really enjoy talking to you. can just like totally pick your brain. You're so interesting to talk to. I got really, and I love your energy and you're also the way you approach it in such an empowering way. I love that. Like I think it's just amazing. yeah, yeah, this is fun. I'm really excited. I actually met you.   Dr. Amelia Kelley (44:26) thank you. You too.   Mm-hmm. Thank you.   Yeah, it was a good it was a good meeting   Michelle (44:41) it was definitely a great meeting. So I would love for you to share for people listening and if they want to learn more, if they want to read your books, how they can reach you and how they can work with you.   Dr. Amelia Kelley (44:47) Mm-hmm.   Sure, so as I was mentioning, I do have my podcast that comes out every Thursday. But if you want to learn basically anything that I have to offer, it's on my website at AmeliaKelly.com, and that's Kelly with an EY. And I have links to my Psychology Today blog. It's called In Your Corner. I've got meditations on Insight Timer on there. There's a couple different quizzes, like if you want to figure out if you're in a...   trauma bond, if you want to learn if you're a highly sensitive person, I have an assessment on there. I also offer what I think to be the most important tools from some of my books that I want to make available to everyone for free, like the safety plan of how to get out of domestic violence situations, suicide safety plan, gas lighting checklist, like some of the things that I feel like everyone really should just have. You don't need to go buy the book.   Those are available too. So you can also find links for all my books and I also have a group that I meet every Tomorrow actually it's meeting. It's every other Thursday It's called powered by ADHD and it's for women with ADHD and sometimes we have guest speakers on which we're gonna have tomorrow night so I'm excited about that and I love that because it's a resource that women anywhere in the world can reach out You don't have to be in the state of North Carolina where I'm licensed. So   virtually anyone who is a woman or identifies as a woman can join that.   of course. Thanks for having me. Yeah, you'll come back. Awesome.  

So, let's talk about polycystic ovarian syndrome (PCOS) and why understanding it is crucial for women's fertility and health… Did you know that 1 in 10 women of reproductive age are affected by polycystic ovarian syndrome? Commonly known as PCOS, this condition that involves hormone imbalances disrupts ovulation, leads to insulin resistance, and can increase risks of miscarriage and pregnancy complications. It affects a lot of women, and yet, many still don't understand how and why it's a problem that needs intervention. That's why in this episode, we'll break down the facts about PCOS, debunk myths, and explore treatment options to help women take control. Whether you're dealing with irregular periods, weight gain, or fertility struggles, tune in and learn how you can help someone you care about on the path to better well-being and fertility. Why you need to check this episode: - Understand how PCOS impacts 1 in 10 women of reproductive age, influencing hormone balance, ovulation, and overall fertility; - Discover the link between insulin resistance, chronic inflammation, and elevated androgen levels that exacerbate PCOS symptoms; - Recognize the importance of early diagnosis through lab work, hormone tracking, and ultrasounds to identify irregularities and improve outcomes; - Learn about lifestyle strategies like weight management, stress reduction, and avoiding environmental toxins to mitigate PCOS symptoms; and - Explore medical treatments, including ovulation-inducing medications like Clomid and Letrozole, to support fertility and symptom management. “Definitely, [there's] some options there. So, it is not a dead-end street when talking about PCOS, when talking about fertility. But the problem is that a lot of people don't know where the road is, and you won't know where the road is unless you're driving, right? So, what have you got to do? You got to drive to the doctor's office. You got to ask the appropriate questions and be able to be open with your doctor if they ask you, hopefully, appropriate questions, so you can give appropriate answers.” – Dr. Berry Pierre Notable Quotes: “One in 10 women of reproductive age are affected by PCOS…So, this isn't like a disease that very few people get. This disease affects a lot of women.” – Dr. Berry Pierre “One of the things I do, especially when I was teaching my students, or with medical residents, I say, we don't order tests because we're hoping for an answer and then we'll kind of figure out our diagnosis. We're ordering a test…to confirm our diagnosis, which is a different ballgame. I'm not just willy-nilly ordering a test just to order it. I'm ordering that test because I assume you have this problem and I want to confirm if it's true with the results.” – Dr. Berry Pierre Mentions: The Myths of Fertility in Men Sign up at www.listentodrberry.com  to join the mailing list. Remember to subscribe to the podcast and share the episode with a friend or family member. Listen on Apple Podcast, Google Play, Stitcher, Soundcloud, iHeartRadio, and Spotify

Dr. Gillett, James O'Hara, & Jake Fantus MD discuss Testosterone, Sexual Function, & fertility. 00:00 Intro01:47 Secret Shopper Study06:58 Dr. Fantas TRT patients 09:16 Are podcast responsible for popularizing TRT? Subcutaneous TRT.12:38 Coming off TRT 16:22 Testicular fibrosis/fertility with long term use21:56 Varicocele 28:31 Venous leak30:34 Guidlines 34:33 Lifestyle changes to improve ED37:25 Epigenetics and Fertility 39:56 SSRIs 41:18 Clomid 45:30 Lab work overestimating free T52:40 Traverse trial 56:31 Aspirin57:03 FSH and fertility in men 01:00:37 Gonadorelin01:03:05 Male Birth Control 01:06:29 How many people have tried TRT?01:09:49 Did TRT create the Red Wave? 01:12:07 Outro Link to Health Update: https://youtu.be/Fe9_vNE2RgQLink to The Longevity Clinic Movement?: https://youtu.be/QKjMujVZLcULink to calculate your free testosterone: https://www.issam.ch/freetesto.htmFor High-quality labs:► https://gilletthealth.com/order-lab-panels/For information on the Gillett Health clinic, lab panels, and health coaching:► https://GillettHealth.comFollow Gillett Health for more content from James and Kyle► https://instagram.com/gilletthealth► https://www.tiktok.com/@gilletthealth► https://twitter.com/gilletthealth► https://www.facebook.com/gilletthealthFollow Kyle Gillett, MD► https://instagram.com/kylegillettmdFollow James O'Hara, NP► https://Instagram.com/jamesoharanpFor 10% off Gorilla Mind products including SIGMA: Use code “GH10”► https://gorillamind.com/For discounts on high-quality supplements►https://www.thorne.com/u/GillettHealth#testosteron #erectiledysfunction #hormones #podcastAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Welcome to The Wholesome Fertility Podcast! Today, I'm addressing an important topic that has come up frequently in my office: fertility-friendly lubricants. Many people don't realize that certain lubricants can negatively affect sperm movement and reduce the chances of conception.   In this episode, I discuss the common issue of vaginal dryness, especially when using fertility medications like Clomid or Letrozole, and how this can be an added challenge for those trying to conceive. I also explore natural ways to boost cervical mucus production, including staying hydrated and making dietary adjustments to improve moisture levels in the body. Additionally, I'll be highlighting fertility-friendly lubricant brands such as Pre-Seed and Good Clean Love, and why choosing products that mimic natural cervical mucus is so crucial.    If you're trying to conceive, this information will help you optimize your chances and ensure you're not unknowingly using something that could hinder your fertility.   Takeaways: Avoid harmful lubricants: Most standard lubricants can be toxic to sperm or slow their movement, which can impact conception. Natural cervical mucus is ideal: Keeping hydrated and consuming foods rich in omega-3s and antioxidants like vitamin C can help increase your body's natural moisture levels. Fertility-friendly lubricants to consider: Products like Pre-Seed, Good Clean Love, and Premom are formulated to be sperm-friendly and closely mimic natural cervical mucus. Vaginal dryness and medications: Fertility medications such as Clomid and Letrozole may cause dryness, making it important to find safe solutions that support sperm health.     Check out Michelle's latest book here: https://www.michelleoravitz.com/thewayoffertility   For more information about Michelle, visit: www.michelleoravitz.com   The Wholesome FertilityFacebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/   Instagram: @thewholesomelotusfertility   Facebook: https://www.facebook.com/thewholesomelotus/     Transcript:   [00:00:00] Welcome to the Wholesome Fertility Podcast. Today I'm going to be talking about something that I have not talked about yet, but it is an important topic because I've had a lot of people in my office come in and ask me about the specific topic. And a lot of times it is very important when it comes to fertility because People often don't realize that there are certain things that can actually be harming your fertility. So stay tuned because you're not going to want to miss this. So today I'm going to be talking about lubricants. This is actually a very common thing that people use lubricants and they don't realize that the majority of lubricants are actually not great for sperm. They're either toxic for sperm or they can impact how the sperm travels and slow down the traveling and fertilization of the egg. [00:01:00] So when it comes to fertility. It's a completely different ballgame, and it's really important to choose lubricants, if necessary, that are sperm friendly. So today I will be talking all about that. So first of all, I wanted to start out by saying, talking about why women can be dry, and sometimes it really is a cervical mucus thing, and And where it comes to cervical mucus, there are definitely things that you can do to impact cervical mucus naturally, but not just cervical mucus. It's also when taking certain fertility medications such as Clomid or Letrozole, those two medications can impact vaginal dryness as well. And this can be extremely frustrating when people are trying to conceive and women are having to have the difficulty and discomfort of vaginal dryness. And at the same time also timed [00:02:00] intercourse. So it kind of puts a whole other challenge to the whole challenging situation to begin with.   So according to fertility and sterility, Vaginal dryness has actually been reported in about at least 46 percent of all reproductive aged women, which is actually really high considering. So this is really important because when it comes to baby making, it's really important that a woman feels comfortable because if a woman is dry, it can cause more irritation. It can even cause bleeding. And we don't want that because when that's the case, then you're feeling more stress in really trying to conceive. So many times people will want to find lubricants and they'll find things that are over the counter or certain products that they don't realize are actually harming the sperm. So they're using this and I've had people come in and say that they've dealt with it. the discomforts of vaginal dryness[00:03:00] and didn't really realize, but for the whole time they've been trying and sometimes it's close to a year they've been using lubricants that are not necessarily great for the sperm and didn't even realize it. So this is why I find it so important in the podcast and in general to give information to people because many times nobody really tells you this stuff. You really think that, okay, what's the big deal? It shouldn't make a difference, but it really does. And the same thing also with figuring out the fertile window. All of these things are typically not things that you learn, not in school and oftentimes not even at the doctor's office. So it is really important to understand your body and understand really like how to optimize your fertile window and how to optimize your chances of conceiving and what those certain things are that can impact. that process. So like mentioned before, [00:04:00] a lot of these lubricants can impact sperm movement and impact how sperm is able to fertilize. And this can obviously be an issue because the sperm needs something that's similar to the cervical mucus, which is why the cervical mucus is so important because it It protects the sperm, but it also is created in a beautiful way to allow the sperm to move as fast as possible and most efficiently so that it is able to get to the egg and fertilize for conception.   Another thing that you want to look at is pH levels and if there's any chemicals in the lubricants that are harmful to sperm. So, ideally, you really want your own body's natural lubricant, which is cervical mucus. And there are a couple of things that you can do to improve that. And then I'll go over some other alternatives if that is not [00:05:00] working. But really what you want to do is increase your, in Chinese medicine speak, yin. Estrogen is a really important hormone in that process during the follicular phase that leads up to ovulation because estrogen is a very yin hormone. Yin is an aspect of the yin and yang that is more moist, more cooling, more feminine. So we want to bring in more moisture and we want to make sure that the body holds in that moisture. So there are definitely things that you can do to improve that and the first thing and it's the most obvious thing and I've seen it be the single handedly like the easiest way for people to improve cervical mucus is hydration. You would be shocked At how important it is to just hydrate because cervical mucus is majority is water. It really consists of water. And so if somebody is dehydrated and I've had a lot of people in the healthcare industry[00:06:00] that come in as patients, they just say they don't have time to drink. And I really push them on this because eventually they can actually shift that. It's just easier not to drink. So it's not that you can't drink. It's just that it. Tends to be easier and then it becomes a bad habit. So a lot of these people that are nurses, a lot of people that are dentists that are in the healthcare field don't really feel like they have an option. I work with them on that and they do change that. So it is possible. Anything's possible.   It's just a matter of putting a little more effort to get in the habit. We're just have water with you to just ensure that you're having it and also having water in the morning. , listen, you know, it might be a little inconvenient to have to go to the bathroom a couple of times extra, but it is really important and it really can impact your cervical mucus in a huge way. I've had people that have noticed vaginal dryness and that they've also had many times where [00:07:00]they were not seeing the same kind of cervical mucus that they used to see when they were younger. And all they did was increase the hydration. and that within a couple of months really shifted things and they started to see it. They actually saw when they wiped that they had more cervical mucus and more like egg white consistency on the peak days. So that is actually a very easy way to do this. And as a rule of thumb, you want to take whatever your weight is in pounds, take that number, divide that in half, and that amount in ounces is what you want you know, to drink every day. So say you're 120 pounds. So divide that by half, that's 60. So you take 60 ounces per day is the rule of thumb of water. And ideally you have that in containers that are not plastic. So either glass or stainless steel. And then also make sure to filter that [00:08:00] water. So you know, just kind of a side note, I always talk about that with my patients. So that's really, really important is to increase hydration and part of hydration also is not just water is from time to time to make sure that you're getting electrolytes as well. You also want healthy carbohydrates. So carbohydrates can also help and carbs can help the yin aspect of our body. So it helps your body absorb and , keep itself hydrated. So that you're able to retain a little bit more water because that water is important to retain in order to hydrate your body in many different ways, including cervical mucus. Another really important vitamin that impacts cervical mucus is actually vitamin C. And you can also increase citrus fruits in your diet. This is something that has been shown to improve. cervical mucus. So these are things that you want to do naturally. Ideally, if you could do things naturally, then you're using your own body's [00:09:00] natural lubricant, which is optimized for sperm health and to protect sperm and to help the chances of conception. So ideally you want to try to get it where your body's doing this. Another important antioxidant is vitamin E as well. And that can help regulate estrogen in your body.   You also want to get foods that are rich in omega 3s. Omega 3 fatty acids are really great for cervical mucus. And if you think about it, just oils in general, healthy oils. So, things like coconut oil that you're taking internally. I know some people use it physically, like as lubricant. I'm not a huge fan, but, Take things oils internally because when you're increasing those oils, which are very Yin substances, you're also improving your own body's ability to moisten itself. And you can also get, , those oils through nuts and [00:10:00] seeds, which are very rich in what we call in Chinese medicine, Jing. Jing is really fertile essence. It's really essence of the body. Okay. And if you think about seeds or nuts, they're basically seeds ready to sprout, which is ultimately like what egg and sperm are. So they're fertile, they're fertile by nature, and they have everything that they need and all the resources within it's the seed in order to fertilize and become fertile. So you want things in nature to borrow from so that it improves your own ability to fertilize as well, which of course is conception.   So, here are things to consider if you were to buy fertility friendly lubricants. So, you want to find something that's water based so that it doesn't decrease sperm motility  because that would be the most similar consistency to natural cervical mucus. You also want lubricants that are free[00:11:00] from parabens, fragrances, or any kind of chemicals, and ultimately to be the closest mimicking of natural cervical mucus.  And here are some brands that are the most fertility friendly. And the first one is precede fertility lubricant. You'll see that very often it's available on Amazon, many different places. And then also good clean love biogenesis fertility lubricant. Another one is conceived plus fertility lubricant. And there's also Nautilus, the lube lubricant. And there are many different ones that you'll see. You'll also see Lola, fertility friendly lube, penchant organic. So these are things that you want to definitely look up and make sure that it says fertility friendly. And I always recommend just do your own research and really look into it. Look at the [00:12:00] reviews and find what you think is best for you but ultimately, like I said before, the best thing that you can do is try to get your own natural lubricants going, especially during the fertile window. If you have that a little bit more than, And I also recommend having sex outside of the fertile window.   I often recommend that. And in that case, you don't have to worry quite as much. I still would use natural ones though, personally, because also when your body receives the sperm outside of the fertile window, then it will, lower its immunity so that you are able to receive the sperm because it's considered like an invader through the body.   So you're able to really lower the immune system, which typically would happen in the second part of the menstrual cycle, which is the luteal phase that you're able to receive the sperm. So the more access your body has, or the more interaction it has with a [00:13:00] sperm, even if it's outside of the fertile window into the luteal phase, the more it becomes open to receiving it. And another plus for that is just really being able to connect outside of the fertile windows so that there's no timing on it. And it really is something that you can put towards your relationship with your partner so you can have that connection. And ultimately that is such an important part of the whole process because I know so many people tell me.   And express how difficult it is to have to. put the pressure of timing and when they could do it. And when you open it up to more of a larger window outside of it, there's less added pressure and there's more time for connection. And as I mentioned this in my book, the way of fertility, which I highly recommend you check out because a lot of the things that I talk about are [00:14:00] all bundled up in there described perfectly because I repeat myself a lot. And this is one of the reasons I wrote the book is because I wanted to put all of my ideas and thoughts and all of my findings and lots of the information that I got from, , ancient wisdom and really the basis of Chinese medicine into a book where you can find it with exercises. But I talk about the connection between the partners and really having that connection because when you do have that connection and you really feel turned on, you will naturally also produce more natural lubricant.   So those are natural processes of the body, but it all starts with the mind. So a lot of it really starts psychologically and it's It's about connecting, opening the heart. So I talk a lot about that in the book. You can look at the episode notes to find out more on how to get that. And I will also list these fertility friendly lubricants that I mentioned in the episode[00:15:00] notes. And you can always reach out to me. on Instagram. I'm always there and my handle is at the wholesome Lotus fertility. If you have any questions you want to reach out, you can find me there. So thank you so much for tuning in today and I hope you have a beautiful day. 

  Some music and sounds in this podcast by @itslucakoala Recorded early October 2024 In this BRAND NEW 3 part  podcast special your host Brittany Baldi Dull invites on her friend Grace Armstrong. Grace is a fertility nutrition specialist that works 1 on 1 with couples and females trying to optimize their overall health— more specifically, for fertility. You can find Grace on instagram @the_fertilitynutritionist for some examples on how she can help you in your personalized health journey. Part 1 and 2 are out now! — These episodes will breakdown lab work as well as the importance of getting your hormones and bloodwork checked for optimal health +  fertility.  Please enjoy part 3 today. We hope you enjoy.  Discussed in this episode — Grace takes a look at Brittany's personal bloodwork — Grace gives examples at what labs to get performed at a local blood lab — Clomid and other ovulation drugs are discussed — Self advocating at your doctor's office —  What Brittany's next steps and YOUR next steps could be towards optimal health and increasing your fertility — And much more! Try AG1 and get a FREE bottle of Vitamin D3K2 AND 5 free AG1 Travel Packs with your first purchase at drinkAG1.com/bosbabes. That's a $48 value for FREE if you go to drinkAG1.com/bosbabes.    THIS MONTH ONLY: Get Up to 50% OFF @honeylove by going to honeylove.com/BRITTANY! #honeylovepod Get 20% OFF and FREE shipping off of your FULL Manscaped order by going to manscaped.com and using my code BRITTANY at checkout Please be sure to visit meditresse.com today if you or someone you know is experiencing extreme or mild hair loss— the hair specialists may be of assistance.  Use my code bosbabes for 10% off your purchases online. For all of your furniture needs please be sure to check out Highpoint Furniture Sales. They are fully family owned and operated with 1 great location in the state of North Carolina— visit their showroom In High Point or shop their website highpointfurnituresales.com — they offer white glove delivery and set up services nationwide! Nolan magic sofa covers help elevate your couch style! With a variety of colors, patterns, and sizing options to choose from —  Protect your couch from stains, spills, pet hair and more! — its a simple setup, simply place the fitted covers on your sofa or couch. To purchase— and get 10% OFF your full purchase today using my personal link—  visit nolaninterior.com/brittany38231 For your triad area realty needs please get in touch with Amy Cromer of ‘Cromer Property Group'. Visit her website today for more information www.cromerpropertygroup.com Luca Koala FREE music on Spotify: https://open.spotify.com/album/5kepJgtnHDGsvYiLlKXQ03?si=wZKjnpjvTXSXz-qnBOkX7w  

In this episode with Dr. Cameron Sepah, you'll get to dive into critical topics like the alarming drop in testosterone and sperm counts, the dangers of endocrine-disrupting chemicals, and why testosterone replacement therapy (TRT) could harm fertility. You'll explore the difference between primary and secondary hypogonadism, alternative therapies like Clomid or enclomiphene that boost natural testosterone production, and the challenges of maintaining fertility during TRT. You'll also hear about the risks of high estrogen levels, the impact of testosterone on libido, the importance of personalized dosing, and cutting-edge innovations like at-home devices that measure key hormones with clinical accuracy. Dr. Cameron Sepah is the CEO of Maximus, an online medical clinic specializing in health and hormone optimization, backed by top venture capitalists including Founders Fund, 8VC, and angel investors such as Dave Asprey of Bulletproof, Ryan Holiday of the Daily Stoic, and the executives behind The Honest Company, Coinbase, Tinder, and Shopify. Cameron is a serial health tech entrepreneur, as a founding team member of Omada Health, a billion-dollar startup that pioneered the field of digital therapeutics. He is a licensed clinical psychologist by training, specializing in behavioral medicine, and a clinical professor of psychiatry, where he trains doctors in evidence-based health care. Tune in to get all the insights you need to make informed decisions about optimizing your testosterone, fertility, and overall health! Full Show notes: https://bengreenfieldlife.com/maximuspodcast SiPhox: Visit siphoxhealth.com/ben with code BEN to get 20% off your health kit! Pendulum: Get 20% off your first month of any Pendulum probiotic with code GREENFIELD at PendulumLife.com/Greenfield. BEAM Minerals: Up your mineral game. Go to beamminerals.com and use code BEN at checkout for 20% off your order. Organifi: Go to Organifi.com/Ben for 20% off your order. ProLon: Right now, you can save 15% on your 5-day nutrition program when you go to ProLonLife.com/GREENFIELD.See omnystudio.com/listener for privacy information.

In this episode, Dr. Rena Malik, MD engages in an enlightening conversation with Dr. Abraham Morgenthaler from Harvard Medical School about the complexities of testosterone health. They explore the intricacies of Clomid treatments, delve into the mechanisms behind testosterone production, and consider environmental factors affecting younger men's hormone levels. The episode further discusses the challenges of diagnosing and treating low testosterone, the influence of cultural and technological shifts on intimacy, and misconceptions around testosterone therapy and prostate cancer risk. Listeners will come away with a deeper understanding of testosterone health, its impact on quality of life, and the personalized approach needed in treatment. Become a Member to Receive Exclusive Content: renamalik.supercast.com Schedule an appointment with me: https://www.renamalikmd.com/appointments ▶️Chapters: 00:00:00 Introduction 00:09:35 Symptoms of low testosterone 00:12:22 Regulating Sexual Behavior 00:17:01 Why is Testosterone Controversial? 00:20:37 Is testosterone is safe and effective? 00:23:40 Testosterone Treatment: No Increased Cancer Risk Found 00:34:14 Optimal diagnosis of test low testosterone 00:36:46 How to measure testosterone 00:44:33 Estradiol 00:49:34 Patient-Focused Care: Thorough Communication and Support 00:51:19 Optimal age-based testosterone levels 01:08:12 Is testing testosterone harmful? 01:10:20 Benefits of testosterone Don't forget to check out Dr. Abraham Morgentaler and Dr. Marianne Brandon Listen to the Sex Doctors podcast on all of your favorite platforms: Apple: https://podcasts.apple.com/ec/podcast/the-sex-doctors/id1761813985?l=en-GB Spotify: https://open.spotify.com/show/0apSFzquJXKoOGnmI6ndgT?si=e5a1e482c7ca46c7 Find them on: Instagram: https://www.instagram.com/thesexdoctors Facebook: https://www.facebook.com/thesexdoctors YouTube: https://www.youtube.com/@thesexdoctorspod TikTok: https://www.tiktok.com/@thesexdoctor LinkedIn (Dr. Abraham): https://www.linkedin.com/in/abraham-morgentaler-md-81628b6 X (Dr. Abraham): https://x.com/DrMorgentaler Let's Connect!: WEBSITE: http://www.renamalikmd.com YOUTUBE: https://www.youtube.com/@RenaMalikMD INSTAGRAM: http://www.instagram.com/RenaMalikMD TWITTER: http://twitter.com/RenaMalikMD FACEBOOK: https://www.facebook.com/RenaMalikMD/ LINKEDIN: https://www.linkedin.com/in/renadmalik PINTEREST: https://www.pinterest.com/renamalikmd/ TIKTOK: https://www.tiktok.com/RenaMalikMD ------------------------------------------------------ DISCLAIMER: This podcast is purely educational and does not constitute medical advice. The content of this podcast is my personal opinion, and not that of my employer(s). Use of this information is at your own risk. Rena Malik, M.D. will not assume any liability for any direct or indirect losses or damages that may result from the use of information contained in this podcast including but not limited to economic loss, injury, illness or death. Learn more about your ad choices. Visit megaphone.fm/adchoices

Happy National Midwifery Week!We are so thankful for and in awe of all midwives do. Great midwives can literally make all the difference. Statistical evidence shows that they can help you have both better birth experiences and outcomes.Meagan and Julie break down the different types of midwives including CNMs, CPM, DEMs, and LPM as well as the settings in which you can find them. They talk about the pros and cons of choosing midwifery care within a hospital or outside of a hospital either at home or in a birth center. We encourage you to interview all types of providers in all types of settings. You may be surprised where your intuition leads you and where you feel is the safest place for you to rock your birth!Midwifery-led Care in Low- and Middle-Income CountriesEvidence-Based Birth Article: The Evidence on MidwivesArticle: Planning a VBAC with Midwifery Care in AustraliaThe VBAC Link Supportive Provider ListNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, hey, hey. You guys, we're talking about midwives today, and when I say we, I mean me and Julie. I have Julie on with us today. Hello, my darling. Julie: Hello! You know, sometimes you've just got to unmute yourself. Meagan: Her headphones were muted, you guys. Julie: Yeah. That's amazing. Meagan: I'm like, “I can't hear you.” You guys, guess what? This is our first month at The VBAC Link where I'm bringing a special subject. Every month we are going to have a week and it's usually going to be the second week of the month where we are going to have a specific topic for those episodes of the week and this is the very first one. It is National Midwives' Week so I thought it would be really fun this week to talk about midwives. We love midwives. We love them. We love them and we are so grateful for them. We want to talk more about the impact that they leave when it comes to our overall experience. Julie: Yes. Meagan: The overall outcomes and honestly, just how flipping amazing they are. We want to talk more and then we'll share of course a story with a midwifery birth. Okay, Julie. You have a review. I'm sticking it to her today to read the review because sometimes I feel like it's nice to switch it up. Julie: Yeah. Let's switch it up. All right, this review– I'm assuming “VBAC Encouragement” is the title of the review.” Meagan: Yes. Julie: “VBAC Encouragement”. It says, “My first birth ended in an emergency Cesarean at 29 weeks and I knew as I was being rolled into the OR that I would go for a VBAC with my next baby. Not long after, The VBAC Link started and I was instantly obsessed.” I love to hear that. “I love the wide range of VBAC and CBAC stories. Listening to the women share honestly and openly was motivating and encouraging. As a doula, this podcast is something that I recommend to my VBAC clients. I'm so thankful for the brave women sharing the good, bad, and ugly of their stories and I'm thankful for Meagan and Julie for holding space for us all.” Aww, I love that. Meagan: I do too. I love the title, “VBAC Encouragement.” That is what this podcast is here for– to encourage you along the way no matter what you choose but to bring that encouragement, that empowerment, and the information from women all over the world literally. All over the world because you guys, we are not alone. I know that sometimes we can feel alone. I feel like sometimes VBAC journeys can feel isolating and it sucks. We don't want you to feel that way so that's why we started the podcast. That's why I'm here. That's why Julie comes on because she misses you and loves you all so much too and we want you to feel that encouragement. Meagan: Okay, you guys. We are talking about midwives. If you have never been cared for by a midwife, I think this is a really great episode to learn more about that and see if midwifery care is something that may apply to you or be something that is desired by you. I know that when I was going along with my VBAC journey, I didn't interview a midwife actually at first. I interviewed OB after OB after OB. Julie did interview a midwife and it didn't go over very well. Julie: No, it was fine. It just didn't feel right at that time. Meagan: What she said didn't make it feel right. What I want to talk about too and the reason why I point that out is because go check out the midwives in your area. Check them out. Go check them out. Really, interview them. Meet with them but guess what? It's okay if it doesn't feel right. It's okay if everyone is like, “Go, go, go. You have to have a midwife. OB no. OB no.” That's not how we are in this podcast. We are like, “Find the right provider for you.” But I do think that midwives are amazing and I do think they bring a different feel and different experience to a birth but even then sometimes you can go and interview a midwife and they're not the right fit. We're going to talk about the types of midwives. This isn't really a type. We're going to be talking about CPM, DEM, and LPM. Julie: In-hospital and out-of-hospital midwives, yeah. Meagan: Yeah, but I also want to talk about the word “medwives”. We have said this in the past where we say, “Oh, that midwife is a ‘medwife'” and what we mean by that is just that they may be more medically-minded. Every midwife is different and every view is different. Like Julie was saying, in-hospital, out-of-hospital, you may have more of a ‘medwife' out of the hospital, but guess what? I've also seen some out-of-hospital midwives who act more like, ‘medwives', really truly. Again, it goes back to finding the right person for you. But can we talk about that? The CPM or DEM? CPM is a certified professional midwife or direct entry midwife, right? Am I correct?Julie: Right. It's really interesting because all over the world, the requirements for midwifery are different. You're going to find different requirements in each country than in the United States, every state has its different requirements and laws surrounding midwifery care. In some states, out-of-hospital midwives cannot attend VBAC at all or they can as long as it's in a birth center. Or sometimes CNM– is a certified nurse midwife which is the credential that you have to have if you are going to work in a hospital but there are some CNMs who do out-of-hospital births as well. There is CPM which is a certified professional midwife which a lot of the midwives are out-of-hospital. That means they have taken the NARM exam which is the national association of registered midwives so they are registered with a national association.Meagan: Northern American Registry of Midwives. Julie: Oh yes. They have completed hundreds of births, lots and lots of hours, gone through the entire certification process and that's a certified midwife. Now, a licensed midwife which is a LDEM, a licensed direct-entry midwife just simply means that they hold licensure with the state. Licencsed midwife and certified midwife is different. Certified means they are certified with the board. Licensed means they are licensed with the state and usually licensed midwives can carry things like Pitocin, Methergine, antibiotics for GBS and things like that which is what the difference is. Licensed means they can have access to these different drugs for care. Meagan: Like Pitocin, and certain things through the IV, medications for hemorrhage, antibiotics, yes. Julie: Right, then CPMs who are certified, yeah. There are arguments for both. And DEM, direct entry midwife means that they are not certified or licensed. That doesn't mean that they are less than, it just means that they are not bound by the rules of NARM or the state. Now, there are again arguments for and against all of these different types. I mean, there are pros and cons to holding certification, holding licensure, and not holding certification and not holding licensure. Each midwife has to decide which route is best for them. Certified nurse-midwife obviously has access to all of the drugs and all of the things. They are certified and licensed. You could call it that but they have to have hospital privileges if they want to deliver in the hospital. You can't just be a CNM and show up to any hospital to deliver with them. They have to have privileges at that hospital. They have to work and be associated with a hospital just like an OB. An OB has to have privileges at any hospital. They can't just walk into any old hospital and deliver a baby. Meagan: Right. I think it's important to know the differences between the providers who you are looking at. Like she was saying, with a CNM, you are more likely to have that type of midwife in a hospital setting than you would be outside of the hospital but sometimes there are still CNMs who have privileges and choose to do birth outside of the hospital. I think it's an important thing to one, know the different types of midwives and two, know what's important to you. There are a lot of people who are like, “I will not birth with anyone else but a CNM.” That's okay. That's okay but you have to find what works best for you. Julie: Sorry, can I add in? Meagan: You're fine. Yeah. Julie: It's also important that you are familiar with the laws in your state if you are going out of the hospital. I don't want this episode to turn into a home birth episode. It should be about all of the midwives in all of the locations, but also, know what the laws are in your state and in your specific area about midwives. In Utah, we are really lucky because we have access to all the types of midwives in all the different locations, but not everywhere is like that. Yeah. Just a little plug-in for that. Meagan: Yes. I agree. I agree. I did mention that I didn't really go for midwifery care when I was looking for my VBAC– Lyla, my second. I don't even know why other than in my mind, this is going to sound so bad but in my mind, I was told that midwives are undereducated. Julie: Less qualified? Meagan: Less qualified to support VBAC. I was told this by many people out in the world and I just believed it. Again, I have grown a lot over the years. It's been so great and I'm glad that I have. That's just where I was.Julie: A lot of people think that though. People don't know. They just don't know. Meagan: No, they don't know so I wanted to boom. Did you hear it? I'm smashing it. Julie: Snipping it. Meagan: That is a myth that is going to be smashed. Midwives are fully capable of supporting you during your VBAC journey. We are going to start going over some stats and things about how midwives really actually do impact VBAC in a positive way but you may even run into and at least I know there are some places here in Utah where providers kind of oversee the midwifery groups in these hospitals and a lot of them will say that midwives are unable to support VBAC. That's another thing that you need to make sure you are asking if you are going in the hospital when you are birthing with midwives because a lot of times you are being seen with your midwife, you're treated by your midwife and everything is great. You've got this relationship with these midwives and then you go into labor and all of a sudden you have an OB overseeing your care because that midwife can oversee your pregnancy but not your birth. Know that that is a thing so make sure that if you are birthing in a hospital with a midwife that you ask, “Will I be birthing with the midwives or am I going to be seen by an OB?” But also know, like I said, you can be seen in a hospital by a midwife. Okay, let's talk about some evidence and what midwives bring to the table and maybe some differences that midwives bring to the table because I do think that in a lot of ways, it is scary to think, Okay. If I have to have a C-section, if I do not have this VBAC and I have to go to a C-section and I have to be treated by an OB– because midwives do not perform Cesareans. They do assist. Let me just say, a lot of midwives come in and they assist a Cesarean, but they do not perform the main Cesarean, that can be intimidating because you want your same provider but I don't know if that's necessarily needed all of the time. Maybe to someone that is. But just know that yes, they cannot perform a Cesarean but they often can assist. That's another good question to ask your midwife, especially in the hospital. If I go to a Cesarean, who will perform it and will you be there no matter what?Okay, let's talk about it. Let's talk about the evidence. Let's talk about experiences and how they can differ. Julie: Do you know what is so funny? I want to go back and touch on the beginning where you said you didn't know and you thought that midwives were less qualified and honestly especially in-hospital, in-hospital midwives– I want everyone to turn their ears on right now– have the exact same training and skills to deliver a baby vaginally as an OB does. The difference between a midwife and an OB in a hospital is a midwife cannot do surgery. I just want to say that very concisely. They are just as qualified. They can even do forceps deliveries. They can do an episiotomy if an episiotomy is necessary. They can do vacuum assist. Well, some hospitals have policies where they will or will not allow a midwife to do forceps or a vacuum but they can administer all different types of medications. They can literally do everything. They can do everything except for the surgery in the hospital.Out of the hospital, I would argue that they still have similar training depending on if they are licensed or not. They may or may not be carrying medications like Pitocin, Methergine, antibiotics, IV fluids, and things like that. But out-of-hospital midwives, many of them, at least the licensed ones, carry those things and can provide the same level of care. The only difference between– not the only difference, a big difference between out-of-hospital midwives and in-hospital midwives is they don't have immediate access to the OR and an OB. But guess what? In states like Utah and many, many states operate similarly, there are very strict and efficient transfer protocols in place so that when a midwife decides you need to transfer, say you are birthing at home, first of all, a midwife is going to be with you a big chunk of the time. They are going to be with you. They're going to be noticing things. They're going to be seeing things. They're not going to be there for just the last 10 minutes of deliveries like these OBs are. They are going to be in your house. I feel like out-of-hospital midwives are more present with you than in-hospital midwives even. They're going to notice things. They're going to see things. They're going to notice trends a lot of the time before a situation becomes emergent if you need to be transferred. There are those random last-second emergencies and there are protocols for how to handle those too, but the majority of the time when there is a transfer needed, you are going to be received at the hospital. The hospital is already going to have your records. They're already going to know what you're coming in for and they're going to be able to seamlessly take over your care, no matter what that looks like there. Now there are rare emergencies when you might need care within seconds. However, those are incredibly rare and that is one of the risks. Those are some of the risks that you need to consider when you think about out-of-hospital versus in-hospital care. But often, I have seen many instances where things have safely gotten transferred to a hospital before they reach the level of needing that severe emergent care. I think that is the biggest thing people don't understand. I don't know how many people I've talked to as a doula and as a birth photographer where they don't want to birth at home because they don't understand the level of care that is provided by out-of-hospital midwives. I'm thinking of a birth I just went to last summer and she was thinking about home birth but the husband was like– this was 36 weeks so they weren't comfortable transferring or anything like that, but I was like, “These home birth midwives are trained in emergencies. They know how to handle all of the same obstetric emergencies in the exact same ways that they do in the hospital. They know how to handle them and address them. If a transfer is necessary, they are going to transfer you. They carry medication. They have stethoscopes and fetal monitors and everything that they do in the hospital to care for you.” The dad was like, “Oh, I didn't know that.” It's not your mom coming to help you deliver your baby. It's a trained, qualified medical professional. I don't know. I saw this quote. Never mind. I'm not circling back. I'm going in a completely different direction. I saw this quote or a little meme thing on Facebook the other day. I was going to send it to you but I didn't. It said something like, “Once your provider and birth location is chosen and locked in place, choice is mostly an illusion.” Meagan: Wow. Mostly an illusion. Julie: Yes. Like the fact that you have a choice in your care is mostly an illusion. I was thinking about that and I was like, Is it really? I've seen some clients really advocate hard, and stuff like that. But I have also seen the majority of clients where providers, nurses, and birth locations have a heavy sway and you can be convinced that things are absolutely necessary and needed by the way that you are approached and if you are approached a different way, then you might make a different choice, right? The power of the provider and the birth location is so big and massive that choice, the fact that you have a choice involved, is mostly an illusion. I was sitting with that because I see it. I've said it before and I'll say it a million more times before I die probably that birth photographers and doulas have the most well-rounded view of birth. Period. Because we see birth in home, in birth centers, in hospitals, in all of the hospitals, in all of the homes, in all the birth centers, with all of the different providers. We can tell you what hospital– I mean, there are nurses at one hospital that will swear up, down, and sideways that this is the way to do things and the next hospital 3 miles down the road is going to do things completely different and their nurses are going to swear by a different way to do things because of the environment that they are in. Meagan: Yeah. 100%.Julie: So if you want to know in your area what hospitals are the best for the type of birth that you want, talk to a birth photographer. Talk to a doula because they are going to be the ones with the most well-rounded view. Period. Meagan: Yeah. We definitely see a lot, you guys. We really do. Remember, if you are looking for a doula, check out thevbaclink.com/findadoula. Search for a doula in your area. You guys, these doulas are amazing and they are VBAC-certified. Julie: What were we going to circle back to? You were saying something. Meagan: Well, there's an article titled, “Effectiveness of Midwifery-led Care on Pregnancy Outcomes in Low and Middle-Income Countries” which is interesting because a lot of the time, when we are in low and middle-income countries, the support is not good. Anyway, they went through and it said that “10 studies were eligible for inclusion in the systemic review of which 5 studies were eligible for inclusion in the meta-analysis. Women receiving–”Julie: I love meta-analyses. They are my favorite. Yeah. Sorry, go ahead. Go on. Meagan: I know you do. It says, “Women receiving midwifery-led care had a significantly lower rate of postpartum hemorrhage and reduced rate of birth–” How do you say this, Julie? It's like asphyxia? Julie: Asphyxia? Meagan: Uh-huh. I've just never known how to say that. It says, “The meta-analysis further showed a significantly reduced risk in emergency Cesarean section. Within the conclusion, it did show that midwifery-led care had a significantly positive impact on improving various maternal and neonatal outcomes in low and middle-income countries. We therefore advise widespread implementation of midwifery-led care in low and middle-income countries.” Let's beef this up in low and middle-income countries. But what does it mean if you are not in a low and middle-income country? Julie: Well, I see the same and similar studies showing that in the United States and all of these other bigger countries that are larger and more educated. It's interesting because– sorry. I have a thought. I'm just trying to put it together. Meagan: That is okay. Julie: Midwifery-led care is probably more accessible and maybe accessible isn't the right word. It's more common probably in lower-income countries. I'm thinking third-world countries and second-world countries because it's expensive to go to a hospital. It's expensive to have an OB. In some countries like Brazil, the C-section rate is very, very high and it's a sign of wealth and status because you can go to this private hospital with these luxury birth suites and stay like a VIP, get your C-section, save your vagina– I use air quotes– “save your vagina” by going to this affluent hospital. Right? Meagan: Yes. Julie: I think in lower-income countries, it's going to be not only an easier thing to do but kind of the only thing to do, maybe the only choice. And here, it's funny because here, out-of-hospital births– first of all, insurance is stupid. In the United States, insurances are so stupid. It's a huge money-making organization, the medical system is. Insurance does cover a big chunk of hospital births and they don't cover out-of-hospital births so a lot of the time, an out-of-hospital birth is kind of the opposite. You have to have a little bit of money in order to pay for an out-of-hospital midwife because your insurance isn't likely going to cover it. More insurances are coming on board with that but it will be a little bit of time before we see that shift. But there are similar outcomes in the United States and in wealthier countries that midwifery-led care, not just out of the hospital, but in-hospital midwifery-led care has lower rates of Cesarean, lower rates of complication, lower rates of induction, lower rates of mortality and morbidity than obstetric-led care. You are going to a surgeon. You are going to a trained surgeon to have a natural, non-complicated delivery. Meagan: It's interesting because going back to the low income, in our minds, we think that the care is not that great. But then we look at it and it's like, the care is doing pretty good over there in these lower-income, third-world countries. Yeah. This is actually in Evidence-Based Birth. It says, “In the United States, there are typically 4 million births each year.” 4 million. You guys, that's a lot. The majority of these births are attended by physicians which are only 9% attended by certified nurse midwives and less than 1% are attended by CPMs, so certified professional midwives or traditional midwives. You guys, that is insane. That is so low. She says in this podcast of hers which we are going to make sure to link because I think it's a really great one, “If you only look at vaginal births, midwives do attend a higher portion of vaginal births in the United States, but still it's only about 14%.”Julie: Yeah. If you have a normal– I use normal very loosely– uncomplicated pregnancy, there is absolutely no reason that you cannot see a midwife either out of the hospital or in the hospital. Now, I would encourage you to go and interview some midwives in your local hospitals. I would encourage you to look into the local birth community and see what people recommend because even if you are going in a hospital and have a midwife, you have the same access to the OR and an OB that can take care of you in case of an emergency. A lot of people are like, “Well, I'd just rather see an OB just in case of an emergency so that way I know who is doing my C-section,” I promise you that the OB doing your C-section, you are only going to see for an hour. They probably are not going to talk to you. It doesn't matter how personable they are or what their bedside manner is or if you know anything because I promise you, when you are on the operating room table, you're not going to be worried about who's doing your surgery. You're just not. I'm sorry. That's maybe a harsh thing to say, but it's going to be the farthest thing from your mind. Plus, in the hospital, your midwife is more than likely going to be assisting with the surgery too so you are going to have a familiar face in the operating room if that happens. I also think everybody knows by now that I am not on board with doing something just in case when it comes to medical care. Just in case things can cause a lot more problems that they are trying to prevent. So yeah. Anyway, that's my two cents. Meagan: Yeah. You know, I really think that when it comes to midwives, there is even more than just reducing things like interventions and Cesareans and inductions which of course, lead to interventions and things like that. I feel like overall, people leave their birth experience having that better view on the birth because of things like that where midwives are with you more and they seem to be allowed more time even with insurance. You guys, insurance, like she said, sucks. It just sucks. It limits our providers. I want to just point that out that a lot of these OBs, I think that they would spend more time with us. I think they want to spend more time with us in a lot of ways, but they can't because insurance pulls them down and makes it so they can't. But these midwives are able to spend so much more time with us in many ways. Okay. Let's see. What else do we want to talk about here? We talked about interventions. Midwives will typically allow parents to go past that 40-week mark. We talked about the ARRIVE trial here in the past where they started inducing first-time moms at 39 weeks and unfortunately, it's stuck in a lot of ways so providers are inducing at 39 weeks and that means we are starting to do things like stripping membranes at 37 and 38 weeks. It seems like providers really, really– and when I say providers, like OB/GYNs, they are really wanting babies to be born for sure by 40 weeks but by 40 weeks, they are really pushing it. Midwives to tend to allow the parents to go past that 40-week mark. That's just something else I've noticed with clients who choose VBAC and then end up choosing midwives. They'll often end up choosing midwives because of that reason and they will feel so much better when they reach that point in pregnancy because they don't feel that crazy pressure to strip their membranes and go into labor or they are going to be facing a Cesarean and things like that. I feel like that's another really big way to change the feeling of your care with midwives is understanding when it comes down to the end of things, they are going to be a little bit more lenient and understanding and not press as hard. Like we said in the beginning, there are a lot of people who do press it– those “medwives” where they are like, “No, you need to have a baby.” We just recorded a story where the midwife was like, “Well, you need to see the OB and you need to do a membrane sweep,” and they were suggesting these things. But really, typically with midwives, you are going to see less pressure in the end of pregnancy. Midwives spend more time in prenatal visits. We were just talking about that. Insurance can limit OBs, but a lot of the time, they will really spend more time with you. They are going to spend 20+ minutes and if you are out of the hospital, sometimes they will spend a whole hour with you going over things. Where are you mentally? Where are you physically? What are you wanting? Going over desires and the plan for the birth. Past experiences may be creeping in because we know that past experiences can creep in along the way. So yeah. Okay, Julie is in her car, you guys. She's rocking it with her cute sunglasses. She is on her way. She is so nice to have the last half hour of her free time spent with us. So Julie, do you have any insight or any extra words on what I was just saying? Julie: You know, I do. Hopefully, you can hear me okay. I'm going to hit a dead spot in two seconds. Meagan: I can hear you great. Julie: Okay, perfect. I have this little– there's a spot on my road where I always cut out so stop me if I need to repeat what I said. I wanted to go back to the beginning and just talk for half a second because we know my first ended in a C-section. For my first birth, I actually started out by looking at birth centers because I wanted an out-of-hospital birth. I knew that from the beginning. I interviewed a couple of midwives and there was one group that I was going to go with at a birth center and I was ready to go but something didn't quite feel right. It wasn't anything the midwives did. It wasn't anything that the birth center was. It wasn't that I didn't feel safe there. It was just that something didn't feel right. So I just stayed with my OB/GYN. I had to get on Clomid to get pregnant. I just stayed with that guy who is the same guy that Meagan had and the same guy who did my C-section because something didn't feel right. I mean, we know now and I can look back in hindsight. This was, gosh, 11.5 years ago. I know that I ended up having preeclampsia and I ended up having to get induced because of it. Had I started out-of-hospital, I would have had to transfer. There was nothing– I would have had to transfer care before I even got to 37 weeks. I had a 36-week induction. That's the thing though. Out-of-hospital midwives have protocols. Each state has different guidelines, but there are requirements for when they have to transfer care– if your blood pressure is high, if you have preeclampsia signs, if you deliver before a certain due date, or after a certain gestational age. You're going to be safe. If you have complications in pregnancy, you're going to be safe. You're going to be transferred. You're going to be cared for. But also, I just want to put emphasis on this which is what I'm tying into the last thing I want to say which is going to be forever long, is that you can trust your intuition. My intuition was telling me that the birth center was not the right place for me even though it checked all of the boxes. Your intuition is not going to tell the future every time, but what I wanted to lead into is that– oh and do you know what is so funny also? I had three out-of-hospital births after that, but with my fourth birth, I started out with the same midwife I had for the other two home births, and for some reason, I felt like I needed to transfer care back to the hospital so I went back to the hospital for two months and all of a sudden, my insurance change and the biggest network of hospitals in my state wasn't covered by my insurance anymore so it felt right to go back to out-of-hospital birth. I don't know why I had to do that whole loop-dee-loop of transferring to a hospital just to transfer back to the same out-of-hospital midwife that I had in the first place but I believe there was a purpose to that. I believe there was a purpose to that. I want to tell you guys that if seeking midwifery care whether in the hospital or out of the hospital feels uncomfortable to you or feels like, I don't know. These midwives still sound like chicken-dancing hippies to me, I would encourage you to go talk to some local midwives whether in a hospital or out of the hospital. Just sit down and talk to them and say, “Hey.” It's easier to talk to an out-of-hospital midwife. Out-of-hospital midwives do free consultations for you. In-hospital midwives, you might have to make an appointment and it might be harder but you should still try and see and get a vibe or just transfer care to them and go to a few appointments and see. You can always switch care back to a different provider or an OB because your intuition is smart but it does not know, it cannot guide you about things that you do not know anything about. I would encourage you to go and chat with these different providers, even different OBs if you want because your provider choice is so, so, so important. It is one of the most important decisions you're going to make in your care for your birth. It should be a good one. Your intuition can't tell you to go see x, y, z provider if you don't even know who x, y, z provider is. Gather as much information as you can. Talk to as many providers as you can. Go see the midwife. Interview the doula. Check out the birth photographer's website. See what I did there? See how it feels because even as a birth photographer, whenever I'm doing interviews with people, I'm not a fly-on-the-wall birth photographer. A lot of birth photographers brag about being a fly on the wall. You won't even know I'm there. No. I don't buy that because who is in your birth space is important. I am a member of your birth team just like every other person in that space, just like your nurses, your OB, your midwife, your doula– everybody there is a member of your birth team. I am a member of your birth team too and I will hold space for you. I will support you and I will love you. I am not a fly on the wall. Now, your provider is a member of your birth team. They probably arguably are one of the biggest influencers about how your birth is going to go and you deserve to be well-informed about who they are. You deserve to have multiple options that you know about and have thoroughly vetted and you deserve to stick up for yourself and do the provider who is more in line with the type of birth you want. How do you do that? You do that by finding out more about the providers who are available to you in all of the different birth locations and settings. Meagan: Yes. So I want to talk more about that too because there are studies and papers out there showing that the attitude or the view on VBAC in that area, in that hospital, in that birth center, both midwives and OBs, but we are talking about midwives here, really impacts the way that a birth can go. So if you don't interview and you don't research and you don't find those connections and even try, you will not know and in the end, it may not be the way you want. Even then, even if we find those perfect midwives, even if Julie went to the hospital midwife, she probably would have had a great experience, but who knows?Julie: Also, arguable too though, you could be seeing the most highly recommended VBAC provider in your area in the most VBAC-supportive hospital in your area that everybody goes to and everybody raves about, and if you don't feel comfortable there for whatever reason, you don't have to see the best, most VBAC-supportive provider if it doesn't feel right and if it doesn't sit right with you. Meagan: Yes. Julie: It goes both ways. Meagan: Yes. Julie: Sorry, I'm really passionate about this clearly. Meagan: No, because it does. It goes both ways. I mean, that's what this podcast is about is conversation and story sharing and finding what's best for you because even with VBAC, VBAC might not be the right option for you, but you don't know unless you learn. You don't know unless you learn more about midwives. Really though, people usually come out of midwifery care having a better experience and a more positive experience. I think that goes along with the lines of they do give a little bit more care. They do seem to be able to dive deeper to them as an individual and what they are wanting and their desires. They are a little less medically minded and a little bit more open-minded. You are less likely to have interventions. You are less likely to have those things that cause trauma and that causes the cascade that leads to the Cesarean. I'm going to have all of the links but I'm just going to read this highlighted. It's a study from Europe actually. It says, “A recent qualitative study in Europe explored the maternity culture in high and low VBAC countries and found that–” I'm talking a lot about high and low countries. Sorry guys, I'm realizing I'm talking a lot about it but a lot of these studies differ. It says, “Clinicians in the high VBAC countries had a positive and pro-VBAC attitude which encouraged women to choose VBAC whereas the countries with low VBAC rate, clinicians held both pro and anti-VBAC views which negatively affected women who were seeking VBAC. Both of these studies have shown that having midwifery care can have a positive influence on VBAC rates with an increase in maternal and neonatal morbidity.”Right there, not only doing the research on your provider, but doing the research within your location, what their thoughts are, what their views are, what their high-VBAC attitude or low-VBAC attitude is. If they are coming at you, even these midwives you guys, and they have all of these stipulations, it might be a red flag. It might not be the right midwifery group for you. Julie: Absolutely. That's where the intuition comes in. I like what you said about the VBAC culture. You can tell at different hospitals. We have been to many, many hospitals in our area. Sorry, can you hear my blinkers? It's distracting. Let's see. I absolutely guarantee you that every hospital has a culture around VBAC. Some of them are positive and supportive and uplifting and some of them are fearful and fear-based and operate on a fact where they are going to be more likely to pull you toward a repeat C-section or other interventions. I encourage you to look into the culture of your hospital but not only hospitals too. I realize it's not just hospital-specific. It's also out-of-hospital midwives. They all have their culture around VBAC. Your out-of-hospital midwives and your in-hospital midwives, all of the midwives, your group whether you see a solo practice or a group OB practice or you see a group midwifery practice or whatever, there is a culture surrounding VBAC. You need to do yourself a favor and figure out what that culture is. I got to my appointment and I need to head in so I'm going to say goodbye really fast. I'm going to leave Meagan alone to wrap up the episode, but yes. My parting words are honoring your intuition, talk as much to your VBAC provider as you can and find out what the culture is surrounding that no matter who you choose to go with and also, do not automatically write off midwives. You are doing yourself a huge disservice if you are not considering a midwife for your care. It doesn't mean you have to go with one, but I feel like everybody should at least look into them. I love you guys! Bye!Meagan: Okay. And wrapping up you guys, I am just going to echo her. I think that completely discrediting midwives without even interviewing them at all is something that is a disservice to ourselves. I'm going to tell you that I did that. I did that. I didn't even consider it. I interviewed 12 providers, 12 providers which is crazy and I didn't interview one midwife. Not one. I was interviewing OBs and MFMs and I realize I don't remember interviewing a single midwife. The only thing I can think of is that I let the outside world lead me to believe that midwives were less qualified. Yale has an article and they say, “First-time mothers giving birth at medical centers where midwives were on their care team were 75% less likely to have their labor induced.” 74% less likely to have their labor induced, 74% less likely to receive Pitocin augmentation, and 12% less likely to deliver by Cesarean which is a big deal. I know most of us listening here are not first-time moms. We've had a Cesarean. Maybe we've had one, two, three, or maybe four, but the stats on midwives are there. It is there and it's something to not ignore so if you have not yet checked out midwives in your area, I highly encourage you to do so. Like Julie said, you don't even have to go with anybody, but at least interviewing them to know and feel the difference of care that you may be able to have is a big deal. I highly encourage you. I love you all. I'm so grateful for midwives. I'm so grateful for my midwife. My VBAC baby was with a midwife and I did have an OB. I was one of those who had an OB backup who could care for me and see me if I needed to. That for me made me feel more comfortable but it's also something that can get confusing. I think we've talked about where sometimes you will do dual care and you will have one person telling you one thing and the other provider telling you the other thing. That can get stressful and confusing so maybe stick with your provider. But do what's best for you. Again, another message. Don't just completely wipe out the idea of a midwife if you have midwives in your area as an option. It may be something that will just blow your mind. Thank you all so much for listening and hey, if you have a midwife who you suggest or you've gone through a VBAC with, we have our VBAC-supportive provider list and we would love for you to add to it. Go check out in the show notes or you can go over to our Instagram and click in our Linktree and we have got our provider list there for you. Or if you are looking for that midwife to interview, go check them out. We definitely love adding to this list and love referring it for everybody looking for a VBAC-supportive provider. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

In this episode, fellow British Columbian Ashley Holmes shares her personal journey with infertility and how it led her to become a Holistic Fertility Coach. Host Lorne Brown dives deep into Ashley's story, discussing her initial challenges with unexplained infertility, her experience with medical interventions like Clomid, and finally, her natural conception through holistic practices. You'll discover the transformative power of yoga, meditation, and Ayurvedic practices in unlocking fertility and overall well-being. Ashley explains how the conscious work of understanding and aligning the mind, body, and spirit can bring about a state of inner peace and create a fertile foundation. If you're battling infertility or looking for holistic approaches to enhance your fertility journey, this episode is packed with practical insights and emotional wisdom that you won't want to miss.   Key takeaways:  Integration of Mind, Body, and Spirit: Learn the importance of combining physical, emotional, and spiritual practices to create a fertile environment. Conscious Creation of Reality: Understand how addressing unconscious patterns and beliefs can transform your fertility journey. Daily Practices for Well-being: Discover simple yet effective daily practices like yoga, meditation, and gratitude to foster presence and receptivity. Emotional Healing: The significance of releasing dense emotions like guilt and shame to free oneself from energetic blockages. Holistic Lifestyle: Tips on adopting a holistic lifestyle, including Ayurvedic practices, to maintain equilibrium and health.   Ashley Holmes Bio: A kombucha-loving, outdoor enthusiast, and mom of three, this Holistic Fertility Coach has transformed her personal fertility struggles into a mission to help others conceive naturally. With certifications in various forms of yoga and Reiki Level II, she has dedicated years to mastering energy medicine. After facing difficult fertility treatments and a challenging pregnancy, she turned to yoga and meditation to rebalance her energy, leading to natural conception. Now, she empowers others to take control of their fertility journey through holistic practices. Where To Find Ashley Holmes:   Website: https://holisticfertilitycoachinc.my.canva.site/ Instagram: https://www.instagram.com/ashley_holmes3202/ Facebook: https://www.facebook.com/ashley.holmes.3979 Holistic Fertility Coach Facebook Group: https://www.facebook.com/groups/271957647919481/?ref=share_group_link Health & Wellness Platform ViBLY: https://vibly.io/expert/ashleyjholmes Free Gift : https://subscribepage.io/nourished-reading How to connect to Lorne Brown online and in person (Vancouver, BC)   Acubalance.ca book virtual or in person conscious work sessions with Dr. Lorne Brown  Lornebrown.com   Conscious hacks and tools to optimize your fertility by Dr. Lorne Brown: https://acubalance.ca/conscious-work/     Download a free copy of the Acubalance Fertility Diet & Recipes and a copy of the ebook 5 Ways to Maximize Your Chances of Getting Pregnant from Acubalance.ca   Connect with Lorne and the podcast on Instagram: @acubalancewellnesscentre @conscious_fertility_podcast @lorne_brown_official DISCLAIMER: By listening to this podcast, you agree not to use it as medical advice to treat any medical condition in either yourself or others. This podcast offers information to help the listener cooperate with physicians, mental health professionals or other healthcare providers in a mutual quest for optimal well-being. We advise listeners to carefully review and understand the ideas presented, and to consult your own physician for any medical issues that you may be having. Under no circumstances shall Acubalance, any guests or contributors to the Conscious Fertility podcast, or any employees, associates, or affiliates of Acubalance be responsible for damages arising from the use of the podcast.

Dr. Natalie Crawford answers fertility questions exclusively from newsletter subscribers. Questions Answered: I was on the birth control pill for 13 years and now have irregular periods. My doctor wants me to start Clomid without any testing. Is this okay? Can we get a fertility workup before age 35 if we haven't been trying for a full year? What are the fertility options for women with a balanced translocation? Is obesity a reason for infertility? My doctor won't refer me to a fertility specialist until my BMI is under 30. How long does it take for sperm counts to recover after getting sick with the flu or a virus? What causes endometriomas? Want to receive my weekly newsletter? Sign up at nataliecrawfordmd.com/newsletter to receive updates, Q&A, special content and my FREE TTC Starter Kit! Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page @nataliecrawfordmd. You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today!      Thanks to our amazing sponsors! Check out these deals just for you: Quince- Go to Quince.com/aaw for free shipping on your order and 365-day returns Ritual-Go to ritual.com/AAW to start Ritual or add Essential For Women 18+ to your subscription today. If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram @nataliecrawfordmd, check out Natalie's YouTube channel Natalie Crawford MD, and if you're interested in becoming a patient, check out Fora Fertility. Learn more about your ad choices. Visit megaphone.fm/adchoices

We're sitting down with the incredible BFP Alumni Rosey. Diagnosed with “unexplained infertility” for basically her entire ten-year journey, Rosey never really knew why she wasn't getting pregnant. Struggling with primary and then secondary infertility, Rosey encountered numerous obstacles that might have made her give up on her dream of becoming a mom. Starting out at 33 years old, she was optimistic she'd get pregnant fast. But after one year of trying, she began to look deeper. That led to no real answers, but a lot of interventions some of which include: Timed intercourse with Clomid IUI with Clomid 3 rounds of egg retrievals (one with no viable eggs) 1 chemical pregnancy 1 miscarriage at 8 weeks Working with 4 different clinics Functional Fertility Doctor And then she made some life changing shifts that led to her baby boy. (But I'll save those for the podcast). You've got to hear this episode because we break it down! After listening, you'll understand why some women succeed despite numerous obstacles and how you can be one of them.  (Spoiler Alert: it's not as complicated or mysterious as you might think.)  Here's some of the biggest takeaways: Paying attention to what feels right vs what does NOT feel right is essential. Being your own best advocate at your clinic (this one is HUGE) Value of trying new things when something isn't working (which takes courage) The power of reminding yourself “This is possible” even when the past may suggest otherwise. How to balance “doing everything you can” without getting attached to one particular cycle being “the one” (Sooo hard but equally as powerful)   If you do one thing for yourself and your fertility today listening to this podcast is it! Then join my FREE, Live Masterclass: FROM BURNT-OUT TO BADASS on October 9th at 12:30 pm EST. I'm teaching the 3-Step System Rosey and other BFP members used to exit conception chaos, enter clarity and increase their odds of getting pregnant! Click HERE to grab the LINK Psst: if you join live you'll also get a free tool you can use right away, AND you'll have a chance to learn more about the BFP and grab some bonuses if you join! (There will also be a replay) It's a total no-brainer. xo

Dr. Natalie Crawford addresses a question from an OB/GYN colleague about managing patients with unexplained infertility and high AMH levels. She explains that unexplained infertility is often due to undiagnosed issues, and a full workup is necessary to understand the underlying causes. The episode delves into the mechanisms of ovulation induction medications like Clomid and Letrozole, which are commonly used to induce ovulation in patients with conditions like PCOS. Throughout the episode, Dr. Crawford emphasizes the importance of patient advocacy and education, encouraging patients to ask questions, understand the reasons behind treatment recommendations, and seek a second opinion if they feel their current treatment plan is not effective or appropriate. Want to receive my weekly newsletter? Sign up at nataliecrawfordmd.com/newsletter to receive updates, Q&A, special content and my FREE TTC Starter Kit! Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page @nataliecrawfordmd. You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today!      Thanks to our amazing sponsors! Check out these deals just for you: Quince- Go to Quince.com/aaw for free shipping on your order and 365-day returns Ritual-Go to ritual.com/AAW to start Ritual or add Essential For Women 18+ to your subscription today. If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram @nataliecrawfordmd, check out Natalie's YouTube channel Natalie Crawford MD, and if you're interested in becoming a patient, check out Fora Fertility. Learn more about your ad choices. Visit megaphone.fm/adchoices

On today's episode, Ali talks to Komel Caruso, the Co-Founder of HerMD, about her infertility journey. Komel talks about growing up in a traditional Muslim household and the sex education (or lack thereof) she received as a Catholic school student. It was, "Don't have sex, you'll get pregnant. You'll just get pregnant every time you have sex. I was just so fearful that if I had sex, I would get pregnant. Even if I was using birth control, I could still get pregnant. That fear leads to a lot of anxiety," she says. Komel also talks about having a "wonderful surprise baby" in her early twenties, discovering that she had PCOS, and what happened when she started taking Clomid. She also talks about IUI, IVF, "feeling like a failure," and finally getting pregnant again via ART. She also talks about her sister and co-founder, Board Certified OBGYN Dr. Somi Javaid, and how they created HerMD, looking to revolutionize women's health and pivot away from "drive-thru gynecology." For more, go to www.hermd.com/TOPICS COVERED IN THIS EPISODE:Infertility; PCOS; IUI; IVF; IVF cycles; IVF treatment; twin pregnancy; Clomid; pregnancy loss; pregnancy after infertility; motherhood after infertility; women's health; sisterhood; OBGYN; reproductive rights EPISODE SPONSORS:WORK OF ARTAli's Children's Book about IVF and Assisted Reproductive Technologyhttps://www.infertileafgroup.com/booksDo not miss Ali's children's book about IVF! It's been getting rave reviews. “Work of ART” is the story of an IVF kiddo the day he learns he is a “work of ART” (born via IVF and ART). For young readers 4-8. Hardcover. Written by Ali Prato; Illustrated by Federico Bonifacini.Personalized and non-personalized versions are available. Order yours now at https://www.infertileafgroup.com/booksFor bulk orders of 10 or more books at 20% off, go to https://www.infertileafgroup.com/bulk-order-requestFERTILITY RALLYIG: @fertilityrallywww.fertilityrally.comNo one should go through infertility alone. Join the Worst Club with the Best Members at fertilityrally.com. We offer 5 to 6 support groups per week, three private Facebook groups, tons of curated IRL and virtual events, and an entire community of more than 500 women available to support you, no matter where you are in your journey.Join today at link in bio on IG @fertilityrally or at www.fertilityrally.com/membershipSAVE $40 on an annual membership with code RALLY2024RECEPTIVA DXhttps://receptivadx.com/ReceptivaDx is the singular test capable of identifying endometriosis,progesterone resistance, and endometritis in one comprehensive analysis. These conditions are often the hidden culprits behind unexplained infertility, directly impacting the success rates of IVF treatments. Ask for the Receptvia DX test today, and use code INFERTILEAF24 for $75 off.Support this podcast at — https://redcircle.com/infertile-af/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Laura est tombée enceinte la première fois avec l'aide de ce qu'elle pensait être un simple « petit boost », du Clomid prescrit par sa gynéco. Sa grossesse se passe bien, son accouchement aussi, les premières heures sont idylliques. Quelques années plus tard sa nouvelle gynéco lui détecte un SOPK (syndrome des ovaires polykystiques) et lui explique que le Clomid est un traitement qui nécessite un vrai suivi pour surveiller le nombre d'embryons qui pourraient se développer dans son utérus.Après une fausse couche, Laura est suivie jusqu'à la période de Noël, et sa gynéco lui conseille de ne pas poursuivre les essais bébé car elle sera en congé en décembre. Mais Laura ne veut pas perdre de temps et n'imagine pas que cela va la conduire à prendre par la suite la décision la plus dure de sa vie.Elle tombe enceinte, de quadruplés. L'un des embryons n'est pas viable et part naturellement mais Laura et son mari n'envisagent pas d'avoir des triplés en plus de leur premier garçon, et font donc le choix de la réduction embryonnaire. Dans cet épisode, Laura nous raconte cette décision qu'elle a du prendre tout en poursuivant sa grossesse, comment s'est passé son accouchement entre l'accueil de ses jumeaux et les adieux à son troisième, et comment elle vit sa maternité avec cette culpabilité qui lui pèsera jusqu'à la fin de sa vie.Bonne écoute !----------------------------------------------Pour soutenir Hello Mammas, il vous suffit de mettre cinq étoiles et un avis sur votre application podcast. Parlez-en aussi autour de vous !Sur Instagram : @hello.mammas Become a member at https://plus.acast.com/s/le-tourbillon. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

If you're struggling to get out of bed, feeling moody, depressed, or suffer from a low libido, this episode is for you. Whether you're male or female, you can benefit from testosterone. Jay Campbell is on a mission to help you discover the benefits of the testosterone optimization therapy. Today we dive into the Testosterone Optimization Bible and the do's and don'ts of testosterone. Episode brought to you by the world's best organic sheets. Code: DEELEY15 Jay Campbell is a four-time international best selling author, men's physique champion and founder of the Jay Campbell Brand and Podcast. 5:41: What's driving low testosterone? 6:00: Wait, Tesla's are bad for your health? 9:50: The average doctor that prescribes therapeutic hormones to people has no idea what they're doing 10:34: What's the ideal age to start TRT? (Best solution: get your FREE testosterone tested, but people as young as 17 can benefit from TRT if they have low levels) 12:51: Would you consider Clomid over TRT? (Clomiphene) 15:13: Difference between free and total testosterone 16:44: Your Doctor tells you you're in 'the normal range' but you don't feel normal... 19:27: Most men need to be between 35-55 of Free Testosterone to feel amazing 20:19: How to feel amazing as a woman approaching or over 40 20:54: Thyroid health must be optimal 22:50: Symptoms of low testosterone in both men and women 24:57: Benefits from taking TRT/Testosterone Replacement Therapy 27:06: TRT can act like Modafinil or Tesofenzine 27:54: Three different delivery systems to take TRT (oral, injectables, and creams) 30:10: You want to mimic your body's natural production 32:59: Best location to use testosterone cream which as the most bioavailability: scrotum (and clitoral region for women) 34:26: Does your body stop making testosterone if you start taking it therapeutically? 36:20: Top 10 questions to ask your Doctor about therapeutic testosterone PDF 36:29: The truth about pellets 39:53: Pellets are the most expensive delivery system 40:06: How do you know if you're a high excreter? 41:21: TestosteroneAddiction.com 42:37: The difference between a pill and a poison is the dosage 42:56: What dosage should we be taking? 43:14: Men; injectable: 150 - 200 milligrams a week (or 2 - 3 clicks if using cream) 45:17: Women; oral: .75 - 2.5 milligrams 47:43: Dr. Scott Howell and androgens 49:42: Aromatase inhibitor supresses estrogen 52:03: Dr. Rob Kominiarek 53:07: Just say no to statins 59:24: If you begin taking testosterone, do you need to take it for the rest of your life? 1:00:07: Testosterone boosters on TV (do they work?) 1:03:13: Can a man over 70 safely start testosterone? 1:04:13: Can testosterone re-grow your hair? 1:05:30: Auxano (use with caution as it contains a toxic PUFA: grapeseed oil) 1:05:41: Folitin to regrow hair 1:05:56: Hair loss is caused by blood flow restriction to the scalp 1:08:45: Fasting is the greatest, again, cellular fumigator 1:12:05: Regenevive & Regeneburn Where to find Jay: Website Instagram Amazon

Send us a Text Message.Dom L'Amour speaks with Friend of the show and my best friend Chris Bate  AKA @chriselb_88. They have a mental check in and also speak about having babies.Imagine wanting to start a family but being faced with the complex world of male infertility and fertility treatments. We promise that by the end of this episode, you'll have a deeper understanding of the emotional, financial, and logistical hurdles that come with this journey. Join me, Dom L'Amour, and my friend Chris Bates as we share our personal stories about navigating the healthcare system, dealing with insurance challenges, and the differences between IVF and IUI treatments. Chris also opens up about his experiences with urologists and the potential role of medications like Clomid. This candid conversation sheds light on the importance of understanding your partner's perspective and desires as you embark on the path to parenthood.Shifting gears, I take a moment to reflect on my current mental state and what I've been up to lately. With Adrian out of town, I've embraced the opportunity to attend jam sessions and open mics, which has been invigorating. Balancing this newfound freedom with the responsibility of caring for our dog, I've also been networking with new musicians and even had a blast at our recent Juneteenth barbecue. Wedding season is in full swing, and I share some insights on the unpredictable nature of outdoor weddings and how we managed our own wedding logistics. Feeling positive and connected, I emphasize the significance of strong communication in maintaining a healthy relationship, even amidst minor family issues.Finally, Chris and I delve into the rollercoaster of fatherhood and family life. We explore the emotional and practical challenges of new parenthood, the rapid development of a five-month-old baby, and the importance of flexibility and perseverance in the fertility process. From key milestones like sitting up and teething to the joy of social interactions, we celebrate the simple pleasures and express our gratitude for every moment. Wrapping things up, I reflect on the joy of reconnecting with friends and the excitement for what the future holds. This episode is a heartfelt tribute to the trials, triumphs, and simple joys of family life.Opening quote: Nelson MandelaOpening and Closing Theme song: Produced by Dom L'AmourTransition Music from Mad Chops Vol. 1 and Mad Chops Vol. 2 by Mad Keysand from Piano Soul Vol.1(Loop Pack) by The Modern Producers TeamCover art by Studio Mania: Custom Art @studiomania99Please subscribe to the podcast, and give us a good rating. 5 stars please and thank you. Follow me on @doml_amour on Instagram. Or at domlamour.comSupport the Show.

Dr. Armando Hernandez-Rey is Conceptions Florida's medical director and triple-board certified in Reproductive Endocrinology and Infertility; Obstetrics and Gynecology; and Surgery. Dr. Armando Hernandez-Rey has over 24 years of experience in the medical field. He graduated from Universidad Autonoma de Ciencias Médicas de Centro America in 1998. He attended medical school at the University of Miami Miller School of Medicine for his specialization in Obstetrics and Gynecology. He specializes in treating patients with polycystic ovary syndrome (PCOS), recurrent pregnancy loss (miscarriage), and severe endometriosis. He is especially interested in fertility preservation (eggfreezing) for patients who must delay childbearing for personal or medical reasons, including cancer and systemic lupus erythematosus. Dr. Hernandez-Rey is an assistant clinical professor at the Herbert Wertheim College of Medicine at Florida International University and serves as an ad-hoc reviewer for the prestigious peer-reviewed journal, Fertility and Sterility. He has also published several articles and chapters in medical literature.   Website https://www.conceptionsflorida.com Instagram https://www.instagram.com/conceptionsflorida/ Facebook https://www.facebook.com/conceptionsfl Tiktok https://www.tiktok.com/@conceptionsflorida     For more information about Michelle, visit: www.michelleoravitz.com   The Wholesome FertilityFacebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/   Instagram: @thewholesomelotusfertility   Facebook:https://www.facebook.com/thewholesomelotus/     Transcript:   Michelle (00:00) Welcome to the podcast, Dr. Hernandez -Ray.   Armando Hernandez-Rey MD (00:04) Thank you, Michelle. Thanks for the invitation. It's really an honor and a privilege to be on your show, on your podcast.   Michelle (00:09) Yes, well, I've heard a lot about you over the years because I've had a lot of patients go to you. And one of the things that I've heard is that you do really well with surgeries and fibroids and you're able to in and   but in a way that still preserves fertility. So that was one of the things that I've learned.   Armando Hernandez-Rey MD (00:32) Well, reproductive endocrinology and infertility as a subspecialty is a surgical subspecialty as is OB -GYN, which is a mandatory path to get to the infertility route. Unfortunately, a lot of the newer generation is not operating because they're not taught, not through no fault of their own, they're not taught. The reality is that it is...   Michelle (00:47) Mm -hmm.   Armando Hernandez-Rey MD (00:55) for a myriad of reasons this phenomenon has happened. Number one, the minimally invasive surgery tract has been developed where you have the person who's really just really perfected their obstetrical skills. And then you have the gynecologic oncology route and the pelvic urogynecology or pelvic reconstruction route and the minimally invasive surgical route. And a lot of the reproductive endocrinologists,   have said, you know what, I'm going to forego surgery and I'm going to refer it out. My personal philosophy, and this is in no way critical to absolutely anybody, it's just my own, is that I went into medicine to be a surgeon, I actually wanted to be an orthopedic surgeon. I ended up not liking it, I had a very bad fracture when I was in my teens playing competitive soccer, and I really had some PTSD from that fracture, so I just couldn't see myself doing   orthopedic surgery, but I somehow found my way towards OBGYN, absolutely loved it. And eventually towards the reproductive endocrinology route, which encompasses a lot of surgery, should you allow it. And so yes, like you said, fibroids are an important part of fertility. you, tubal reconstruction used to be much more important than it is now. People are more, are bypassing that route and going directly to in vitro fertilization.   Endometriosis, as I said, I was running a little bit late today. I was in a very, very complex endometriosis case with a patient with bilateral endometriomas and complete frozen pelvis and scar tissue. And, you know, just a little bit longer, I had to work with the colorectal surgeons to do some resection of the colon because it was, you know, endometriosis is such an awful, awful disease. So yes, to answer your question, I...   Michelle (02:41) Yeah.   Armando Hernandez-Rey MD (02:44) Absolutely love surgery. I think it's an integral part of the infertility journey to get a patient from being infertile to getting them to a high level of success with any sort of treatment. And hopefully it's more conservative than having to resort to artificial insemination or in vitro and with just surgery and corrective surgery, we can help the couple achieve a pregnancy.   Michelle (03:07) Yeah, and I think it's important because I think that a lot of people might not realize that there are certain people that specialize in this or have experience doing that, doing surgery and really getting in there because it is important to find somebody who's specialized if you have a complicated case.   Armando Hernandez-Rey MD (03:23) I think it's important. I think people feel well taken care of. Again, my perception, people feel well taken care of when everything is done in house. Meaning, you know, there's no messages that get lost as you refer a patient out who may have the minimally invasive surgery knowledge, but not necessarily the focus on infertility, reproductive endocrinology.   Michelle (03:33) Mm -hmm.   Armando Hernandez-Rey MD (03:50) specialist has and I think people feel comfortable with that.   Michelle (03:52) Yeah, absolutely. Because there's some people that will take out fibroids, but they're not doing it with fertility in mind. You know, for many women, it could just be just taking out fibroids, but you're doing these things with fertility in mind.   Armando Hernandez-Rey MD (04:07) There are many great surgeons out there that are not infertility specialists. You know, I want to make sure that I'm clear. I just think that I was, I always love surgery. I happen to do surgery and I feel my patients feel very comfortable with me doing the surgery and not being referred out. It's what I think. You know, the journey, the infertility journey is very complex. It requires a lot of a woman in particular more than the male and to be   Michelle (04:25) Yeah.   Armando Hernandez-Rey MD (04:36) you know, passed around, it gets complicated. And I think it's nice to be able to offer that service to patients.   Michelle (04:44) Yeah, for sure. And then you do specialize in miscarriages.   Armando Hernandez-Rey MD (04:49) Sure, I mean, I think we all really have a focus on on as you know, we're all specialized in miscarriages and and PCOS and all that there's some people that tend to see More miscarriage patients or they people will refer miscarriage patients to us We have a particular kind of focus on that, you know, I think a lot of it is   genetic, a lot of it is immunologic, a lot of it is just taking a holistic approach to things and not just focusing on one or the more common causes of infertility. And even now, I think that, you know, the use of supplements, which maybe 15 years ago was maybe considered some snake oil. Now, I think there's a lot of provocative data that has shown that supplements do work, in particular in   Michelle (05:18) Mm -hmm.   Armando Hernandez-Rey MD (05:44) cases with recurrent miscarriage. And now we have the ability to measure those levels and we are now ability to supplement those levels and they have tremendous impact positively on these patients.   Michelle (05:57) And what supplements have you seen help with miscarriages?   Armando Hernandez-Rey MD (06:02) Well, I think a lot of it has to do with what the cause of the miscarriages is. Oftentimes, believe it or not, miscarriages can alluded to fibroids, it could be anatomical, sub -mucosal myoma. Well, there's not gonna be any supplement that's gonna help with that. It's just purely the surgical route or the diminished ovarian reserve,   Michelle (06:07) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (06:29) cause for recurrent miscarriages, which is older women or ovaries that are behaving or eggs that are behaving older than what their chronological age would dictate, you have a higher chance for aneuploidy. And in those cases, there's a variable cocktail of supplements that we use, including ubiquinol, including N -acetylcysteine, including vitamin E, even melatonin has been shown to be very, very effective. And I can go on and on, even alpha lipoic acid.   Michelle (06:50) Mm -hmm.   Armando Hernandez-Rey MD (06:57) as well. There's some very nice studies coming out of Mayo Clinic that have shown that aflalipoic acid is very, very good for recurrent miscarriages. So again, things that we thought were, well, they can't hurt, now we know that they absolutely help.   Michelle (06:57) Yeah.   Right. Yeah. I mean, that's great because it just helps to know that there's something that people can do that really does make a difference. And it's not just like in theory with miscarriages when it comes to immunology. I'd love to talk about that because I know that that's a big one. Actually, I did see a study that showed that women who have are more sexually active, that their immune system calms down. It behaves differently in the luteal phase.   Armando Hernandez-Rey MD (07:31) Mm -hmm.   Michelle (07:44) so that it's able to receive life so that it's not seeing like the sperm as an invader the, yeah.   Armando Hernandez-Rey MD (07:50) So women that are more sexually active than others, it's probably a function of repeated antigen exposure, which is the more the woman is exposed to the antigens of the sperm, more there becomes an acquiescence by the immune system to be more receptive of that embryo. Because remember, the embryo is   Michelle (08:06) Mm -hmm.   Armando Hernandez-Rey MD (08:19) a haplotype, meaning it's half female, half the woman, half the mother, and half the male. And the only genes that the immune system of the mother has got to harbor the pregnancy are her own. And so oftentimes the immunologic processes are heightened because it does not recognize the male antigens that are formed part of the embryo in general. But as a whole, I mean, recurrent pregnancy loss,   Michelle (08:33) Mm -hmm. Right.   Armando Hernandez-Rey MD (08:47) is, is a small portion of the general population and, it's skewed towards advanced maternal age and advanced paternal age. so the immunologic component, while absolutely important, I think it's the one where we're still not a hundred percent sure how to absolutely treat it. Although supplementation and.   immune suppression definitely are known to work. It's the testing that I think we still need a lot more work in doing because you know people talk about NK cells and you know that was part of my thesis when I was a fellow. So we talk about NK cells and ANA and antiphospholipids and all of that and the reality is that these tests have very very   poor sensitivity in the realm of immunologic infertility or reproductive immunology. And so you may have COVID and then you can test positive or lightly positive for NK cells. And so I think that the overwhelming response by the treating physician is, well, they're positive, they must be immunologically incapable of handling a pregnancy. So therefore we should treat.   Michelle (09:40) Mm -hmm.   Armando Hernandez-Rey MD (10:04) with nowadays what we use as intralipids. Back in the day, we used to use IVIG that has kind of fallen by the wayside a little bit. I think it's better to treat empirically than to have someone treat or test for all of these different immune markers that really, really in the presence of immunology and reproductive immunology,   They have very low sensitivity. Now if you're treating or you're looking for lupus or rheumatoid arthritis or mixed collagen disorder or Sjogren's for sure, they are your go -tos every single time.   Michelle (10:44) And what about a PRP for ovaries? What has do you do offer that?   Armando Hernandez-Rey MD (10:50) ovaries. American study of reproductive medicine came out with a black box warning that they do not recommend PRP for ovaries. Now, PRP for recurrent implantation failure, poor lining development, there is some very robust data that there may be some room or benefit for this.   Michelle (10:57) okay.   Mm -hmm.   Armando Hernandez-Rey MD (11:14) And we do do offer that. We do not offer intra ovarian PRP because ASRM has a huge black box warning on this. It's a liability. The potential for infection is there. Tubo ovarian abscess have been reported, adhesions, periovarian adhesions, and with very little to no benefit whatsoever. I mean, the whole premise for it is that we are...   Michelle (11:16) Okay.   wow, okay, I didn't know that.   Mm -hmm.   Okay, got it.   Armando Hernandez-Rey MD (11:42) regenerating the follicle complex and therefore improving egg quality and that definitively has not been shown to be the case. Although anybody who suffers from that as I would be would be like, slide me up. But unfortunately, you know, it's very easy for us to fall prey to things that we desperately want without having the medical literature to corroborate it or back it up.   Michelle (11:49) Got it.   Right.   Got it. So that's actually showing to not necessarily be what a lot of people originally thought, but for the uterus, it has been shown to help.   Armando Hernandez-Rey MD (12:15) Yes, we are doing PRP installations and very select group of women with those diagnoses in particular. And.   Michelle (12:25) So who would be a good candidate? Somebody who's had failed transfers, inflammation.   Armando Hernandez-Rey MD (12:30) Yes, someone with very high quality embryos, high quality embryos that are not getting pregnant. Also patients, for example, patients who have adenomyosis that do not develop a nice lining, a thickened lining. Those have been shown. Our numbers are very small, you know, by no means.   Michelle (12:42) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (12:53) they are in the realm of what a randomized controlled trial should be. We're following the data from the randomized controlled trials and from the literature that's out there. So patients with adenomyosis who have poor lining development, recurrent implantation failure, so patients with euploid embryos, that means a normal embryo that's tested that looks to be high quality. Also, after a second implantation failure, we'll...   offer that to the patient as a possibility.   Michelle (13:19) Mm hmm. Got it. Awesome. And then also we were talking about Ozempic pre -talk. So I'd love to get your... Yes. Yeah. Ozempic babies.   Armando Hernandez-Rey MD (13:24) the topic du jour these days, right?   It's right. So as we were discussing, I mean, this, this phenomena is not really a phenomenon that's surprising at all. It is just a, a byproduct, a side effect of, of how the medication works and the effects that positive effects that I have on women with in particular, and ambulatory disorders, specifically polycystic ovarian syndrome, which is often tied to or associated with insulin resistance, obesity, sometimes even overt.   type 2 diabetes and the elevated levels of insulin, the elevated testosterone levels, they all work together to create this sort of environment within the ovary and the system of the female which creates an ovulatory disorder or dysfunction. And as a woman loses weight by virtue of the way that these GLP1s or glucocortes   Michelle (13:58) Mm -hmm.   Armando Hernandez-Rey MD (14:22) Glucagon like peptides work They're very successful. They're very good at number one slowing gastric emptying which in turn slows down the release of sugar into the blood system to the Number one number two it stops the the release of glucose produced by the liver and Number three increases insulin levels so increase insulin levels helps get the the   the sugar into the muscles out of the circulation and out of stimulating the ovaries and the theca cells to produce more androgens which then get produced produce more estrogen which then stops the hypothalamic pituitary ovarian axis from functioning correctly and as these levels drop patients automatically begin to have spontaneous ovulation if the system is working and the male has normal sperm and they're sexually active.   this is how the ozempic baby phenomena occurs. And what we discussed also is that the concern is of the downstream consequences of ozempic babies given that the current recommendations are to have at least a two month washout period before anybody starts to try to conceive.   Michelle (15:32) So two month washout means like really not trying anything. Yeah. And then also, I know like naturally, myonocytol is really helpful as well for insulin resistance. It might take a little longer. And then also metformin has been used as well.   Armando Hernandez-Rey MD (15:37) No exposure, right? No exposure.   Yeah. Yes. So, my own hospital is, is a, is a great product. my own hospital alone, although you will find oftentimes my, my own hospital with a D chimeric, hospital and really the literature shows that my own hospital by itself is the one that truly has the most benefit might be hard to find.   Michelle (16:06) Right, yeah.   Right because for a little while they said my own hospital and dechiro, but now they're going back to saying just my own ocital, correct?   Armando Hernandez-Rey MD (16:23) Yeah, well the way that it's normally found in the body is at a ratio of 20 to 1. And that's what those supplements show, 20 to 1. Although we know now that in the ovary it's almost 40 to 1 ratio of myoinocytol to D -chimeric, inocytol.   Michelle (16:30) Mm -hmm.   Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (16:49) Myo Inositol is actually not an essential vitamin, but it's considered like a vitamin, but it's in the category of B8 It's a glucose like peptide that basically helps to Help the system function by processing the circulating blood sugar in a way that's more physiologic and there by lowering insulin levels and thereby also helping tremendously with   Michelle (16:56) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (17:16) regularity of cycles and even spontaneous ovulation as well. And metformin obviously is medication that's been around for many, many years. It is somewhat of a controversial drug. It is an anti -aging drug even these days because we know that insulin levels are so profoundly toxic for aging for the muscle and for the system in general.   Michelle (17:29) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (17:45) And so we know it works, we know that it helps with the efficiency of insulin. And so it's certainly been used for many, many, many years in the presence of patients with polycystic ovarian syndrome. I would challenge people to be a little bit more meticulous about using it in patients who are the lean PCOS.   Michelle (18:11) Right.   Armando Hernandez-Rey MD (18:11) or the skinny PCOS or the ovulatory PCOS even though insulin levels have been shown to be higher, slightly higher in...   Michelle (18:19) So you're talking about being cautious with metformin, not necessarily myonositol. Yeah, yeah.   Armando Hernandez-Rey MD (18:22) Metformin, you also don't want very high levels of myelonostetal because they can be, you know, there is some quote unquote toxicity. I think the recommendations are up to four grams per day. I think all the recommendations are four grams per day in two divided doses, two grams in the morning and two grams at night. I've seen patients be on eight grams and 10 grams and toxicity really starts happening around the greater than 10 gram dose.   Michelle (18:29) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (18:52) I in our office we only use it, you know, what's recommended which is the four gram total per day two grams in the morning two grams at night and I don't think it's the end -all be -all I don't think it's you know treating anything in life is multi -pronged. It's not just one single thing perhaps but I definitely believe very wholeheartedly that it does assist in in adjunct treatment, although we certainly have patients put patients on on myocytil and combined with   Michelle (19:06) Yeah. Right.   Armando Hernandez-Rey MD (19:20) diet and exercise and have been able to achieve pregnancies on their own, which is obviously what we want instead of having to go through treatments.   Michelle (19:27) That's great. I mean, I will say that I was very surprised this past year. two different patients came from different, different places, not yours, it was other doctors, but I think the nutritionist there suggested metformin when they did not have insulin resistance or PCOS for egg quality.   Armando Hernandez-Rey MD (19:47) Yeah, I'm not familiar with any studies that have shown that have improved that. In fact, when I was a fellow, we were, just as I was coming into fellowship, where I trained, Rutgers was involved with a very well known and publicized study, it's called the PP COAS study, which looked at patients on placebo versus metformin alone versus metformin with Clomid, sorry.   placebo versus clomid versus clomid with metformin and there was no difference in pregnancy rates or anything else. I'll go one step further with them going back to the myonocytol. It has even been shown to decrease the rates of gestational diabetes and so in our patients with PCOS with who are you know   Michelle (20:18) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (20:39) Stage one, type one obesity, type two, we'll continue them on the myonostetal throughout the pregnancy and when they leave us and go to their OB -GYN, in our referral letter back, we'll say that we're recommending for her to continue on myonostetal because there have been improvements in sugar levels and glycemic control and reduction in gestational diabetes overall.   Michelle (20:54) Yeah, that's good to know.   another big one is vitamin D. A lot of people, even though we're in Florida here, we have a lot of sun. A lot of people are very deficient in vitamin D.   Armando Hernandez-Rey MD (21:11) Yeah, What it is is a combination of things. Number one, we're not as sun exposed as you think we are. You know, we're always in a car, we're always indoors, it's very hot. And yes, we go out to the beach and there is a lot of sun, but we become very, very sensitive to the sun and to the untoward effects of the sun.   Michelle (21:17) Mm -hmm.   Armando Hernandez-Rey MD (21:35) So we protect ourselves tremendously. That's number one. Number two is that I think the levels are set higher than what the average person can sustain with just diet and sun exposure. And actually the recommendations now in the infertility world that when you order a vitamin D from Quest, they'll tell you that the levels are, you want them at   Michelle (21:38) Mm -hmm.   Armando Hernandez-Rey MD (22:04) definitively above 20 Certainly above 30 and now recently now the recommendations are that for them to go above 40 and and and Yeah, I'm not yeah, so I heard I've read 40 I it was a Paper that came out of Either the Lancet or   Michelle (22:11) Yes, yep, I've been hearing that or even 50. Yeah.   Armando Hernandez-Rey MD (22:27) or fertility necessarily, anyone, one of, that they recommend now for vitamin D levels to be above 40. So that's really hard. I mean, I work really hard. I take a lot of vitamin D and I'm just barely scraping like 50. You know, I take about 5 ,000 units a day, which is what we're recommending nowadays, 5 ,000 units of vitamin D. And I take that every single day and I barely scratch,   Michelle (22:38) Mm -hmm.   Yeah.   Armando Hernandez-Rey MD (22:56) you know, 45, 50 every time I get an average check. So I'm not getting as much sun as I think I am, number one. I am out fairly often. I do play some golf, not enough. And yet it's not enough. So definitely supplementation's important.   Michelle (23:03) Mm -hmm.   Yeah, magnesium is also important. That's another thing. It's to not be deficient in magnesium because magnesium plays an important role of our absorption of D, which, you know, obviously doing this, I learned, I was like, that's might be deficient magnesium and be taking a lot of D and then their body's not processing, which is why it's important sometimes even in foods, foods have everything. So like,   even beef liver, you know, from Chinese medicine perspective is so beneficial because it has iron, but it has it in a combination of nutrients that helps the body absorb it.   Armando Hernandez-Rey MD (23:46) Yeah, B6, B12 are incredibly important for iron absorption as well. So all of these things are extremely important. Everything is all intertwined and we're just learning about this. And for us, I've really gotten grabbed hold of this whole longevity thing, hence my aura ring and all of this. And...   Michelle (23:57) It is.   Yeah.   Armando Hernandez-Rey MD (24:09) I'm just trying to apply a lot of the things that we know today work for longevity medicine and anti -aging principles to the infertility world because it's all intertwined. It's all intertwined.   Michelle (24:16) Yeah.   without a doubt. It's funny because that you say that because I always say it's pretty much anti aging. Yeah.   Armando Hernandez-Rey MD (24:26) Yeah, totally, totally. They're even coming up with a way to stop menopause.   Michelle (24:36) wow. How?   Armando Hernandez-Rey MD (24:37) which is extremely interesting. Believe it or not, recombinant antimullerian hormones.   Michelle (24:42) How is that? Explain that.   Armando Hernandez-Rey MD (24:46) So the way that antimullerine, the function of antimullerine hormone at the level of the ovary is that it stops follicular recruitment. That's why women with PCOS have higher AMHs and therefore they have higher egg counts and higher, they tend to go into menopause later on, et cetera. That's because they have high levels of antimullerine hormone. So by reproducing or creating it in the laboratory and then from an early stage,   This is in its infancy, by the way, okay? So this is, yeah, this company, I believe she's a Harvard scientist, biochemist or something, who's coming up. My point is that, listen, that it's all intertwined, aging and even in menopause, for God sakes. Now I've been doing this for so long that I now,   Michelle (25:18) It's new.   Mm -hmm.   Armando Hernandez-Rey MD (25:39) seeing menopausal patients who were like, you know, listen, you took care of my baby, you're a reproductive metachronologist, you understand the science, will you treat me? And, you know, like, and I realized, like, somewhere, some women got like, they got a some bad luck thrown their way because, you know, with the WHI results and the way they were interpreted, they made hormones bad. And somewhere along the way, someone said,   It's okay for women to suffer from menopause, just suck it up. Like it's not okay. That's not okay. That's not okay. And so if you start from very early on and, you know, and, and really practice what you preach, which is healthcare and not sick care, which is what we practice in the United States, you know, we're just very, we, we're not proactive. We're reactive to when a patient is sick instead of early intervention, early screening and all of that.   Michelle (26:25) Yeah, absolutely.   Armando Hernandez-Rey MD (26:30) And that goes for the infertility world and that goes for a woman's long reproductive life extending past menopause. I think we still have a lot of challenges to overcome, but I think that we're heading in the right direction. Sorry to digress a little bit. I went off on a tangent there for a second.   Michelle (26:43) Yeah, for sure. no, it's okay. But you know what? I love the passion and I love that, that, you know, ultimately is great. It's important, very important, because it's true. And I agree a lot with what you just said, that we should be proactive when it comes to healthcare. I mean, really when it comes to so many things and something else that I...   that I read, it was an animal study. It was a study on, I believe it was like, I don't remember which kind of animal it was. I think it was like either sheep or cows or some form of those where they actually gave them oxytocin right before IUI. And that improved the chances of the conception rates, which I thought was very interesting because I think that that's one of the things with IUI that's missing because obviously you're taking away the connection.   that is usually there when you're just under natural circumstance. And I thought it was interesting because I was looking into it for something else to understand from a Chinese medicine perspective, because they have this heart -uterusconnection, that connection, the bonding. And so what I found was interesting too is that oxytocin increases around ovulation and after intercourse. And usually what they look at it as its role is usually for labor.   not so much conception. So I was just going to kind of like pick your brain on that. Any thoughts on that?   Armando Hernandez-Rey MD (28:13) Well, I mean, oxytocin is secreted at the time of... I'm not sure of ovulation, I didn't know that. But definitely at the time of...   Michelle (28:21) or it increases around that time, like right before ovulation in the cycle, a woman cycle.   Armando Hernandez-Rey MD (28:27) What we know that it's involved is at the time of orgasm. And so this may promote uterine contractility, which is what is used for intrapartum, to promote contractility of the uterus, to promote descent and eventual delivery. And we know that it's intimately involved in orgasm, we're seeing.   Michelle (28:33) Mm -hmm.   Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (28:55) during intercourse and orgasm and so with you know the projection of with the secretion of oxytocin and it causing uterine contractility obviously not at the same level that it does during labor but at smaller amounts then I can see how there could be a role for oxytocin in artificial insemination.   Michelle (29:18) even in fertility in general and because it's got to be there for a reason why would the body produce it around that time?   Armando Hernandez-Rey MD (29:25) Well, yeah, I guess, but it's either IUI or IVF and we definitely don't want oxytocin during the IVF cycle.   Michelle (29:33) Right, because you don't want to contract, right?   Armando Hernandez-Rey MD (29:35) Right, because we're transferring an embryo where there should not be any oxytocin. And you can have the most beautiful embryo, but if you screw up the embryo transfer, through no fault, just because it's a difficult transfer for a myriad of reasons, and you cause uterine contractility, then there's a high likelihood of pregnancy not occurring during that time.   Michelle (29:57) Right. I think it would be an interesting thing to look into for IUI. There might be something to it, because if it works with animals, and the animals obviously have similar certain functions that we do, mammals, that seems like an interesting thing.   Armando Hernandez-Rey MD (30:10) Yeah.   I think there's not going to be a lot of resources put into improving IUI, to be honest with you. IUI, I think it is what it is. And I mean, I think the majority of research is going to go to improving even more IVF rates, because I think ultimately patients are going to want to go more.   Michelle (30:22) Mm -hmm. Yeah.   Armando Hernandez-Rey MD (30:40) towards IBF, no matter how hard we try to say, hey, listen, there's this option or this option or this option. It's more become a more of an instant gratification society. Number one, number two, people are waiting longer. So therefore they're more pressed for time, if you will. And I think there will be less of a motivation to go down a treatment option that frankly,   Michelle (30:48) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (31:07) You know, has a low pregnancy rate.   Michelle (31:09) Right. And then my other question is, what are your, thoughts about a lower intensity cycle?   like lower amounts of hormones for older women. In some cases I've heard it might be a little better. you do? Yeah, yeah.   Armando Hernandez-Rey MD (31:24) We use it all the time. Yeah, we use it all the time. I think it's...   a very successful option in cases with severely diminished ovarian reserve. I think that the senescent ovary does not do well with high impact medication or high doses of medication separately, but you know, jointly the medication costs are exorbitant and you end up having the same number of eggs that are mature, that get fertilized with a mini stent protocol as you do with   Michelle (31:38) Okay.   Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (31:59) a high dose regimen.   Michelle (32:02) Okay, so you've seen good success with that.   Armando Hernandez-Rey MD (32:06) Well, I mean, not good success because generally these cases are, we've seen success. Let's call it that. Because the patients that you're treating with these medics, with this protocol are patients who are POI, you know, premature ovarian insufficiency, diminished ovarian reserve, poor egg quality, high rate maniploidy. So these are your poor responders essentially. And they're very...   Michelle (32:12) Yeah, okay.   Mm -hmm. Mm -hmm.   Armando Hernandez-Rey MD (32:34) specific factors that propel a woman to have success with this protocol compared to her twin sister with almost the same testing who doesn't do as well.   Michelle (32:47) Got it. And then lastly, we talked about this in the pre -talk, let's talk about marijuana and sperm, data is showing. Yeah.   Armando Hernandez-Rey MD (32:55) I don't do it myself, but I have no problem with people that do. What the data has shown that we're just becoming more and more familiar because the overwhelming number of people who are using cannabis and open about it, which is the second part, which was very difficult to conduct studies because it was so people were ostracized. They were looked at.   not the wrong way and seen as in the fringe. And now it's, you know, it's so mainstream. but so now we're, we're keenly aware, of patients were able to analyze them and what we know without a shadow of a doubt that the potency of the cannabis that's being produced these days is anywhere between eight to 12 times more potent than I think I use the joke of the guys at Woodstock back in the sixties, right?   Michelle (33:21) Mm -hmm.   Mm -hmm.   Armando Hernandez-Rey MD (33:46) where everybody was getting pregnant and everybody was high on life, all of those things. And then what we've also known, which I did mention, is that using the vape pens, whatever types of inhalers as opposed to the traditional joint, if you will, increase the potency of that by a factor of two to three. The cannabis that was already potent to begin with.   Michelle (34:08) Yeah.   Right.   Armando Hernandez-Rey MD (34:14) So what you're seeing in males in particular, and I'm not sure that the literature is so complete on the female aspects, are that we're seeing a high levels of fragmentation. And what fragmentation is, is imagine that sperm is like an Amazon box. And inside that box, there's a porcelain doll that's wrapped in these packing cubes. They're held very, very tight. And under...   Michelle (34:26) Mm -hmm.   Armando Hernandez-Rey MD (34:40) The best of circumstances, those packing cubes are wound so tight, packed so tight that nothing, if I kick the box off the Amazon truck, nothing is gonna happen to the porcelain doll. Well, as fragmentation occurs and it happens under natural conditions and old guys like me, you know, patients who, occupational hazards, firefighters, exposed to toxins, a lot of people who use fertilizers, et cetera, et cetera.   you see high levels of fragmentation. I'm talking about DNA fragmentation. And so what we're seeing is high levels of fragmentation at the level of the DNA of the sperm, which has significant effects on embryo quality, embryo development, and pregnancy rates, and high levels of aneuploidy, which is abnormal embryos. So,   Michelle (35:10) So you're talking about DNA fragmentation. Yeah. Yeah.   Mm -hmm.   Armando Hernandez-Rey MD (35:33) You know, I'm not here to like, you know, slap you on the wrist and say don't smoke weed, but really that's what you're facing. And we know that this happens in women with cigarette smoking. Like this is a well -known cause of an accelerated transition to perimenopause. You know, 65 % of women who smoked a pack a day for greater than 15 years will go into menopause before the age of 40, assuming they started before their 20s. That's a pretty...   Michelle (35:40) Bye.   Mm -hmm.   Armando Hernandez-Rey MD (36:03) ominous number, actually. Thankfully, not many women smoke these days, cigarettes anyway. So I guess the results of cannabis on females is yet to be elucidated, but we definitely have some pretty compelling evidence in terms of the male data that show that it can have detrimental or deleterious effects on sperm quality and not necessarily on numbers.   Michelle (36:04) Yeah.   Mm -hmm.   right, which is what people look at usually when I mean, that's like the, the analysis is always on numbers shape and, numbers shape it. Yeah. And morphology and they won't necessarily look at the DNA fragmentation. That's actually not something that REIs usually initially look at.   Armando Hernandez-Rey MD (36:33) Exactly.   the thesis in morphology.   is done in a well not initially unless there's comorbid situations or things that raise your red flags. For example, advanced paternal age, we always do it. Particularly in egg donor cycles, right? Because patients will be like, well, I'm using an egg donor and why don't I have bad energy? Well, because your husband could be 70 or 60 and   Michelle (37:11) Yeah.   Armando Hernandez-Rey MD (37:14) And then their fragmentation is completely elevated and through the roof. So yeah. So, you know, firefighters, occupational hazards.   Michelle (37:18) Right. So, yeah, it's important. It's important for people to hear this because they can go in and say, the semen analysis was perfect. But that, like what you just said, is not really checked. So they may not, in a healthy, like, younger guy.   Armando Hernandez-Rey MD (37:35) It's not as nuanced as we once thought it was.   Michelle (37:38) Yeah. Yeah. Interesting. It's, it's fun. It's always fun for me to talk to our, our ease, you know, just to get, to pick your brain and get your thoughts. and you're my neighbors. So it's pretty cool.   Armando Hernandez-Rey MD (37:50) That's right. Thank you very much for the invitation. This was really fun. We spoke about a wide array of different topics here. So this was really nice to connect this way.   Michelle (37:53) Yeah.   Yeah.   Yeah, for sure. And I know that a lot of people are going to be like, this is interesting information. Cause I know that what you just mentioned, a lot of it is not common knowledge. people don't know automatically hear about this or really know to think about asking about it. So, so I appreciate all your information, all your good, good data. And, for people who would like to work with you or in town, how can they find more about you?   Armando Hernandez-Rey MD (38:27) Well, we are at Conceptions Florida. We have two offices in Merritt Park, Coral Gables and one in Miramar and hopefully soon also in Boca. And I'm there Armando Hernandez -Ray, MD I'm sure. Easy to find these days on Google, but I'm happy to help in any way that we can. We've been doing this for a long time, quite successfully, thankfully. And we take a lot of pride, humbly speaking, but probably also.   in having a good footprint in South Florida and the infertility world and trying to offer the best care possible.   Michelle (39:01) Awesome. Well, this was such a pleasure and thank you so much for coming on today.   Armando Hernandez-Rey MD (39:05) Thank you, Michelle.    

This episode explores reproductive medicine and the importance of a holistic approach to fertility. Dr. Timea Belej Rak, an expert in obstetrics, gynecology, reproductive endocrinology, and hypnosis, shares her personal fertility journey, including her use of Clomid and an IUI cycle, emphasizing the difficulty of balancing work and studies while trying to conceive. Dr. Belej Rak highlights the need for comprehensive information and informed decisions in fertility treatments, discussing the lack of explanations she received and the advancements in fertility medications. She underscores the benefits of hypnosis for pain management, advocating for a holistic approach that empowers individuals with knowledge throughout their fertility journey.     Key takeaways: ●      Dr. Timea Belej Rak shares her personal fertility journey and the importance of researching fertility options. ●      The episode highlights advancements in fertility treatments, including IVF. ●      The concept of a comprehensive program combining various modalities to optimize fertility success is discussed. ●      Listeners are encouraged to empower themselves with knowledge and embrace a holistic approach to fertility.     Bio: Timea Belej-Rak, MD, is an obstetrician-gynecologist with specialty training in fertility. Her passion is helping her patients navigate their fertility journey. She received her MD, and specialty training from the University of Toronto. She practices at Anova Fertility and Reproductive Health and lives with her husband and daughter in Toronto, Canada.   Where To Find Dr. Timea Belej Rak:    -       Instagram: @femwellnessdrtbr -       https://femwellness.ca/ -       Book: Embrace Your Fertility   How to connect to Lorne Brown online and in person (Vancouver, BC)   Acubalance.ca book virtual or in person conscious work sessions with Dr. Lorne Brown Lornebrown.com   Conscious hacks and tools to optimize your fertility by Dr. Lorne Brown: https://acubalance.ca/conscious-work/     Download a free copy of the Acubalance Fertility Diet & Recipes and a copy of the ebook 5 Ways to Maximize Your Chances of Getting Pregnant from Acubalance.ca   Connect with Lorne and the podcast on Instagram:   @acubalancewellnesscentre @conscious_fertility_podcast @lorne_brown_official     DISCLAIMER: By listening to this podcast, you agree not to use it as medical advice to treat any medical condition in either yourself or others. This podcast offers information to help the listener cooperate with physicians, mental health professionals or other healthcare providers in a mutual quest for optimal well-being. We advise listeners to carefully review and understand the ideas presented, and to consult your own physician for any medical issues that you may be having. Under no circumstances shall Acubalance, any guests or contributors to the Conscious Fertility podcast, or any employees, associates, or affiliates of Acubalance be responsible for damages arising from the use of the podcast.

Many patients ease into fertility treatment with simple medications such as clomiphene or letrozole. 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 discuss the basics of ovulation induction treatments using Clomid and Femara. They review how each medication acts and which patients benefit most by these treatments. The Fertility Docs outline differences in ovulation induction with OB/Gyns vs. REIs, and the pros and cons of these treatments. Join us as we discuss some of the most readily accessible and affordable fertility treatments available! Have 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 Path Fertility 

Dr. Natalie Crawford discusses the data on the impact of marijuana and tobacco use on male and female fertility. Everyone's body is different therefore will react to their environment differently. Understanding these impacts is crucial for individuals navigating infertility or treatment, as lifestyle choices play a significant role in reproductive health. By staying informed, individuals can make empowered decisions to optimize their chances of success. She also discusses the effect vaping can have on fertility. We work so hard to get the best outcomes, so listen to this episode to learn more about how marijuana and tobacco use can impact fertility outcomes such as genetics, miscarriage, and ectopic pregnancy. Natalie answers your questions in FFS-For Fertility's Sake How long would you give Clomid to work? I have PCOS and reduced sperm count. Can your AMH change month to month? Can HCG release before implantation happens after an embryo transfer? We have moved Fertility In The News to the weekly newsletter in order to keep the podcast more evergreen. If you want to sign up go to nataliecrawfordmd.com/newsletter to sign up! Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page @nataliecrawfordmd. You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today!      Thanks to our amazing sponsors! Check out these deals just for you: Quince- Go to Quince.com/aaw for free shipping on your order and 365-day returns Ritual-Go to ritual.com/AAW to start Ritual or add Essential For Women 18+ to your subscription today. Apostrophe- Get your first visit for only five dollars at Apostrophe.com/AAW or use the code AAW at checkout. Honeylove- Get 20% OFF by going to honeylove.com/AAW! If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram @nataliecrawfordmd, check out Natalie's YouTube channel Natalie Crawford MD, and if you're interested in becoming a patient, check out Fora Fertility. Learn more about your ad choices. Visit megaphone.fm/adchoices

Peter Bacon is currently the CEO of Disability Employment Australia – an industry association representing providers of disability employment services. He grew up in the United Kingdom and soon after college was offered an opportunity to join a firm to deal with helping persons with disabilities to gain employment. He quickly realized that he loved the work and wanted to dedicate his life to the efforts of promoting employment and the rights of persons with disabilities. Our conversation ranges through various aspects of issues about disability employment. He discuss what is currently happening in Australia and how a commission report has just been produced that acknowledges that persons with disabilities are systematically being excluded. Now the real fun begins. As Peter says, the problem has been named. Our time is well worth your listen. Peter Bacon offers many insights that can be of use to all of us. About the Guest: Peter has worked in disability employment for more than 15 years. He started out on the frontline in East London, attracted to the role by a friend who said it was ‘all about drinking cups of tea and helping people'. Pretty soon he discovered that he wanted this to be his life's work – that the transformative power of building a relationship with someone and helping them achieve their career dreams was unmatchable. After that he was offered the opportunity to do a variety of business development and strategy roles within disability employment and adjacent spaces, including skills and training, justice and rehabilitation, as well as the opportunity to work in international markets. Throughout, he has always prioritised the ‘voice of the customer' and impact on the most vulnerable and marginalised communities. Seven years ago, Peter was offered the opportunity to move to Australia to head up strategy at major non-profit Campbell Page. During his six years there, he took a lead on diversifying the organisation into new markets including social enterprise, through an environmental initiative for young people following the bushfires. Since February this year, Peter has been CEO of Disability Employment Australia – an industry association representing providers of disability employment services and with the aim of unlocking the potential of people with disability across Australia. Since taking on the role, he has pivoted the organisation to focus on ‘all dimensions' of disability employment, including the vital role of the ‘demand' side amid increasing expectations of employer involvement with diversity, equality and inclusion. This is a potentially transformative moment for disability employment in Australia thanks to the Disability Royal Commission Report that details systematic and structural exclusion of people with disability from mainstream Australian life, and as the Disability Employment Service is reformed against this backdrop. Peter is excited to be a part of these debates and to lead a significant, sustained shift in the disability employment rate and as to how people with disability are treated within the workplace. Ways to connect with Peter: Email-peter.bacon@disabilityemployment.org.au About the Host: Michael Hingson is a New York Times best-selling author, international lecturer, and Chief Vision Officer for accessiBe. Michael, blind since birth, survived the 9/11 attacks with the help of his guide dog Roselle. This story is the subject of his best-selling book, Thunder Dog. Michael gives over 100 presentations around the world each year speaking to influential groups such as Exxon Mobile, AT&T, Federal Express, Scripps College, Rutgers University, Children's Hospital, and the American Red Cross just to name a few. He is Ambassador for the National Braille Literacy Campaign for the National Federation of the Blind and also serves as Ambassador for the American Humane Association's 2012 Hero Dog Awards. https://michaelhingson.com https://www.facebook.com/michael.hingson.author.speaker/ https://twitter.com/mhingson https://www.youtube.com/user/mhingson https://www.linkedin.com/in/michaelhingson/ accessiBe Links https://accessibe.com/ https://www.youtube.com/c/accessiBe https://www.linkedin.com/company/accessibe/mycompany/ https://www.facebook.com/accessibe/ Thanks for listening! Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page. Do you have some feedback or questions about this episode? Leave a comment in the section below! Subscribe to the podcast If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can also subscribe in your favorite podcast app. Leave us an Apple Podcasts review Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you have a minute, please leave an honest review on Apple Podcasts. Transcription Notes: Michael Hingson ** 00:00 Access Cast and accessiBe Initiative presents Unstoppable Mindset. The podcast where inclusion, diversity and the unexpected meet. Hi, I'm Michael Hingson, Chief Vision Officer for accessiBe and the author of the number one New York Times bestselling book, Thunder dog, the story of a blind man, his guide dog and the triumph of trust. Thanks for joining me on my podcast as we explore our own blinding fears of inclusion unacceptance and our resistance to change. We will discover the idea that no matter the situation, or the people we encounter, our own fears, and prejudices often are our strongest barriers to moving forward. The unstoppable mindset podcast is sponsored by accessiBe, that's a c c e s s i capital B e. Visit www.accessibe.com to learn how you can make your website accessible for persons with disabilities. And to help make the internet fully inclusive by the year 2025. Glad you dropped by we're happy to meet you and to have you here with us.   Michael Hingson ** 01:21 Well, hi, and thank you once again for listening to unstoppable mindset and we're really glad you're here. We're having a lot of fun doing this. It's been going on since August of 2021. I've enjoyed every episode, I've gotten to learn a lot from all of our guests. I value that greatly I hope that you have as well. And we have another one today another exciting guest Peter Bacon down in Australia who is involved very seriously in the whole issue of disability employment and I guess you got started Peter because somebody said it's all about having a having cups of tea and helping people I want to hear about that. But Peter, welcome to unstoppable mindset.   Peter Bacon ** 02:00 Thanks, Michael. Great failure.   Michael Hingson ** 02:03 So what kind of tea?   Peter Bacon ** 02:07 I think it was English breakfast tea. Ah, gosh.   Michael Hingson ** 02:10 I love PG Tips.   Peter Bacon ** 02:12 Yeah, that's that's that's high quality tea. My great grandfather used to be a salesman for Yorkshire tea. So I should probably give a shout out to Yorkshire. Ah,   Michael Hingson ** 02:22 I've heard of Yorkshire tea. I haven't tried it. But people have recommended that I should try that too. But we have a relative, a cousin who teaches at the University of Manchester and she came over to visit us in when we were when I was living. My wife and I were in New Jersey and she brought a British care package and there were biscuits in it and other things and there was a box of PG Tips t and we both fell in love with it. It was hard to get in the US at the time. We found a place where we could mail order at some and then when we moved back to California after September 11 We found a market that had literally what they called a British aisle. And on the British aisle they sold PG Tips T and then we discovered that Amazon carried it so I get PG Tips T pretty inexpensively now and love it so I have it every day.   Peter Bacon ** 03:17 Sounds like you're quite the aficionado. I mean, being a Brit living in Australia. There are similar things. So there's, you know where the British Isles are in terms of within supermarkets. Also, there's various Facebook groups which relate to these things. I'm not that bothered about most of those things, but I do quite like milk chocolate digestive, so I always find them if I'd see that.   Michael Hingson ** 03:40 There you go. Yeah, well, that that makes sense to well, we yeah, I've just I've always enjoyed PG Tips, tea. It's a lot of fun. When I wrote vendor dog, I don't know whether you've read it the book about me and Roselle in the World Trade Center. I even mentioned it in there so well. I don't mind promoting PG Tips. T it's good to   Peter Bacon ** 04:01 get you on payroll, Michael. It   Michael Hingson ** 04:03 should. Well, I'm trying to Yeah, by that time, I'm trying to remember I think we had discovered it. I don't know whether we had discovered it through Amazon. But I buy it's like $20 and I get a twin pack. Each pack holds 260 or 280 bags. So it's 560 bags of tea for $20. So that now that Karen has passed away that lasts me, you know, half well a long time. It's 280 days every year so it takes a while to go through it. Because I well it does. It goes faster than that because i i make a pot I put three bat or two bags in a pot. And I drink a whole pot in the course of the morning. And then I don't drink any of it the rest of the day. I drink water the rest of the day.   Peter Bacon ** 04:54 Yeah, well I mean we're big on our caffeine here in Australia. Melvin, particularly when I go back home, when I go back home to Britain and drink my coffee, I can't cope at all because the coffee is so good in Melbourne. So yeah, yeah, there's a big bonus about living.   Michael Hingson ** 05:11 There you go. The caffeine has never done anything for me. It's really for me all about it being hot. But I like PG Tips over just having hot waters. So that's what I have. But the caffeine has never done anything more for me. I could I could drink a cup at night, and it wouldn't make a difference.   Peter Bacon ** 05:29 For me, I've got two young kids. So it's an important part of my life. Well,   Michael Hingson ** 05:32 they're see, are they going to grow up to be tea drinkers?   Peter Bacon ** 05:38 I don't know. I've already thought my eldest is 10. I've taught her how to use the coffee machine at home. It's like a proper coffee machine. So she's she's at the very least she's a trainee barista, which would be a good job for her to get to sort of 16 or 17. I think,   Michael Hingson ** 05:52 well, if it's a good coffee machine, it'll make hot chocolate to you. There you go. See? Well, Tim, tell me a little about the younger Peter, the early Peter growing up and all that if you would.   Peter Bacon ** 06:06 Yeah. So I was brought up in high school boy, Tunbridge Wells in Canton, England. And it was, you know, it wasn't necessarily that much of a, I did okay, epidemic, I wouldn't say was that much of a happy child. And a lot of that was down to I was, it was an dyspraxic. And, like, so many things. You know, education wants people to fit nicely into boxes. And nicely into a box. I was, you know, almost report said bright, but disorganized. Reports from my board might say the same thing now. But   Michael Hingson ** 06:50 keep you hired still, though. Yeah.   Peter Bacon ** 06:52 You know, I have people who helped me. Because I had systems that I do think to my head to, to get over those other things. But I wasn't you know, that that was a struggle for me, because it was it was that thing of well, what is causing this. And obviously, I got a diagnosis when I was 16 1516, that I was just practicing. And then suddenly everything made sense. Well, that's why I'm struggling. That's why I'm finding it hard to organize myself. But also, and there were some important lessons that I learned through through that period, some of which we may touch on later. But also, I was pretty well fired up with a sense of social justice, and where that came from, what was brought up with my family and all those kinds of things. And I went to university to study politics, and did okay, there. And I came out with this idea that I wanted to do a job that made the world a better place. That was really what I was looking for. And I thought, well, I know what I do, I'll go into politics, you know, you've got an opportunity to make the world better if you're if you're in politics. So what I did, I went to work for the Liberal Democrats did jobs and sort of policy campaigns for about a year, 18 months. And after that period, I went well, I don't think I'm gonna make my difference here. I really struggle. I really struggled with it. The because actually was, you know, you had my idealized sort of West Wing idea of what politics is like. But actually, most of the time, it's just about, well, what's going to win us the next election,   Michael Hingson ** 08:30 which is so sad that it's that way these days. Yeah.   Peter Bacon ** 08:37 And maybe on some level, it's worse than winning the next election, because we have the better ideas that we can implement. And that's going to make the world a better place. But I struggled to find that. Yeah, I also, I also struggled to, I was really struggled with the idea of, you know, you have your party line. And you have to just parrot that, and you have to support your political party. And critically, you know, the same way that you were just sports team. And well, actually, I'm quite critical of my sports teams. But, you know, I struggled with that to the idea that actually, your ideas weren't worth much if they weren't part of the party line. So I searched for something else to do. And I had a friend, and she was working as what they call an employment visor in East London for a company called NGS. And she said, Well, this is a bit different. But there's a job over here where what you do is you sit down with people, you make and drink cups of tea, and you try and help them try and find a job to try and help them in their lives. And I said, Well, I'll give that a go. Because at least I can drink tea. There you go. So I've got half a minute. So that's how I sort of started, you know slightly cluelessly, naively, all those kinds of things. That's how I started by My career in disability employment, and it's with a few variations where I've been set.   Michael Hingson ** 10:08 So what what did you start out doing? Or how did how did all of that work for you? So   Peter Bacon ** 10:14 I started out on a contract called Pathways to work. So it was a government service that was contracted out to a bunch of different organizations, some for profits or not for profits. And it was essentially about helping people with what they called health conditions. So people were claiming government benefits by virtue of the fact they and disability condition illness. And I was about helping them to find work. And I work for pretty good company colleges. So you've got a decent amount of training, you know, few weeks training, perhaps, which isn't bad by industry standards, and with good follow ups, and but I was pitching I had a caseload of 100 people or more, who were living in some of the poorest parts of East London, we had pretty complex slides. And my job was to find as many as I could have that group jobs, and to be decently respectful to the rest. So that's what I was doing. And obviously, you go into it fairly cluelessly. It just at that time, the company I work for had a pretty good philosophy of just recruiting people with the right values, who are kind of bright and good communicators. And so it was it was quite a, you know, a really good band of people who are similar to me. And yeah, so So you would see people, they, they'd come because they, it's got a job. And you would work with them, you put a plan together, you talk about what their dreams were, what their aspirations were, what their motivations were, but also the things that they were facing in their lives. You put that plan together, need, they try and execute on that plan. And sometimes it would work, sometimes you would go through and they would find a job that was meaningful to them. And they would stay in that job. And it would be a great experience. But oftentimes, it didn't work that way. Because lives don't. And, you know, circumstances from change. And so you have to roll with that too. But certainly, for me, it's like an experience of you know, helping people in those situations experience that sort of thing every politician should ever have. Because actually, you really see the impact of policy. You really see how much things like a little tweak to a Working Tax Credit can make when people are right on the breadline, but is considered a real privilege to be able to help people. And it was in those moments of actually the plan coming together, and helping people to find work that was absolutely transformative to their lives, that I realized that my life's purpose was in this work. You know, I think of a guy called Derrick who came to me and first time he indicated to me, he said, is, you know, is probably in his mid 50s, late 50s, perhaps you had neck problems and back problems. But the real reason why he was off work wasn't to do with his physical shape. It was to do with the fact that he had lost a lot of hope, I think about a better future for himself. And he said, RP, I, you know, was it was it was interesting, we're in an office in Stratford in East London that overlooked at that time, the Olympic size is being built, because not that had the Olympics in 2012. years would have been about 2008 2009 sort of time, so you could literally see outside, you could see the the Olympics are being built. And so people would say, oh, there's no jobs from EP and I'd say, yeah, look out there. The world is coming to Stratford, change the chain. But Derek, you said our Pete was finished outline, which I use on everyone going live? And he said, Yeah, well, I'm not sure about that. Because my factories to be out there. And that was the last time I work and they bulldoze it for the Olympic site, which put me back on my heels a little bit. But anyway, so we talked about it. We said, well, you know, do you want to work? Yeah, I do. I just don't think I ever will again. And I said, Well, why do you want to work? as well. You don't quite like working one but really the answer is I'm ashamed by our four grandkids LM ashamed to even see them because when it comes down to their birthdays or Christmas, I can't afford presents and don't feel like I'm a proper granddad to that. And I can't hold my head high. And that was a tough thing to hear. But then, but then we got to work, you know, so Well, what do you want to do? He said, I love history. I love history too. So, you know, often talking through bits of history and aromas and such, like, we weren't, well, okay, let's try and find your job work in the museum. So we wrote to every museum, and it's sort of reasonable public transport radius of his house. And he eventually ended up getting a job at the Greenwich Maritime Museum, doing sort of like janitorial work, which was fine, this conditioning was alright with that. And he loved it. He absolutely adored it. You know, he loved seeing particularly loved seeing that sort of groups of school kids coming along as part of their tours. And he just thought, yeah, I'm part of that I'm proud to kids learning about history, which is something I'm so passionate about. But at the moment, where it really came through to me was when he sent me a photo of him and his grandkids at Christmas with their presence, just like that. Yeah, if you can, if I do anything in my life, I've done that. Right. I think he had to do that more times over the net. And then you move into other roles, and you like wanting to set the conditions where that can happen more often. But that that kind of moment was a moment, I found my purpose, because I realized that it's just a spectacular privilege of being part of that journey.   Michael Hingson ** 16:32 So does he realize today how much not only did you help him, but he helped you?   Peter Bacon ** 16:40 Yeah, well, I'd love to one. I don't know. I think certainly, I would talk to him about that. I'd say look, you know, things like this are the reason why, you know, I get out of bed in the morning. Why I try so hard. And, you know, thank you for that. But, uh, but perhaps, yeah, perhaps there isn't a point there actually. It wasn't mutual. a mutual thing? Yeah. Well,   Michael Hingson ** 17:06 you know, it's, it's interesting to really specialize in that, and really help people find jobs. What kind of barriers did people throw in your way? As you were trying to find these? These employment opportunities? I'm sure. Employers were oftentimes very skeptical and so on, as is usually the case. Yeah,   Peter Bacon ** 17:31 employee employers, frankly. So we're talking about 15 years ago, is when I was on the front line. But yeah, we've not moved that forward that far since or, or at all, really, I've moved across the world and found some of the same issues, which is I think, it is just going to blame employers. And sometimes I do. But I think also, what we need to really do is look at everything that causes that to be the case, certainly, one of the things that you hear from employers is, oh, it's just going to be too hard. You know, this is going to be extra effort for me, I don't need extra effort. I don't need burden. To point out, why do you achieve that? We actually have things that we can do to make this easier. And, you know, in the case of something like that, there'll be a massive asset to your workforce, and you have their documents. But that's even if you get to the point where you can have those make those points to a decision maker. Ultimately, the problem is that institution means so many employers are set up not to make a commitment to disability employment. One of the worst things that we've seen, you know, talking about the last 1520 years, one of the worst things that we've seen is the over professionalization of HR and recruitment. So if you say, right, I'm going to be very specific about the box that the person must fit in order for them to get to an interview, eventually get the job. Well, unfortunately, a lot of the time that specificity, rules out diversity in the two things are inherently diametrically opposed sometimes. So actually, it's a systematic exclusion is the big problem that I see. And obviously, that goes to employees, but it also goes to society, education in general. We've got to be segregated, and we've got to address those systematic issues. So if we're going back to well, what do they hear from employers in that era? What do I hear from employers now? It's really the result of the systematic thing. So you hear I don't have anyone with disability in my workforce. So I don't know that I set out to do it. I'm like, you definitely do. You just don't you just haven't set up a situation where people feel psychologically safe to disclose that. And you've not asked probably, but you will have people in your your workforce who've got disability. And if they think that, then you get to a point where being diverse and being inclusive isn't normalized, it feels weird to people it feels alien. And so therefore, they don't think, Oh, actually, it's relatively simple to employ someone like Derek or someone like Michael some like Peter, because actually, they have a pretty good idea about, about how we can work with them to tailor the job to what they need. It's it's there's almost a mythology that creeps up around it. So you need to do mythologize that you to normalize. So I think there's all sorts of barriers that get thrown in the way the reality is employees aren't doing enough. But perhaps that's also a result of factors that are we as society or as government doing enough also to address those systematic issues. So it's, it's a, it is a complex and thorny one. But I think it's something that we all need to be battling.   Michael Hingson ** 20:56 Well, it's interesting to, to talk about this and to hear what you're saying.   Michael Hingson ** 21:05 Because it's, it is easy to get very frustrated at employers. But we all know that they're just as much a part of society and we're raised and brought up buying into certain myths that aren't really true. But the other part about it is, however, that CEOs and so on, often start their companies because they have a vision. And the problem is they don't carry that vision over to other things other than just whatever it is that they're creating or doing. So they don't vision, having people who are different becoming part of their workforce, even though the value that is brought by a person with disability is tremendous, such as we know how hard it is to get a job. We know the unemployment rates, and how serious they are. And so if we get a job, we really are pretty grateful overall to wanting to make sure we keep that job.   Peter Bacon ** 22:05 Well, that's right. I mean, what's your what's your experience? Obviously, you know, you you're from America today, it's a different, it's a different economy. It's a different culture from Australia, or Britain that I've worked in what's been your experience of employers, and maybe some of the barriers that might have been in your way,   Michael Hingson ** 22:22 I think the attitudes are really the same. That is people are overall, not nearly as excited about hiring people with disabilities, because as I describe it, people think that disability means a lack of ability, and we've got to get away from that. Disability is a characteristic and we all exhibit in our own ways, whether we are blind in a wheelchair, or sighted and rely on light to be able to function. Disability is something that we all have, in one way or another. It's a characteristic that everyone on the planet has. And until we get people to recognize that disability does not mean a lack of ability, and that just because some of us are different than others, it doesn't mean that we can't do the job, we are going to continue to have these problems wherever we are in the world.   Peter Bacon ** 23:21 I think that's I think that's right. And I think it's only there's a couple of points that are made to that. One is, I think we need to bring up our kids better when it comes when it comes to actually understanding that point. I think you know, I've done it before we've you know, been walking through a shopping center, and, and someone will say, you know, you'll see a kid saying, Oh, look at that, you know anything about wheelchair, I want to go out and ask the person about the wheelchair. And their mom will be like, Oh, no, don't do that. Absolutely don't no, no, no. taboo, taboo. Yeah. Well, actually, that's not unhealthy.   Michael Hingson ** 24:00 No, it's not at all. It promotes the fear. It promotes   Peter Bacon ** 24:03 the fear and promotes of that person's alien. They're different from us in a way that I think a lot of other ways wouldn't be tolerated. You know, you know, if your employer says, I don't want to employ this person, because they're disabled, would they be allowed to say that? If it was because they're black? No, they wouldn't. Well, they're very well or not presented, but they will be seen immediately as as being racist, but people will say that openly about people with disability. And that's bigotry. But and with all bigotry, I'm afraid. You know, you've got to start with the way that we educate our kids, the way that we talk about society and as a community. So you've got to you've got to start there. And the second one is, and I think it's why the education is so important, because it's something I think a lot about is well, what should government be doing? I, particularly with employers, to put a thumb on the scale, because as far as I concerned, the kind of just let employers gradually engage with their subjects hasn't worked. Like, it's, it's going too slowly, like in Australia, the rate of disability employment, it's maybe shifted a little, but it's not shifted much over a couple of decades of investment. And why is that? It's because we have too little expectation of employee. So I think a lot about what should government be doing to bit of a carrot and stick approach, right, so, but if you go with the stick, what I worry about is, let's say you go, and some countries do, let's put quite as in place that you have to have, you know, in America, you probably call it servitude action, right? You have, you have to engage with this, you have to do it. And my worry is that if we haven't educated society enough, when you do that, is quite counterproductive, because it breeds a certain resentment. And I think, you know, if somebody if you feel I was someone got the leg up into the job only because of a quota, that can be problematic. So I think that well actually have to do if you're gonna do something like that, you have to do the education piece around it. And that also goes to people with disability around actually knowing that it's okay, if you're doing the leveling of the playing field. And I think back to I mentioned that 16 year old me earlier. And so then dyspraxia kick, in meant that, you know, I did exam to the, you know, I'm old enough that when I did exams, it was it was handwritten, exact. That was what was expected in the UK. And my handwriting is absolutely atrocious. I struggled to write legibly, but   Michael Hingson ** 26:45 but still you should have been you should have been a doctor.   Peter Bacon ** 26:49 Apart from my lack of ability of all things scientific. Sure. But yeah, my team often sort of like, oh, my gosh, yeah, they see me I'll go to the whiteboard to write something on it. And it'll be impenetrable to anyone but me, right? But because of that, if they give me an extra half an hour and exam if I wanted it, so it comes down at the end of every exam, and they'd say, Pete, do you want the extra half an hour? Every single time? I said, No. Why did I say no? One, because I didn't want other people to think that I've got great grades because I had a leg up. And two, I didn't want me to think that I did. I didn't want myself to go well, I only succeeded because I but now I've reflected that and go well at all, they were trying to do them as level the playing field. But you have to acknowledge that in leveling the playing field, you have might have to sit uncomfortably with the fact that to other people, it might look like you're getting an unfair advantage. So these are all all the things I think about when I think about well, how does the government put his thumb on the scale in a way that brings society with it in a way that we at the attitudes move in a positive way? Rather than we just set it up as a kind of zero sob? You know, resentment building kind of protests. Yeah.   Michael Hingson ** 28:15 Well, and we really need to understand what equality and leveling the playing field is all about. You're absolutely right. In colleges today, in Well, first of all, in this country, you really probably couldn't get away with saying, Well, I can't hire you because you you're disabled, or you have a disability. Because of the Americans with Disabilities Act. In fact, there's a television show that's been on here for several years called What would you do, and it's, it's hosted by a guy named John King Yonas on ABC television. And the idea behind the show was they would put actors in situations and portray different kinds of scenarios, to see how the people around them behaved. And so my favorite is still there is one where two deaf actresses and it was in part, their idea came into a coffee shop. Well, so they were just deaf students from Rochester Institute for the Deaf, but they came in to this coffee shop and there was an actor who played the barista. And what they did is they came up and they said they wanted a job and his his role was to consistently say, I can't hire you, I'm not going to hire you. And they say, why? Well, because you're deaf. You can't hear what I say. And just, you know, you can imagine all the things that that he would say, you know, I can't hire you and, and finally, and some people looked daggers at at him and a few people really reacted pretty violently about it. But one group of three HR people pulled him aside and said, Look, you're handling this all wrong. You can't say that the person's death well, but the person to put you can't Don't say that they have more rights than we do. What you do is you accept the application then just right, not a fit, and file it. Yeah. You know, and those are HR people. The reality is that so what they're saying is, it's open discrimination that they weren't practicing, as John Ken Jonas pointed out, but the problem is, it does happen all too often. And it does still continue. And we still have any number of cases that are litigated to try to deal with it. But it ultimately comes down to we're not including people with disabilities and the subject. In life conversations, we're still feared, we're not looked at the same way other people are. And so we're not included. And as a result, we continue to see the fear promulgated, like you said, about the mother saying, don't talk to that person in the wheelchair to the child. I've seen that happen a lot. Yeah. And my wife, who was in a wheelchair, her whole life, experience the same thing.   Peter Bacon ** 31:10 And I'm sure she'd love to have been asked by small town to start to sort of break down those barriers.   Michael Hingson ** 31:18 Yeah, we're not breaking it down nearly as much as we can, or should I mean, look how fast we started dealing with LGBTQ and other things. Although there's and of course, the backlash of the people who hate that. But still, it's at least being talked about, it's at least out in the open. And we're almost to the end of October, which is National Disability Employment Awareness Month. And honestly, I have yet to see on any of the major TV networks in the news, or any of the shows, discussions about it. And that's what happens every single year.   Peter Bacon ** 31:55 You're so right. I mean, it's a really in Australia, it's actually I think we're having an important moment, it's still not as prominent as I'd like it to be. But what we just had his we just had what we call a Royal Commission here with and that's sort of the big, well funded commissions. That happened every few years into critical issues. And this one was what we call the shorthand it phrase, the disability Royal Commission, but it was really looking at the whole piece around exclusion, and exploitation and abuse of people with disability in the system. And the reason why it's an important moment, is because that Royal Commission reported down that Australia is systematically excluded excluding people with disability from mainstream life. And that results in some terrible things, it certainly results in the kind of things we've been talking about in terms of, you know, worse economic outcomes. But it also involves things like people be absolutely abused the system. So, and it's harrowing to think about, it's harrowing to read. But it's important, because you've got to name the problem before you start dealing with it. And the problem is that systematic exclusion, so a number of things are going to come out of that report, as they're forming your task force on the back of it, there is some, the headline thing is the desegregation of education, which will sort of happen over the coming decades, because it's not easy to change it. But obviously, that's about getting rid of dual systems of schooling and properly funding, inclusive schooling with a mainstream education. But there's also things there, like the entering ending of sheltered workshops where people with disability are paid to the very, you know, I made to sort of, you know, it's a job, but it's at a rate far less than national minimum wage, to do routine jobs. So there's things like that. But also, there's things that sort of, I think, hit on the world of the immediate world of disability employment, too. So I see this is a moment where everyone Australia can say, actually, we know because they met $600 million review has happened into the way that we treat people with Australia, disability in Australia. And that fundamentally, the way that we treat people disability is a disgrace. And let's start changing that. Let's let this be the moment where we say, Ah, that was the moment where the government pivoted where society got on board and we've really changed things for the better. And those things unfortunately, you can't you can't change the way that society others thinks about people with disability as being alien, or there's going to be can't do it overnight. Right. But the best way to do it is to name it and to start working on it. So to have those points around how do we start doing it? I think actually calling it out for what it is. And then moving on from there is an important moment for Australia.   Michael Hingson ** 35:20 I think that is definitely a good start. And one of the things that I think would be very helpful is if the Commission as they're going through and talking about solutions, would make sure that part of what they do is include disability education, in the school system, we've got to start teaching children about it. And we've got to start teaching children, not to fear disabilities, not to fear people with disabilities. And to understand all it really means is they're different. Yeah,   Peter Bacon ** 35:52 I think that's that's exactly right. I think the desegregation of schools is part of that. But you're right. But to train kids to do that, you also need to train their teachers to think like that. You need to train the parents to think like that. And I think you're right, it's exactly that it's about going well, actually, we're all different. We all have different things that we bring to the table, we all have different challenges. Don't Don't other people don't go, oh, just because someone's in a wheelchair. That's the fact that's their defining characteristic. It isn't. It isn't it? is their way of getting round.   Michael Hingson ** 36:31 Makes it as part of what makes them who they are. But it's just a part, just like yeah, short people aren't going to make great centers in basketball, or probably not unless they can jump real high. But the reality is that, that we all have gifts, and we all need to be able to use the gifts that we have. And it's important to recognize that I've talked several times on this podcast about how I say everyone has a disability. And for most people, your light dependent, if the power goes out, you guys are in a world of hurt until you find a new light source. But that doesn't mean that you don't have a disability says that mostly because we've really concentrated on making light on demand part of our lives, you don't generally have the problem. But I've seen it happen all too often where the power goes out and people don't know what to do. They start screaming, and they may or may not find a flashlight or a smartphone to turn on to get light. But that's the first thing they want to do is to get light. I don't need to do that.   Peter Bacon ** 37:36 No, no. And you know, that might might be one of the reasons why, you know, when you know that in the Twin Towers, you actually were able to deal with things currently.   Michael Hingson ** 37:47 Not really, because we had power and lighting all the way down. The reason that I was able to deal with it was that I learned what to do in an emergency. And it created I learned it so deeply and so well, that it created a mindset in me. Because I was imagining all sorts of things above us, when we saw people coming down the stairs, past us who were burned and so on. We can only imagine what was going on up above. But, you know, I was on the south side of the building when it was hit on the north side. And the belt building was hit 18 floors above us. So as people you know, people always say, Well, of course you didn't know you couldn't see it, excuse me, nobody could Superman and X ray vision were are not real yet. And the fact is, as we were going down the stairs, nobody knew what was going on. I was the first one with a group near me that figured out, we were smelling something and I figured out it was the fumes from burning jet fuel. But what we still didn't really know. And the reality is it's not a matter of eyesight. But for me getting down was all about having knowledge. I didn't rely on needing to read signs to know what to do. I already knew what to do.   Peter Bacon ** 39:00 You and that is an example of how to you had a strength, you're prepared. You know which which I think again, is goes to how different people have different challenges and different strengths, but because of who they are. And that strength, it's a blight. So it's an incredibly powerful and patient example of that. And I think when we think about the workplace and again, it's about understandings of understandings of disability. And it's not just that I speak to employers, and they go, alright, well. I don't have anyone working here with disability because I don't have anyone in the wheelchair. And I say, what well are the 4% of people with disability near the wheel wheelchair, that's just like one element. Yeah. And, and so, you know, they say, Oh, well, I don't want you know, art or they might say, Oh, well, you know on disability accessible, I've put in ramps everywhere. And I like good. I'm glad you've put in ramps everywhere good stuff. However that is that is not it? And then the conversation goes well actually one is one is the most important thing that we can do to be close to people with disability. And I say actually, it's about approach. It's about attitude. It's about well, actually, am I going to do exactly what you said, which is take people as they come and say, Well, what are you good at? And one of the things that we're going to need to think about in terms of the way that we manage you. So you might get somebody you know, I've had this and the job was always had that conversation, I say, How can I help you to thrive in work? What can help you flourish here? And so I might say, Well, I'm basically fine. But I do get quite acute stress, and anxiety. And here's the times when that happens. These are my triggers. So one of them, it might be doing a big presentation. And so and so then you then you get into a real conversation about how to manage someone, it's not really about disability, although you might, if it's significant enough, it might be classed as disability is a base about how to manage somebody within their full self. So so this person might say, well, actually my triggers big presentation. So you said right, okay, so Are we avoiding in presentations, then? No. But what I might need is a day free before that clear to make sure I'm absolutely 100% prepared, is that will mitigate my anxiety? Okay, well, what we'll do is we're going to block out your diary, for a day before we get to those big presentations. That's fine. And I think that, you know, it's, it's that point about actually just managing the whole person. So you can bring your whole self to work. You got some great strengths that we want to maximize, you got some challenges that we need to think about mitigate whatever. And that's the biggest change that most employees can make to actually get the biggest workplace adaptation that you can make. And I think that's one of the main things that I'm saying to employers, and then they go, I can do that. That's fine. I can do that. Well, go ahead. Yeah. Yeah.   Michael Hingson ** 42:12 Well, the other thing, it seems to me is if I, if I find a person who was very stressed out, because they were afraid of doing big presentations, and they needed a day to prepare, but then they came in and did the best presentation I ever saw. I would want to start giving that person more big presentations, and more days to prepare, because eventually, they're going to realize they don't need a day to prepare anymore. They're used to doing it, which is another part of the process. People always say one of their biggest fears is public speaking. And I'm sure people say to me, and would say to me, Well, you're not afraid because you can't see the audience. Look, my first presentation, after September 11 was two weeks. And a day later, I had been invited to speak at a church service in central New Jersey. And I asked the pastor, how many people were going to be at this outdoor service 6000. I knew the number. I knew what that meant. Don't tell me about whether I can see them or not. I knew they were there. But it did. It didn't matter. Because I was used to talking to people in a variety of different kind of public situations. But I realized that a lot of people are afraid of public speaking, because that's what they've been taught. That's what they've been told, is one of our greatest fears. And we've got to get away from doing so much to teach people how to be afraid.   Peter Bacon ** 43:40 Yeah, I think that's that's exactly right, to teaching people how to be afraid, but also teaching people that difference. Difference is something to be afraid of. I mean, the whole of human history is a litany of being afraid of difference, and then acting in terrible ways because of it. You know, to get to the point about politics, like who are the politicians who are who are least like that we need to get to political? Yeah, it is those who seek to amplify those divisions, or create new divisions where none existed, right? That that is the most awful thing that people can do. And unfortunately, it's still wielded as a weapon like that, to this day. I suspect the next US presidential election, that's going to be a big part of it. And the more that we do that, the harder we're going to be able to get away from this actual where it is get to is just common sense. And we are all people. We're all here trying to live good lives. Doesn't matter whether you've got a disability, what the color of your skin is, any of those things, that we are all different and that's good. It is not bad. And I think getting to that realization runs to the heart of where disability employment is which is Disability Employment is good. Being an employer, we have a diverse staff is good, I can show you the numbers. But really, I want you to believe it in your heart more than I want you to believe it in your mind. Because that's where real change happens. And   Michael Hingson ** 45:13 that's where we have to go, we have to recognize that part of the cost of doing business should and is inclusion, whatever that means. I mean, we provide coffee machines for people, we provide monitors for people. The National Federation of the Blind is the largest consumer organization of blind people in the United States. And they pay a hefty electric bill every month at the National Center in Baltimore, Maryland, for the sighted people who work there to be able to have lights. Yeah, those are those of us who are blind. And those who work there who are blind, don't need the lights. But the other people do the light dependent people. So whose disability are we providing an accommodation for the real?   Peter Bacon ** 46:01 Nice adaptation? Yeah, good estimate the workplace adaptation for the site? I think. Yeah, it   Michael Hingson ** 46:05 is. It is, it's a reasonable accommodation for sighted people who are light dependent. So I love to use light dependent instead of sighted people because that's the disability that we we have to deal with, for all of you. And it is it is still, you know, something that is so rarely really discussed. But speaking of differences, and so on what decided to take you away from London to Australia?   Peter Bacon ** 46:34 The short answer is love. Which is the best answer, isn't it? Yeah, my wife's Australia. So Nicola, we met we met in the UK, we both work for a company I work for that it just is an Australian company, both work there and, you know, sort of got together there. And then the Bentley sort of production point of having found in that kind of thing. And it's really well, where do you want to bring up your family. And for us, Australia, it's great, great place to bring up your family, you know, they got good weather, we were walking distance for the beach, it's a great place to bring up kids. And I was also offered the opportunity to move. Yeah, I sort of want to look at the mate said. So. It's always made for me in the stories, isn't it, mate said. Others. There's a job out here with your name on it, Pete, which is sort of heading up strategy for not for profit, we've had significant disability employment services. So that was part of what I was looking at. But also there was other things that I was doing to which I was quite a joy when I was there. Clearly, I said a pub. Obviously, in Australia, we had the terrible bushfires four years ago now, you know, burned a huge amount of land. Yeah, scarred families, economies. And like, you know, the sad part of Southern New South Wales, particularly where, you know, did quite a lot of work for my previous employer. And the trauma that's there from that entire experience is absolutely palpable. And so being part of a nonprofit that had a significant presence in that world, but you know, they're headquartered Campbell pays for company was headquartered in Batemans. Bay, which is right at the heart of when it was buyers here. I was I was trying to do something positive. So what we did is we set up a social enterprise, which was about doing Bush regeneration, giving jobs training, to really disadvantaged people, many young people, but not exclusively in that area. But there was a lot of big bush regeneration to be done a lot of planting a lot of just work to, to make sure that healthy landscape again. And so yeah, that was that was, well, you know, we've got some good funding and to do that, we've pivoted a bit commercial social enterprise to and so and suddenly, I really enjoyed to the idea of becoming more of a job creator as well as just an advocate for disability, Clomid. That's your job creation was was great. And also, you know, we had a very diverse team, they're physically, you know, hard to get people with sort of major physical conditions into Bush regeneration jobs, but certainly people pretty significant disabilities, psychosocial conditions, etc. And there's opportunity for them to learn the craft of how you look after the land around you how you connect to that land and strengthen it. And so that was something which I did when I was there that I really enjoyed.   Michael Hingson ** 49:49 So what's the organization that you work for now?   49:51 So now I work for an organization called Disability Employment Australia. So I've been co there for eight for nine months now. And our job is to represent was I always think that we have sort of two key sort of stakeholders in this. So the first is, we are the Industry Association for providing the Disability Employment Services in Australia, what that includes those who deliver what we call death, disability employment service, but also other services such as the National Disability Insurance Scheme. And then our call beneficiary, which is, of course, people with disability, making sure that we are holding the government to account when it comes to making sure that it's doing all the right things, in terms of policy settings for people with disability, and importantly, that we're leading the charge when it comes to doing things like getting employees to engage with diversity and inclusion. So, yeah, that's here to work for now.   Michael Hingson ** 50:56 Wow. So you, you sound like you really love it? And do you get to influence the government a lot? Because of what you do?   51:05 I'd like to think so. You know, it's recently had the year of, of government, of ministers and state departments. So, yes, I think we have a pretty good voice to government. And there's lots of relatively important things where we've been influential. So if you look at say, the Royal Commission report that I was referencing earlier, there's quite a few things in there that we, disability, Australia, have been advocating for, like the institution of a Disability Forum and center for excellence. Like it's there's some technical things around the level of mutual obligation, which is effectively sanctions regimes that people with disability have if they don't engage, which we are in favor of limiting. Also, things like eligibility or support from government, require influential and so so yeah, I think we have the year of government. We're just a small organization, though. So we need to punch above our weight. But but also, we importantly, have very good relationships with our members. So we are able to be quite influential in helping them to collaborate and to work on things that are cross sectoral. So for example, we are currently about to launch a new training module, which is there a micro credential for all disability employment professionals in the field of Australia. So we're doing quite a lot to raise the standards in our industry, too.   Michael Hingson ** 52:50 Were you involved in doing any of the work with the Commission? Or how did how did you have input to help that?   52:57 Yeah, so they had a series of hearings or consultations, as well as opportunities to pull in submissions. And, you know, da were did testify at those hearings, and provided a lot of submissions around around these issues of employment, obviously, employment is only one relatively small element of what they were, they were looking at it from a whole system's perspective. But yeah, so do a pilot that we're constantly making policy submissions on on other items. So we have something called the National Disability Insurance Scheme here. It's a major thing. Which funds support for people with disability lifelong disability, where they get better chunks of funding that they can administer, and spend on the things they need to live a more independent and happy life. And there's many great things about that scheme. really supportive of it. But it's something that's been implemented over the last decade, and it certainly has some improvements that can be made. And some of those improvements, for example, are in the world of employment and how it actually claimant to participants of the NDIS can receive more support and support when it comes to employment. So that's the kind of thing was we're making policy submissions into a lot.   Michael Hingson ** 54:25 What kind of global lessons,   54:30 global lessons that we can learn from, what you're doing, or just global lessons in general that you feel that we need to tell the world more about, and encourage the world to adopt.   54:41 But I think there's two things I talked about. One is, I think we probably need to get a bit better at sharing. It's funny because, you know, I speak to people I email or colleagues from from other countries of the world. And we're dealing with the same things, you know, especially those kind of Western The veteran style developed economies, right. So I went to the World Association's post employment conference in Vancouver in June of this year. And I was struck by the similarities and the fact that actually workforce participation rates, people with disability are consistently at that sort of mid 50s type rate. I think I'm slightly better at a macro, actually. But that might be sort of the way that you count unemployment. But there's a lot of similarities, then we need to share. So one thing I'm quite excited about is I am on the board of the World Association supported employment. And in four years time, the global conference is coming to Australia. And it's a workout with Sydney, we're going to host a live but it's coming to Australia. So that's a good example of where we collaborate. But in terms of the lessons of what works, and global literature review, and speaking with colleagues and that kind of thing, the big thing I would say, is that you can talk all you like about technology and all sorts of WIZO innovations. But the reality is, there's nothing more powerful than the humans helping humans. That's, that's the reality is, if you've got somebody who needs a bit of support, find a job to overcome their challenges. Having somebody who read he's got a bit of expertise, who really cares, he wants to build a relationship, and they share that journey together. That is a most important thing that you can do. Obviously, there are variables in there like how well trained is that other staff have experienced? Are they? Do you have access and technology that maybe helps that Job Search work better? How are your relationships with employers, all those things count? But most important of all, is have you got a really committed human helping that other human? Because that's where you see transformations.   Michael Hingson ** 56:54 We've talked a lot about attitudes, which I think is absolutely appropriate, and probably the biggest thing we face. But at the same time, what's the role of Technology and Disability Employment and making it better? Do you think?   57:09 I think it's a really interesting question. And one that I'm grappling with, I think, you look at any of the sorts of papers about the future directions of economies, etc. And you see, our world is higher skilled jobs, AI or that kind of thing. And I think AI certainly is, is it is an opportunity, because the ability to work within those systems is not restricted to geography. So I think that's something which, as it evolves, could be a really great thing for people with disability who are who want work, also can do things like overtime, it will improve things like job matching, all that kind of thing to make to take a bit of friction out of that system. But the biggest development, and one, which I hadn't necessarily foreseen is the flexibility that workplaces are now taking primarily because the pandemic happened. You know, it's funny, you know, you spend years talking to businesses about actually you can change your business model, you can be more flexible, you can use remote working more, and again, and that to heart that if we need to do that it'd be a five year change management project. And then the pandemic happens. Yeah. And they do it within two weeks.   Michael Hingson ** 58:35 And I was only asking you about whether you thought that the pandemic made a significant difference in disability employment and just the world in general. And you're talking about that. Go ahead. I   Peter Bacon ** 58:45 think so. I think it has, because I think it means that the idea, I mean, it's kind of things Firstly, more people are working at home, I'm calling in, I can see you're you're in your house, I mean by house. Five years ago, at least I would have been in my office, right. So that so the fact that we're now working that hybrid way or the remote way, certainly erodes the importance of geography in a way, which I think is important for people with disability and respect for everyone, frankly. And that's a pretty big change. However, one of the things around that that I think about quite a lot is that firstly, it tends to apply more to people who already have a job. So as you there's a relatively small percentage of jobs that are advertised with flexibility of that, compared to the number of jobs, we've actually done flexibly if you know what I mean. So if you're in a job and you say, right, okay, can I have an extra day a week to work at home? Lots of employers will accommodate that. However, they won't necessarily advertise the fact that they're to do so. The other thing is around the types of jobs so So, obviously people with disabilities at all different types of jobs, but the ones who are unemployed tend to go in at those relatively low levels, not exclusively by any means, but tend to. And then you hope there's an opportunity to build up from there. But again, those jobs, which are at the relatively low levels tend to be the ones with less flexibility. I think it's notable that, you know, we talked a lot around the sort of key personnel, key service workers during COVID. And then all the ones those were people badly paid, but have to be present. And I think there's a reality there, which really to think through a little bit more about how the benefits of flexibility can accrue to people working at all levels of the labor market, and how we can also be upfront advertised flexibility as a component of the role, rather than something that has to be asked for what what somebody's in the room? Yeah, well,   Michael Hingson ** 1:00:58 and the problem is, I see both sides of that, because they're all too many people who try to take too much advantage of things. And so it is an issue, but at the same time, we do need to recognize that there is a value and be more flexible than we have. And I think we're seeing more that in reality, it's a good thing to let people have some time to work at home, less stress. So many things happen if you do that, right.   1:01:29 Ah, yeah, absolutely. And for all sorts of reasons. In my personal case, it gives me more talent for kids exactly, like more than out to get into the city. You know, that's three hours each day that I get back to spend with my children. But that's, you know, kids aren't young for long. That's massive. So, so there's huge advantages. And that's great for my well being, which makes me a more productive worker be you know, so there's huge advantages to do that. Yeah, maybe people might take advantage sometimes. But it's your good boss, you have an understanding of the output of people working for you. And you understand what acceptable looks like and what not acceptable looks like I think,   Michael Hingson ** 1:02:13 well, yes, it's right. If you're a good boss, you, you deal with the people who are taking advantage of it. And hopefully, they they grow to understand.   1:02:25 Yeah, that's right. And, you know, and you can, you can always have a look at the, the way that you extend the flexibility. But But overall, I did, and is a, a massively important part of what's happened over the over the past five years. But also, we should not ignore that lesson of how quickly employers can pivot if they need to, if they need to. Yeah, all those businesses like, you know, the ones that make gin, who are making hammers that hand sanitizer, within a week of having to do it, by when they need to, when there's an economic imperative to do so. Businesses can change fast. So what's the implication for Disability Employment one is around flexibility. But the second is, if you really wanted to pivot to being a fantastic inclusive employer, people with disabilities, you can change quickly. Yep, it's not this thing that is a five year change management project as Yeah,   Michael Hingson ** 1:03:23 I agree. What are your hopes for the future in terms of disability employment type services, and so on? I am hopeful.   1:03:35 And I think we have to be in the kind of work that we do. So from an Australian perspective, and is to that point, which I made earlier around, there was a moment here, where we've admitted what the problem is. And that problem is systematic exclusion. If we start from that premise, and start building from that premise, I think there's a lot of hope. If we go well, actually, what we need to do exactly, as you say, is address education and awareness and attitudes. That's a great start. If we start disaggregating ourselves, that will be these are things that are actually the building blocks to changing the way that disability employment works. Beyond that, I think I have a moment and the kind of people I work with in my movement, to really lobby government are making substantive change that will change the prospects for people with disability when it comes to employment. So this point around, you know, can I get to the government saying, right, you need to put the thumb on you no need to put your thumb on the scale when it comes to employers and how much they're engaging. That conversation is now open. When I go to the, you know, government and say, You need to be better employers of people with disability, your your right to employ people disability or pitiful. Well, they are going to need to change, you know, so I think we are in a moment now. Certainly in Australia, where we've named the problem. We know that it can't be swept under the carpet. And we can start dealing with it. So that makes me very hopeful for the future. globally. It's a classic case of you know, the certain Lucic Martin Luther King quote about the the Ark of moral justice being being long, but it doesn't waver on a straight line. I think that's, I think, I think that's where we're at, like, I think I th

Dive into the inspiring journey of Deidre, a mom of twins, on the latest episode of the Empowering NICU Parents' Podcast!

Welcome to another episode of The Pulling Curls Podcast: Pregnancy & Parenting Untangled. Today, in Episode 227, we are joined by Winter Redd to discuss a profoundly touching subject—'Rainbow Babies'. Winter shares her personal journey of pregnancy after experiencing the heartbreak of a stillbirth, exploring the complexities of navigating hope, grief, and the joys of expecting anew. We'll delve into the emotional landscape of becoming pregnant after a loss, the anxiety it can bring, and the ways to cope with fear and foster attachment. This episode is an important one for anyone who has faced loss or is walking the delicate path towards healing and hope with a new life on the way. Join host Hilary Erickson as we untangle the emotional threads of Rainbow Babies. Today's guest is Winter Redd. Winter cohosts with her husband Lee, the Still A Part of Us podcast, a show about stillbirth and infant loss. They started this podcast after their son Brannan was born still at 38 weeks. We interview moms and dads who have experienced a similar loss, so they have a chance to tell the birth and life story of their baby. Links for you: Winter's previous episode on parenting through stillbirth. Timestamps: 00:00 July 2018, devastated, anxious for another baby. 05:24 Pandemic allowed privacy during pregnancy after loss. 08:23 Monitoring baby's movements for peace of mind. 12:58 Counselor urges positive thinking for pregnancy outcome. 13:54 Choosing a name, bonding with baby Felix. 17:33 Mixing up family names is natural. 23:55 Mel Robbins encourages envisioning best case scenarios. 25:24 Remembering deceased child helps grieving parents cope. 28:16 Pregnant after loss? Here's some support. Keypoints: Pregnancy After Loss: The episode features guest Winter Redd sharing her personal journey of pregnancy after experiencing a heartbreaking stillbirth at 38 weeks, conveying the complexities and emotional challenges involved. Navigating Grief and Anxiety: The discussion addresses the prevalence of stillbirths and miscarriages, acknowledging the increased anxiety they can cause for parents during subsequent pregnancies. The Pandemic's Privacy: Winter Redd describes the unexpected sense of relief provided by the COVID-19 pandemic's privacy, allowing her to navigate her emotions without the external pressure usually associated with pregnancy after a loss. Support Systems: Hilary Erickson emphasizes the importance of having a solid support network and the necessity of love and attachment during pregnancy, even when fearing loss. Naming and Bonding: Winter and her husband bond with their baby early on, naming him Felix, and forging an emotional connection despite fears and past trauma. Dealing with Guilt: The episode candidly explores feelings of detachment and guilt that can arise during pregnancy and after the birth of a child following a loss, normalizing them as part of the healing process. Rainbow Babies: Although the symbolism of "rainbow babies" as a sign of hope is discussed, Hilary Erickson reveals her personal decision not to label her child under this term to avoid attaching the weight of past loss. Advocacy in Healthcare: Hilary underscores the critical role of self-advocacy in healthcare after a loss, sharing her experience of switching doctors to a stillbirth expert and seeking couple's therapy for emotional support. Podcast Resources: "Still a Part of Us" is recommended as a helpful podcast for those who have experienced a loss. However, Hilary advises against listening while pregnant due to its emotional content. Continuation and Remembrance: As the episode concludes, Hilary Erickson reflects on maintaining a connection with the child lost, imagining his personality at five years old and addressing the social discomfort around stillbirth and loss. The next episode is teased to cover postpartum sleep challenges. Producer: Drew Erickson Hilary Erickson, Winter Redd, stillbirth, pregnancy after loss, miscarriage prevalence, pandemic pregnancy, emotional support, love and attachment, baby naming, guilt in pregnancy, family dynamics, rainbow babies, hope symbolism, using Clomid, home doppler, counting kicks, non-stress tests, healthcare advocacy, stillbirth expert, couple's therapy, attachment issues, rainbow baby term, third child, podcast "Still a Part of Us", pregnancy after loss support, parenting after loss, emotional strength, connecting with lost child, stillbirth discomfort, sleep after baby.

Dr. Klimczak and Dr. Reed discuss how Lala from Vanderpump Rules got pregnant with her IUI treatment. They discuss IUI (intrauterine insemination) treatment in detail including how to troubleshoot your IUI cycle. They discuss common problems that come up and potential solutions to optimize chances for success.

Episode 122. I discuss my workup for infertility and irregular periods, including hypo hypo and PCOS. I talk about starting Provera (progesterone) and Clomid (clomiphene citrate) to induce ovulation. Editing Service for Pre-Med and Medical Students (CV, personal statement, applications): ⁠https://www.fiverr.com/firstlinepod⁠  Visit First Line's website and blog: ⁠https://poddcaststudios.wixsite.com/firstlinepodcast⁠ For a discount off your TrueLearn subscription use link: ⁠https://truelearn.referralrock.com/l/firstline/⁠ and code: firstline Instagram: @firstlinepodcast Facebook: ⁠www.facebook.com/firstlinepodcast⁠ Email: firstlinepodcast@yahoo.com Content on First Line is for educational and informational purposes only, not as medical advice. Views expressed are my own and do not represent any organizations I am associated with.

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Derek is a fitness educator, the entrepreneur behind More Plates More Dates, and an expert in exogenous molecules commonly used and misused by bodybuilders and athletes. In this episode, Derek returns to the podcast to explore the impact of exogenous molecules on male and female health. He covers testosterone, DHT, DHEA, progesterone, clomiphene (Clomid), hCG, and various peptides, alongside updates from the FDA affecting peptide use. Additionally, he addresses the recent hype around increasing muscle mass through myostatin inhibition via follistatin gene therapy and supplementation. Additionally, Derek discusses the various strategies that bodybuilders use for losing fat while preserving muscle, including insights on weight loss drugs. We discuss: Testosterone and DHT: mechanisms of action, regulation of muscle growth, and influence on male and female characteristics [2:15]; TRT in women: the complexities and potential risks associated with testosterone use in women [9:00]; DHEA supplementation: exploring the benefits and risks for women, and the differing effects on men vs. women [22:00]; The role of progesterone in both men and women, pros and cons of supplementation, the importance of tailored doses, and more [28:00]; Measuring levels of free testosterone [37:15]; The trend towards earlier interest in TRT, and the risks of underground sources of testosterone [42:00]; The complexities and considerations surrounding the use of Clomid, E-Clomid, and hCG in TRT [46:00]; Low testosterone: diagnosis, potential causes, treatment options, and other considerations [53:45]; Growth hormone-releasing peptides: rationale and implications of the recent FDA categorization as high-risk substances [1:03:45]; Follistatin gene therapy and myostatin inhibition for increasing muscle mass: the recent hype online, human and animal data, and the need for more research [1:14:45]; Simple tips for lowering calorie intake and losing fat [1:32:30]; Methods of sustainable fat loss with muscle preservation: insights gleaned from bodybuilders [1:40:00]; Could prolonged fasting impact testosterone levels? [1:55:30]; High-protein ice cream [1:57:00]; Exploring fat loss supplements and drugs: L-carnitine, yohimbine, and more [2:02:15]; Potential remedies for individuals experiencing metabolic dysfunction due to hypercortisolemia [2:12:30]; The cornerstones of body composition improvement remain nutrition and exercise, even in the presence of exogenous testosterone [2:19:15]; The importance of approaching health advice found online with a critical eye and a healthy dose of skepticism [2:23:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

After five years of navigating fertility struggles, ovulation tests, and numerous attempts, Mia's journey to motherhood took an unexpected turn. Join me on the PCOS Repair podcast as I have the honor of sharing Mia's raw and honest story, exploring the highs, and lows, of her IVF journey.PCOS and Starting a Family At 27, Mia received a PCOS diagnosis, setting the stage for a challenging fertility journey. Despite weight loss attempts and medications, initial rounds of Clomid and IUI proved unsuccessful. Mia faced disappointments and emotional turmoil, compounded by the physical toll of fertility treatments as she continued on to IVF.Mindset and Lifestyle TransformationNearly a decade later, at 36, Mia felt the urgency to start a family. This time, she sought a holistic approach, combining IVF with a focus on health and vitality. Her mindset shift from feeling helpless to actively participating in her fertility journey became a powerful tool for success.Mia's mindset transformation played a crucial role as she embraced a proactive and positive approach. Her commitment to optimizing nutrition, movement, and self-care became integral to preparing her body for IVF.Embracing The Unexpected After several rounds, it wasn't until the fourth IVF attempt that Mia received the call she had been eagerly awaiting. The news was positive – she was pregnant. A whirlwind of emotions accompanied the revelation, especially when she learned some additional unexpected news. Mia's story shares so much hope and inspiration for navigating PCOS and fertility challenges. And don't forget to share your takeaways and connect with me on Instagram @Nourishedtohealthy.You can take the quiz to discover your root cause hereThe full list of Resources & References Mentioned can be found on the Episode webpage at:https://nourishedtohealthy.com/87Let's continue the conversation on Instagram! What did you find helpful in this episode and what follow-up questions do you have?

Nobody who's going through IVF, trying multiple rounds of IUI, taking Clomid, suffered a miscarriage or had a still born child, feels in control.  The very nature of this stuff feels so far out of our control it's frightening. That means, if you're anything like me, you dig in your heals and fight tooth and nail to control as much as you possibly can. You try to be perfect, thinking it'll help you get pregnant. Right? Today's show is here to remedy that pressure, stress and negativity with something much more helpful: a proven strategy to help you stop trying to control the uncontrollable and instead get really clear on what you can control and how to do it. Letting go of what you can't control creates so much more space for freedom, flexibility and focus on what really matters, what really works to get you pregnant in the end. I've got the strategy for doing this, and I'm sharing it on today's show. For daily high vibe inspiration, down to earth validation and essential tools to navigate your journey to your baby follow me @BadassFertility There's *ONE spot* left for the Badass Fertility Group Coaching Program (BFP) January 2024 cohort. JOIN HERE

Join urologists Dr. Justin Dubin and Dr. Kevin Chu as they explore the impact of testosterone on fertility and the various medications available to increase testosterone levels while preserving fertility. The discussion covers the use of Clomid and HCG, their mechanisms of action, side effects, and effectiveness. The combination of Clomid and HCG is also explored, as well as the use of testosterone for fertility preservation. The conversation concludes with a discussion on aromatase inhibitors and the importance of medical supervision when using these medications. Listen free NOW on Spotify, Apple Podcasts, Amazon, and Youtube. Go to manscaped.com and use the code "MANUP" to get 20% off your first purchase.

We're back with SEASON 3! Pop the champagne, it's the 1 year anniversary of Motherhood Intended!In this episode, Jacqueline shares the unique conception and birth stories of her six children - the two sons she's blessed with at home, her three angels in heaven, and a baby girl on the way due in April. *trigger warning* the topics of premature delivery, miscarriage, and stillbirth are discussed.In this episode...Infertility, a blocked fallopian tube, hypothyroidismClomid, IUIs, IVFClubbed feet birth defect, cervical insufficiency, polyhydramniosBedrest, premature delivery, the NICU, c-sectionsMiscarriages and stillbirthPregnancy after lossPlacental abruptionGenetic testing of embryosSurrogacyGrief, trauma, and anxietyStruggling to conceive? Download this *free* Month-by-Month Roadmap to Your Fertility Success to help you stay calm and focused on your journey to baby. •  Leave a review for the podcast•  Join the Motherhood Intended Community•  Follow @motherhood_intended on Instagram• Apply to be a guest on the podcast• Want in on the ground floor of Motherhood Intended? Reach out to Jacqueline for available opportunities! --> hello@motherhoodintended.comIf you're interested in helping give the absolute greatest gift to deserving parents, learn more about becoming a surrogate (and earn up to $650 just for taking the first few simple steps!): share.conceiveabilities.com/hello12Support the showLoving the podcast? Then we would love your support with the production of the show! With the help of our audience, the podcast will be able to bring you the best content, most interesting guests, and helpful resources. Consider skipping your coffee run today and instead show some love here: https://www.buymeacoffee.com/motherhoodintended

Trying to conceive with PCOS can feel like navigating a maze of wrong answers, especially when you don't have the right support. In this episode, I cut the fluff and dive into the nitty-gritty of common PCOS mistakes we should leave behind this year! 1. Accepting all your labs look normal even when you don't feel well. 2. Going to Dr. Google and self-prescribing supplements. 3. Jumping straight to Clomid, IUI, and IVF. Have a topic you really want covered this year? Shoot me a DM on Instagram @drdanielle.nd and let's chat! ___ ⁠Join my mailing list⁠⁠ ⁠⁠Book a discovery call⁠⁠ ⁠⁠Fullscript Supplement Dispensary⁠⁠

Uncover the fascinating truths about timed intercourse in our latest episode, "Timing is Everything." Dr. Mark Amols takes you on an enlightening journey, revealing the effectiveness and secrets of this fertility technique. From understanding the optimal timing to exploring the roles of ovulation kits and fertility drugs, this episode is packed with essential insights. Whether you're exploring fertility options or simply curious, this episode will captivate and educate, shedding light on a topic shrouded in myths and half-truths. Join us for an engaging dive into the world of timed intercourse!

When we last talked to Kristyn, in January 2020, she shared how "nothing on the road to motherhood was easy" for her, from the "Clomid crazies" to her first failed frozen embryo transfer. At the time, her IVF twins were toddlers. Today, her twins are five years old, and Kristyn fills us in on what's happened since our last podcast episode, including two more years of fertility treatments. "In total, I did five embryo transfers over two years," she says. "Two losses and three that didn't implant at all. I just can't believe I'm here. I was so sure two years ago that we were gonna have three kids. Now I'm in this limbo period where I don't know what to do next." In addition to her family building journey, Kristyn shares how she pivoted from founding The Fertility Tribe to co-founding Rescripted, which covers women's health and wellness from first period to last period.  For more, go to www.rescripted.com/ TOPICS COVERED IN THIS EPISODE: Twin pregnancy; Asherman's Syndrome; PCOS; embryo transfers; IVF; miscarriage; blighted ovum For podcast sponsorship or partnership inquiries, please email infertileafstories@gmail.com EPISODE SPONSORS: FERTILITY RALLY @fertilityrally www.fertilityrally.com No one should go through infertility alone. Join the Worst Club with the Best Members at fertilityrally.com. We offer 4 to 5 support groups per week, 4 private Facebook groups, tons of curated IRL and virtual events, and an entire community of more than 500 women available to support you, no matter where you are in your journey. Join now at link in bio on IG @fertilityrally or at www.fertilityrally.com RECEPTIVA DX ReceptivaDx is the only test that can identify endometriosis, progesterone resistance and endometritis in a single sample, all causes for unexplained infertility and thus success rates of IVF treatments. ReceptivaDx includes BCL6, a marker that identifies uterine inflammation most often associated with asymptomatic (silent) endometriosis. BCL6 is found in more than 50% of women with unexplained infertility and over 65% of women with two or more IVF failures. If positive for the ReceptivaDx test, treatment options can improve the chances for a successful live birth 5 fold! Learn more at receptivadx.com or download our app “Receptivadx" -- and USE CODE INFERTILEAF23 for $75 off the test BINTO Today, Binto gets you your supplements in individual daily packets with your name on them. Binto makes it easy to stick to your supplement routine and enjoy taking them every day. Along with your supplements, Binto's health providers offer online chat support and telehealth appointments to make sure you feel supported, informed, and empowered when it comes to your health. Take the quiz and get started on your prenatal supplement routine! Head to mybinto.com, take the quiz and enter promo code INFERTILEAF for 20% off your first month. For more, go to mybinto.com S'MOO  S'moo's  best-selling hormone balance powder is formulated with 7 essential vitamins, minerals, and herbs that are all highly recommended for Hormone Balance, Fertility, and PCOS. Now is the perfect time to give it a try, with an exclusive early Black Friday offer just for Infertile AF podcast listeners. Go to thesmooco.com enjoy a generous 20% off sitewide using code 'InfertileAF' at checkout Support this podcast at: https://redcircle.com/infertile-af/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy Our Sponsors: Check out Mosie Baby and use my code INFERTILEAF for a great deal: https://mosiebaby.com/ Support this podcast at — https://redcircle.com/infertile-af/donationsAdvertising Inquiries: https://redcircle.com/brands Learn more about your ad choices. Visit podcastchoices.com/adchoices

GSD Mode Health and Fitness Podcast Episode with Jim Brown and Joshua Smith...

Brett is joined today by Beth Huddleston & Tiffany McKee to discuss all things hormone health.  Beth has an extensive background in the medical field with degrees/certifications as an RN, BSN, FNP-BC, with a Masters in Nursing.  She's served 12 years as a Registered Nurse, mostly in ER/trauma/acute care and is a NP with acute care and hormones. Tiffany comes with a 15 year background in fitness, nutrition support, personal training/group coaching classes, and an overall fitness influencer.  The three of them discuss some common myths surrounding hormone replacement therapy, some common side effects, & the most common benefits people see in using this to regain their youthfulness and defy aging.  Connect with Beth on instagram @mrs.shavedgorillaConnect with Tiffany on Instagram @fitmckee1You can connect with Brett on Facebook, Instagram, & X @bpop80

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter We discuss: Derek's interest in weightlifting and experimentation with anabolic steroids at a young age [3:15]; Derek's experience acquiring steroids from underground labs and the potential long-term fertility concerns early in his bodybuilding career [12:00]; The backstory on More Plates, More Dates and Derek's unique ability to blend scientific knowledge with personal observation [17:00]; Growth hormone – from extreme use-cases to the more typical – and the misconception that it's the “elixir of life” [21:30]; Growth hormone 101: definition, where it comes from, and the challenges of measuring it [28:45]; Does exogenous growth hormone compromise one's ability to make endogenous growth hormone? [40:00]; The use of growth hormone in restoration of tissue during periods of healing [42:00]; Growth hormone-releasing peptides to increase endogenous GH: various peptides, risks, benefits, and comparison to exogenous growth hormone [48:45]; The role of growth hormone in building muscle and burning fat, as well as its effects on sleep and daytime lethargy [1:02:30]; The evolution of drug use in the sport of bodybuilding [1:10:30]; What explains the protruding abdomens on some bodybuilders and athletes? [1:20:30]; Death of bodybuilders [1:26:00]; The complex interplay of hormones, and the conversion of testosterone into metabolites like DHT and estrogen [1:33:45]; Post-finasteride syndrome and how Derek successfully treated his hair loss [1:43:15]; Testosterone replacement therapy: compelling use-cases, side effects, and optimal dosing schedules [1:57:15]; Aromatase inhibitors to suppress estrogen, and the misconceptions around estrogen in men [2:16:00]; Other hormones beyond testosterone for male sex hormone replacement [2:21:00]; The history of anabolic compounds, and the differing effects of various anabolic testosterone derivatives and related drugs [2:24:30]; Use of SARMs by bodybuilders [2:29:45]; Anabolic steroid and testosterone regimens of professional bodybuilders and the downstream consequences [2:36:15]; The challenge of accurate hormone testing in the presence of anabolic steroids and supplements [2:44:45]; The use of Clomid, hCG, and enclomiphene [2:47:15]; Concerns about fertility: comparing the use of testosterone and hCG [3:00:30]; The use of BPC-157 peptide for healing injuries [3:12:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

Dr. Jane Levesque discusses How to Improve Fertility with Dr. Ben Weitz. [If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]    Podcast Highlights 0:55  One of the biggest obstacles for couples trying to conceive is that there is so much information that it is difficult to know what is true and what's not and where you are in your journey.  Some couples wonder if the conventional route, whether it's IVF, IUI, or medications like letrozole or Clomid to stimulate ovulation is the only option. 3:00  When Dr. Levesque sees a new client for the first time, she spends a lot of time going through their history and then she starts by looking at their previous labs, which often their doctors have not looked at very closely.  Often their doctors may have told them that their labs are normal because they are busy and skim through them and they also are only looking at the reds and have no sense of what optimal ranges are.  For example, when it comes to vitamin D and the normal range is 30 to 100, but if you are at 30 is that good?  No, that's low and vitamin D is important for hormone production, to make our neurotransmitters, and for our immune system function. There's actual vitamin D receptors on both the egg and the sperm.  Dr. Levesque likes to see vitamin D levels in the 60 to 80 ng/mL range.  6:35  For women it is important to figure out if they are ovulating and if the quality of their eggs is good.  If the woman is not healthy, then her eggs will likely not be healthy.  If they are struggling with fatigue, digestive disorders, anxiety, or skin issues, then they are not going to have healthy eggs either.  We need to look at the FSH to LH ratio and estrogen and testosterone on day three and at progesterone on day 21 or 22, if they have a 28 day cycle.  We also want to look at electrolytes, at a liver panel, a kidney panel, and then it is helpful to get a Gut Zoomer stool test.  Dr. Levesque has seen a number of women in their 20s with an FSH well above 10, which is a strong indication that they are no longer ovulating and this may indicate premature ovarian failure.  When testing on day three, we want a FSH/LH ratio to be close to 1:1.  If LH is really high, this is a sign of Polycystic Ovarian Syndrome. 10:04  Hormone testing.  Dr. Levesque likes to test estrogen on day three of the cycle but she also likes to look at the DUTCH (dried urine) hormone panel to look at the metabolites to see you well you are breaking down your hormones.  A lot of symptoms, such as painful periods, heavy periods, fibroids, and even endometriosis are related to the bad estrogen, Estrone, due to endocrine disrupting substances.  There are three main forms of estrogen: 1. Estradiol E1, 2. Estrone, E2, and 3. Estriol, E3.  Estradiol is the good estrogen, Estrone is the bad estrogen and the one most associated with breast cancer, and Estriol that is in the middle. Estriol is high during pregnancy, but also high in fibroids and endometriosis. 14:09  Birth control.  Many women have been taking birth control for years and sometimes for decades and this can make it difficult to become pregnant. Birth control is synthetic hormones and your body has to process it and this takes a lot of nutrients, including N-acetylcysteine and CoQ10, zinc, and selenium. There's also a connection with the gut microbiome.  Imbalanced hormones affect the microbiome balance, which makes it harder for the body to produce neurotransmitters like dopamine and serotonin.  16:01  The microbiome and hormone connection.  There's a connection between the microbiome and our hormones.  If you have imbalanced hormones you likely have microbiome issues.  We think that our gut is separate from our reproductive system but your uterine lining is only separated from your GI tract by a tiny, little membrane.

Dr. Natalie Crawford answers the voicemails you called in. Questions Answered: When to remove IUD? How to choose a long term storage facility for frozen eggs? Does having one miscarriage mean you have a higher chance of having another? Conventional IVF vs ICSI for a lesbian couple with no known fertility issues? Clomid or Letrozole for medicated IUI for unexplained infertility? Is it normal to have a positive pregnancy test one evening and a negative test the next morning? I have a blocked tube and have had three unsuccessful IUIs. Should I see further testing? How important is it to take antibiotics when getting an HSG? Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page @nataliecrawfordmd. You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today!      Thanks to our amazing sponsors! Check out these deals just for you: Apostrophe- Get your first visit for only five dollars at Apostrophe.com/AAW or use the code AAW at checkout. Strategy- Get 15% off your first purchase by using the code AAW at checkout when you go to strategyskincare.com or go to https://strategyskincare.com/discount/AAW BetterHelp - Go to BetterHelp.com/AAW today to get 10% off your first month. Liquid IV- Go to liquidiv.com and use code AAW at checkout for 20% off Nutrisense- Visit nutrisense.io and use code AAW to save $30 and get 1 month of free dietitian support. If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram @nataliecrawfordmd, check out Natalie's YouTube channel Natalie Crawford MD, and if you're interested in becoming a patient, check out Fora Fertility. Learn more about your ad choices. Visit megaphone.fm/adchoices

Today, Ali talks to Jewish Fertility Foundation founder Elana Frank about getting married but not getting pregnant right away, going through fertility treatments in Israel, getting put on Clomid without even getting an exam, and so much more. She also talks about IUIs, IVF, transferring multiple embryos, embryo donation, having her babies, and why she started the JFF.  TOPICS COVERED IN THIS EPISODE: Infertility; IVF; Jewish infertility; IUIs; infertility treatment in Israel; Clomid; embryo donation  For sponsorship or partnership inquiries, please email infertileafstories@gmail.com EPISODE SPONSORS: FERTILITY RALLY @fertilityrally www.fertilityrally.com No one should go through infertility alone. Join the Worst Club with the Best Members at fertilityrally.com. We offer 4 to 5 support groups per week, 4 private Facebook groups, tons of curated IRL and virtual events, and an entire community of more than 500 women available to support you, no matter where you are in your journey. Join now at link in bio on IG @fertilityrally or at www.fertilityrally.com RECEPTIVA DX ReceptivaDx is the only test that can identify endometriosis, progesterone resistance and endometritis in a single sample, all causes for unexplained infertility and thus success rates of IVF treatments. ReceptivaDx includes BCL6, a marker that identifies uterine inflammation most often associated with asymptomatic (silent) endometriosis. BCL6 is found in more than 50% of women with unexplained infertility and over 65% of women with two or more IVF failures. If positive for the ReceptivaDx test, treatment options can improve the chances for a successful live birth 5 fold! Learn more at receptivadx.com or download our app “Receptivadx" -- and USE CODE INFERTILEAF23 for $75 off the test Fertility Coach Academy and Elizabeth King Fertility Coaching Ready to turn your passion for fertility into a purpose-driven career? Visit www.fertilitycoachacademy.com. You'll be empowered to make a difference, while embracing the mind, body, and spirit approach. Or are you seeking personalized guidance on your own journey? Visit www.elizabethking.com. Unleash your potential and unlock the doors to parenthood. Use code "InfertileAF" on both for your special 25% discount. Support this podcast at: https://redcircle.com/infertile-af/donations Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy Support this podcast at — https://redcircle.com/infertile-af/donationsAdvertising Inquiries: https://redcircle.com/brands Learn more about your ad choices. Visit podcastchoices.com/adchoices

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:    Gary: Hi Dr. Cabral, I perhaps have the stump Cabral of the day. (I know this will be 12+ weeks until answered and that's ok) A little context for me (chronic constipation, leaky gut, and bacterial overgrowth, tons of gas and bloating) I did the FM detox followed by the CBO Protocol with Mastic Gum (because of C.Diff) and the Citricidal Drops followed by the CBO finisher. (I followed it all to a tee) It helped some but definitely did not fix the issues. 5 1/2 years of this now. I've been working with your team and they've been very helpful, but I think everyone is out of answers of what to do next. I know it is stressed based (been doing sauna, relaxation exercises, bineural beats, etc) Where do I go from here? P.S. perhaps ileocecal valve dysfunction? Thank you! Gary   Maria: Is it true that kale and spinach cause kidneys stones.   Alexandra: Hi, first I'd like to say thank you. I've worked with one of your health coaches and the results are truly amazing. I am writing to you today at our daughter. Our 2.5 year old had split nights (up for 2-3 hours and just can't sleep. Mostly calm) at around 18 months old and lasted almost 8 weeks straight. We thought it was a sleep pressure thing and did all the things to try to fix it, but in the end we had to just ride it out and we think it was developmental. The split nights have now started back up. My husband and I both work and with having a 5 month old, split nights with our 2.5 year old are extremely exhausting. She had the flu and we did have to give her Motrin to keep her comfortable. I usually let her ride out the fevers, but she was miserable. Anyway, looking for help ! Thanks   Geoff: Hi Dr. Cabral! Have you had any experience with high alkaline phosphate levels? My levels have been above the normal range (as high as 156, currently 135) since May of 2022. I'm 44, active, and in good shape, 5'10" 152 lbs. I'm sure I'm leaving out vital background info, sorry! I started TRT (cypionate injections after about 10 years of taking Clomid) around the same time as the high readings of the alkaline phosphate. Would that have anything to do with it? My PCP sent me to have an ultrasound that looked at my kidneys, liver, and gall bladder which came back normal. His suggestion is to keep an eye on it, but I'd prefer to take action if there is anything I can do. Any suggestions are greatly appreciated! Thank you for all you do! You are a real beacon of light for all of us!   Kelly: Hi Dr. Cabral! I'm a Registered Dietitian currently going through your IHP Levels 1 and 2. It's been a great learning experience so far and I am very thankful. I had the virus back in November 2020 (the OG virus) and my main symptom was loss of smell along with a severe headache between my eyes and above my nose. Over the past 2+ years, my smell has slowly returned but is not nearly the same as it was prior to losing it. Most people I know had a return of smell after a few weeks. I'm not too sure why I have it so severe. Do you have any    Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community's questions!      - - - Show Notes and Resources: StephenCabral.com/2591 - - - Get a FREE Copy of Dr. Cabral's Book: The Rain Barrel Effect - - - Join the Community & Get Your Questions Answered: CabralSupportGroup.com - - - Dr. Cabral's Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - Get Your Question Answered On An Upcoming HouseCall: StephenCabral.com/askcabral - - - Would You Take 30 Seconds To Rate & Review The Cabral Concept? The best way to help me spread our mission of true natural health is to pass on the good word, and I read and appreciate every review!