Podcasts about hsg

Understanding Unicornuate Uterus: What It Is, Prevalence, Risks, and a Positive Outlook A unicornuate uterus is a rare congenital condition where the uterus develops with only one half, or "horn," instead of the typical two-horned shape of a normal uterus. This happens during fetal development when one of the Müllerian ducts, which form the uterus, fails to develop fully. As a result, the uterus is smaller, has only one functioning fallopian tube, and may or may not have a rudimentary horn (a small, underdeveloped second horn). This condition falls under the category of Müllerian duct anomalies, which affect the female reproductive tract. For those diagnosed, understanding the condition, its implications, and the potential for a healthy pregnancy can provide reassurance and hope.   What Is a Unicornuate Uterus? The uterus typically forms as a pear-shaped organ with two symmetrical halves that fuse during fetal development. In a unicornuate uterus, only one half develops fully, creating a smaller-than-average uterine cavity. This anomaly can occur with or without a rudimentary horn, which may or may not be connected to the main uterine cavity. If a rudimentary horn is present, it might cause complications like pain if it accumulates menstrual blood, as it often lacks a connection to the cervix or vagina. The condition is often diagnosed during routine imaging, such as an ultrasound, MRI, or hysterosalpingogram (HSG), typically when a woman seeks medical advice for fertility issues, pelvic pain, or irregular menstruation. In some cases, it's discovered incidentally during pregnancy or unrelated medical evaluations.   How Prevalent Is It? Unicornuate uterus is one of the rarest Müllerian duct anomalies, occurring in approximately 0.1% to 0.4% of women in the general population. Among women with Müllerian anomalies, it accounts for about 2% to 13% of cases. The condition is congenital, meaning it's present at birth, but it often goes undiagnosed until adulthood because many women experience no symptoms. Its rarity can make it feel isolating for those diagnosed, but awareness and medical advancements have made it easier to manage and understand. Risks Associated with Unicornuate Uterus While many women with a unicornuate uterus lead healthy lives, the condition can pose challenges, particularly related to fertility and pregnancy. The smaller uterine cavity and reduced endometrial surface area can increase the risk of certain complications, though these are not inevitable. Below are some potential risks: Fertility Challenges: The smaller uterus and single fallopian tube may slightly reduce the chances of conception, especially if the rudimentary horn or other structural issues interfere with ovulation or implantation. However, many women with a unicornuate uterus conceive naturally without intervention. Miscarriage: The limited space in the uterine cavity can increase the risk of miscarriage, particularly in the first trimester. Studies suggest miscarriage rates may be higher (around 20-30%) compared to women with a typical uterus, though exact figures vary. Preterm Birth: The smaller uterus may not accommodate a growing fetus as easily, potentially leading to preterm labor or delivery before 37 weeks. Research indicates preterm birth rates in women with a unicornuate uterus range from 10-20%. Fetal Growth Restriction: The restricted uterine space can sometimes limit fetal growth, leading to low birth weight or intrauterine growth restriction (IUGR). Malpresentation: Babies in a unicornuate uterus may be more likely to position themselves in a breech or transverse position due to the confined space, which could complicate delivery. Cesarean Section: While not mandatory, a cesarean may be recommended in cases of malpresentation, preterm labor, or other complications. However, this is not a universal requirement. Other Complications: Women with a unicornuate uterus may have a higher risk of endometriosis or painful periods, especially if a non-communicating rudimentary horn is present. Kidney abnormalities are also associated with Müllerian anomalies, as the kidneys and reproductive tract develop simultaneously in the fetus. Despite these risks, it's critical to note that not every woman with a unicornuate uterus will experience these complications. With proper medical care, many achieve successful pregnancies and deliveries.   A Positive Outlook: Normal Vaginal Delivery Is Probable The diagnosis of a unicornuate uterus can feel daunting, but it's important to emphasize that a healthy, full-term pregnancy and a normal vaginal delivery are entirely possible. Advances in obstetrics and prenatal care have significantly improved outcomes for women with this condition. Here's why you can remain optimistic: Personalized Care: Working with an experienced obstetrician or maternal-fetal medicine specialist ensures close monitoring throughout pregnancy. Regular ultrasounds can track fetal growth, position, and amniotic fluid levels, allowing for timely interventions if needed. Not Doomed to Cesarean: While some women may need a cesarean due to specific complications, many with a unicornuate uterus deliver vaginally without issue. The decision depends on factors like fetal position, labor progression, and overall health, not the uterine anomaly alone. Full-Term Pregnancies Are Achievable: With careful monitoring, many women carry their pregnancies to term (37-40 weeks). Preterm birth is a risk, but it's not a certainty, and modern neonatal care can support babies born slightly early if needed. Healthy Babies: Countless women with a unicornuate uterus give birth to healthy, thriving babies. The condition does not inherently affect the baby's development or genetic health. Support and Advocacy: Connecting with others who have similar experiences, whether through online communities or support groups, can provide emotional strength and practical advice. Knowing you're not alone can make all the difference. A unicornuate uterus is a rare but manageable condition that requires awareness and, in some cases, specialized care. While there are risks to consider, they are not insurmountable, and many women with this anomaly experience successful pregnancies and vaginal deliveries without complications. With the right support, you can embrace your unique journey, knowing that a unicornuate uterus does not mean you're destined for preterm birth, cesarean delivery, or pregnancy complications. Instead, it's a testament to your resilience and the incredible capabilities of modern medicine to support you every step of the way.   Connect With Us: YouTube: Dive deeper into pregnancy tips and stories atyoutube.com/maternalresources . Instagram: Follow us for daily inspiration and updates at @maternalresources . Facebook: Join our community at facebook.com/IntegrativeOB Tiktok: NatureBack Doc on TikTok Grab Our Book! Check out The NatureBack Method for Birth—your guide to a empowered pregnancy and delivery. Shop now at naturebackbook.myshopify.com .    

What are the must-have tests when trying to figure out infertility? In this episode of Fertility Docs Uncensored, we're joined by Anate Brauer, MD, a physician at RMA New York, to break it all down with our trio of fertility gurus—Dr. Carrie Bedient from the Fertility Center of Las Vegas, Dr. Susan Hudson from Texas Fertility Center, and Dr. Abby Eblen from Nashville Fertility Center. Together, they dive into the top 4 tests you shouldn't skip when facing infertility. We're talking AMH (antimullerian hormone) to evaluate egg quantity. They discuss egg quantity vs. quality (yes, there's a difference!), why age really does matter (ugh, we know), and what tests like TSH, FSH, and estrogen levels can tell us. They get into the nitty-gritty of semen analysis—because guys, you're half the equation—and the dynamic duo of uterine evaluations: HSG and saline sonogram to check for polyps, fibroids, and make sure your fallopian tubes are open. And just when you thought we were done, we throw in a little genetic twist with carrier screening, explaining why matching mutations isn't as romantic as it sounds. Whether you're just starting your fertility journey or deep in the diagnostic weeds, this episode is packed with laughs, knowledge, and more than a few “aha!” moments. Don't miss it!

Der gebürtige Isländer Björn Oddsson hat den Schellenursli in seine Muttersprache übersetzt. Die grösste Herausforderung war die Reimform, welche in Island strengen Regeln unterliegt. Weitere Themen: · Thurgau setzt Fachstab Trockenheit ein · Seit mehr als 80 Jahren für die Rheinebene und ihren Unterhalt im Einsatz · Kunstwerk "Fliege Erika" soll an der HSG bleiben · Komplette Evakuierung von Brienz GR wird wahrscheinlicher

Jetzt auf eine Zusammenarbeit mit uns bewerben: https://pumpkincareers.com/jetzt-hier-bewerben/?htrafficsource=organic&hcategory=yt_organic&el=wirtschaftskrisediebestenerfolgeausmaerz2025190425 Referenzen: https://pumpkincareers.com/erfahrungen/?htrafficsource=organic&hcategory=yt_organic&el=wirtschaftskrisediebestenerfolgeausmaerz2025190425 Mein SPIEGEL-Bestseller-Buch: https://nach-ganz-oben.de/?htrafficsource=organic&hcategory=yt_organic&el=wirtschaftskrisediebestenerfolgeausmaerz2025190425 In dieser spannenden Folge des BWL-Podcasts präsentieren David Döbele und Jonas Stegh zahlreiche Coaching-Erfolgsgeschichten aus dem März – von Praktikumszusagen bei Top-Unternehmen wie Big4, M&A-Boutiquen und Strategieberatungen bis hin zu Stipendien, Top-Noten, Master-Zusagen an Elite-Unis und außergewöhnlichen Karriere-Boosts durch das Coaching bei pumpkin. _____________________________________________ Timestamps 00:00:00 - Intro 00:01:24 - Audit-Praktikum, HSG, M&A Praktikum 00:02:08 - Stipendium beim Ernst-Ludwig-Ehrlich-Werk 00:04:10 - Studienwechsel & Inhouse-Consulting Praktikum 00:05:13 - Tech-M&A Praktikum 00:07:14 - Zusage für Spring Week bei einem Asset Manager 00:07:30 - 1,3-Schnitt trotz 66 ECTS Punkten 00:08:39 - Bachelor-Verbesserung & mehrere M&A-Zusagen 00:10:08 - Ausbildung → Studium → 2 M&A Praktika 00:10:50 - Werkstudent im Private Equity 00:12:05 - Master-Zusage NOVA 00:13:00 - Top-Start ins Studium 00:14:17 - Starke Notenverbesserung & Inhouse-Consulting Praktikum in der Schweiz 00:17:30 - Master-Zusage Brown University mit Stipendium 00:18:53 - Starke Notenverbesserung u 00:21:00 - ZEMS Master & 100%-Stipendium 00:21:48 - Frühzeitig beworben → Sommerpraktikum 00:23:05 - Big4 Praktikum direkt nach dem Abi 00:23:55 - Sneak Peek: BCG, Berger & mehr 00:25:17 - Outro _____________________________________________ Weitere hilfreiche YouTube-Videos: Der Karriere Insider Podcast: https://www.youtube.com/@KarriereInsiderPodcast INVESTMENT BANKER WERDEN (Guide): https://youtu.be/smtlWs5WPUM?si=nLG14-z-VNx0bk0f UNTERNEHMENSBERATER WERDEN (Guide): https://youtu.be/jLK24iLsGPM?si=5DlTJvVKLf1FhpnU Die besten Unis für den Bachelor: https://youtu.be/n-YSo8ss0Ks Die besten Unis für den Master: https://youtu.be/fdKknPZzO4w ALLE JOBS NACH DEM BWL-STUDIUM: https://youtu.be/D1Ssf6uAQlY ALLE FINANCE JOBS nach dem BWL-Studium: https://youtu.be/6kD05whSvEU _____________________________________________ Wenn du dich für den Berufseinstieg in Investment Banking, Unternehmensberatung oder Private Equity interessierst, haben wir hier einige nützliche Links für dich zusammengefasst: Target-Uni-Report: https://pumpkincareers.com/target-uni-report?htrafficsource=organic&hcategory=yt_organic&el=wirtschaftskrisediebestenerfolgeausmaerz2025190425 Investment Banking Analyst Report: https://pumpkincareers.com/investment-banking-analyst-report?htrafficsource=organic&hcategory=yt_organic&el=wirtschaftskrisediebestenerfolgeausmaerz2025190425 Consulting Einsteiger Report: https://pumpkincareers.com/consulting-report?htrafficsource=organic&hcategory=yt_organic&el=wirtschaftskrisediebestenerfolgeausmaerz2025190425 Eine Gesamtübersicht über alle unsere bisher veröffentlichten Reports findest du übrigens hier: https://pumpkincareers.com/reports/?htrafficsource=organic&hcategory=yt_organic&el=wirtschaftskrisediebestenerfolgeausmaerz2025190425 Schau gerne auch noch auf unserem Blog vorbei: https://pumpkincareers.com/blog/?htrafficsource=organic&hcategory=yt_organic&el=wirtschaftskrisediebestenerfolgeausmaerz2025190425

HSG anjlok hingga minus 7,90% ke level 5.996! Perdagangan juga sempat dihentikan sementara, kala IHSG menyentuh level 5 ribu 912 atau melemah 9,19%. Perdagangan dihentikan selama 30 menit terhitung pukul 9 hingga 9.30.

Timestamps:6:54 - An investor generating returns for their LP8:22 - The Swiss startup ecosystem is 18 years old12:09 - Does big data drive innovation?19:20 - What if you don't perform as promised?21:25 - Dealing with FINMA regulations as a VCClick here to check out our free Founders Agreement masterclass, with Melanie Gabriel from Yokoy, Christof Roduner from Scandit, and Viviana Gropengiesser from Talent Kick.About Andrea Silberschmidt-Buhofer, Teddy Amberg, David Hug & Tanvi Singh:Andrea Silberschmidt-Buhofer is the general partner at EquityPitcher Ventures, an early-growth VC firm that focuses on B2B tech startups, and the vice-president of FEM'UP SWITZERLAND. She holds a MSc in Entrepreneurship from the UCL School of Management and is also a startup coach at Venturelab.Teddy Amberg is the founding partner at Spicehaus Partners, a VC fund that focuses on seed and early stage Swiss tech companies. He holds an MA in Banking and Finance from HSG and worked at Partners Group and CreditGate24 before founding Spicehaus Partners in 2018.David Hug is the co-founder of Marcau Partners, an investment manager managing Ringier Digital Ventures and Lightbird Ventures AG. He holds a MSc in Entrepreneurial Management from the Hochschule für Technik und Wirtschaft Chur and worked at btov Partners and Zürcher Kantonalbank before becoming a VC in 2015.Tanvi Singh is the founding partner at Nirmata-ai Ventures, a VC fund focusing on AI-driven investments for a sustainable future. She holds a Master's degree from UZH and worked for banks like Credit Suisse and UBS before founding Nirmata in 2024.During their chat with our co-host Merle, these 4 VCs shared their best practices for managing a fund. Their tips included:Being proactive in including your LPs in your fund's journey by giving them co-investment opportunities and full access to your data room;Not shortcutting when it comes to compliance and regulatory demands (or you will regret it!);Underpromising and overdelivering when it comes to the goals you communicate to your LPs, and being transparent with them when something goes wrong, so as to ensure that trust is never broken;Sticking to your portfolio companies both in good times and in bad — the startup journey is rocky, and your investments need your help!The cover portrait was edited by ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.smartportrait.io⁠⁠⁠⁠⁠⁠⁠⁠‍‍Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners.

In this heartfelt episode of the Millionaire Car Salesman Podcast, Sean V. Bradley and LA Williams celebrate the life and legacy of Jim “The Alpha Dawg” Ziegler, forever an icon in the automotive industry. Joined by renowned guest Cory Mosley, the podcast pays tribute to Ziegler's profound impact and lasting influence on automotive sales culture and training. Through anecdotes, shared experiences, and enlightening discussions, listeners are provided a deep dive into the principles that Ziegler embodied, particularly his advocacy for dealers and his dynamic approach to sales training. "I wouldn't be in the car business if it weren't for what Jim taught me in his training." The episode eloquently captures Ziegler's ethos of doing things his way and the indelible mark he left on the automotive industry. From discussions about the early days of Ziegler's career to his massive influence on automotive sales techniques, the conversation touches on the many elements that made Ziegler a cherished mentor and industry leader.  "He loved his wife, he loved his family, and he loved the industry." The podcast also highlights Ziegler's personal insights on the importance of work-life balance and the human side of being a business legend, offering listeners a balanced perspective of both his professional contributions and his personal journey. Feel and listen with your heart as we honor the loss of an automotive legend.   Key Takeaways: ✅ Ziegler was a staunch advocate for automotive dealers, committed to enhancing dealership profitability and industry standards. ✅ The significance of mastering one's craft in automotive sales was a central theme of Ziegler's career, emphasizing his desire to elevate others in the industry. ✅ The importance of personal legacy and balancing professional success with meaningful personal relationships, a lesson from Ziegler's experiences. ✅ The role of the National Speakers Association (NSA) in elevating Ziegler's and others' careers, serving as a pivotal institution for professional growth and networking in public speaking. ✅ The evolving impact of technology and virtual platforms in car sales and dealership operations, as reflected in Ziegler's career transition over time.     About Jim “The Alpha Dawg” Ziegler, CSP, HSG Jim Ziegler, CSP, HSG - Known as "The Alpha Dawg," Ziegler was a legendary figure in the automotive industry with a career spanning nearly five decades. He was a consultant, speaker, and trainer, recognized for his contributions to F&I and automotive sales training. Holding the titles of Certified Speaking Professional (CSP) and HSG, Jim was known for his bold personality and his impactful presence in the industry.   About Cory Mosley, CSP Meet Cory Mosley, CSP, Award-Winning Business Growth & Media Expert. Cory Mosley, CSP, is an entrepreneur, sought-after strategic consultant, media personality, results-driven coach, and certified speaking professional. Cory's experience in the business and media arena spans over twenty years and includes global strategy, business development, and marketing work. His client list includes Fortune 100 companies, global tier 1 and 2 suppliers, countless small business and franchise operations, professional associations, and non-profits. Cory specializes in Business Growth Strategy, Rebranding, Thought Leadership Content Creation, Event Speaking, and Custom Training and Development Programs.   About Sean V. Bradley, CSP Sean V. Bradley, CSP is the President of Dealer Synergy and co-creator of the Millionaire Car Salesman Podcast. With decades of experience, Sean is a celebrated figure in automotive sales training, recognized for his innovative strategies and motivational speaking.   About LA Williams III - Known as “The Blind Master” LA Williams III - Known as “The Blind Master” is the co-host of the Millionaire Car Salesman Podcast, Williams is known for his remarkable talent in inspiring and training automotive professionals. He contributes his extensive knowledge and engaging style to help drive sales success and motivate others.     Honoring the Alpha Dawg: The Lasting Legacy of Jim Ziegler in the Automotive Industry Key Takeaways Jim Ziegler's unwavering dedication to the automotive industry showcased his deep love and commitment to his craft, his family, and his peers. Emphasizing the importance of vigilance in business, Ziegler often cautioned against distractions disguised as opportunities, a principle that applies universally beyond automotive sales. Ziegler's larger-than-life persona and unparalleled influence have left an indelible mark on countless individuals within the automotive and speaking communities.   The Indomitable Jim Ziegler: A True Icon in the Automotive World Jim Ziegler's name resonates deeply within the automotive industry. Known as the "Alpha Dawg," Jim dedicated nearly five decades of his life to revolutionizing automotive sales and training. His powerful impact was not just limited to dealerships and sales teams but extended to empowering individuals through professional speaking. This article delves into Jim Ziegler's unmatched legacy, the principles he championed, and what it truly meant to have crossed paths with such a titan. One of Ziegler's peers, Sean V. Bradley, remarked, "Jim loved it. Day after day, he loved the industry." This passion for automotive sales and training was evident in all that Jim did—from his staunch advocacy for dealerships to his direct confrontations with entities that threatened the industry's sanctity. Jim Ziegler embodied what it means to be a true leader and innovator, and his influence will be felt for generations to come.   Pioneering a Dealer-Centric Approach Jim Ziegler was renowned for his unwavering commitment to the automotive profession and the people within it. His advocacy was unparalleled as he battled against anything that could detrimentally impact dealers, managers, and sales personnel. Emphasizing the need for integrity while making a profit, Ziegler once proclaimed, "Success leaves clues." This insight reflected his belief in the industry's potential—championing a dealer-centric model where professionalism and profitability went hand-in-hand. Ziegler's influence was palpable, from battling legislative efforts that threatened dealerships to crafting meticulously designed strategies to increase profitability. His colleagues noted how his strategies empowered automotive professionals at all levels, yielding measurable economic benefits. Jim's passion extended beyond the tangible, often challenging the status quo with his bombastic approach and willingness to confront adversity head-on. As Cory Mosley, another leading industry figure, stated, "This was a guy who came into our industry and fundamentally affected tens of thousands of people."   The Power of Persona: A Charismatic Figure Ziegler was known for his charisma, the allure of which was not only leveraged to drive sales but also to inspire legions within his community. His larger-than-life personality drew people in and his no-nonsense approach kept them engaged. Yet beyond the swagger and humor, Jim was a passionate advocate for continuous improvement. He emphasized the importance of mastering one's craft, often challenging peers to embrace the industry as if earning a master's degree. His sayings and stories are legendary. From stating, "Alpha Dawg don't fly in the back of no planes," to his memorable meme wars with peers, Jim was unapologetically himself and lived by his truth. This authenticity struck a chord with many, creating a ripple effect of admiration and respect across the industry. Jim's willingness to put himself out there and embrace failure was another facet of his enduring appeal. Whether mentoring up-and-coming trainers or forging lifelong friendships, Jim's influence was marked by his transparent honesty and keen desire to share his vast expertise. As L.A. Williams described, "He was a good guy to be around; he always loosened you up."   Navigating Opportunities: A Lesson in Focus Perhaps one of Ziegler's most impactful teachings was, "Beware of distractions disguised as opportunities." This timeless advice is not only applicable to the automotive industry but also serves as a broader lesson in life and business strategy. It encourages individuals to remain focused and discerning amid myriad distractions vying for attention in the digital age. By embodying this tenet, Ziegler was not only teaching the essentials of sales but also imparting wisdom that transcended the boundaries of industry-specific knowledge. His guidance urged professionals to identify the substantive opportunities from the noise—a skill crucial for success in both personal and professional domains. Jim's philosophy serves as a poignant reminder of the need for clarity and focus in our pursuits. Applying this approach can result in improved decision-making and reinforces the importance of maintaining a strategic vision. Reflecting on Jim Ziegler's Legacy Jim Ziegler's legacy is one of passionate advocacy, relentless pursuit of excellence, and the profound ability to influence those around him. Through his direct approach to both the joys and challenges of automotive sales and professional speaking, Jim equipped countless individuals with the knowledge and motivation to succeed. His unique blend of humor, wisdom, and integrity cemented his status as a towering figure within and beyond the automotive field. Reflecting on Ziegler's contributions invites us to ponder our own legacies—what we Stand for and what we leave behind. To honor Jim Zieg     Resources: Podium: Discover how Podium's innovative AI technology can unlock unparalleled efficiency and drive your dealership's sales to new heights. Visit www.podium.com/mcs to learn more!   NCC: Credit-Driven Retailing - NCC delivers industry-best credit-driven retailing for auto dealerships, combining a powerful credit and compliance engine and fully integrated CRM/Desking platform for maximum profitability.   Complete CRM: Complete CRM is a streamlined, all-in-one system that simplifies your dealership software and processes so you can manage every aspect of your operation with ease; from tracking and following up on leads, desking deals, managing inventory, marketing to your customers, and more.   Dealer Synergy & Bradley On Demand: The automotive industry's #1 training, tracking, testing, and certification platform and consulting & accountability firm.   The Millionaire Car Salesman Facebook Group: Join the #1 Mastermind Group in the Automotive Industry! With over 28,000 members, gain access to successful automotive mentors & managers, the best industry practices, & collaborate with automotive professionals from around the WORLD! Join The Millionaire Car Salesman Facebook Group today!   Win the Game of Googleopoly: Unlocking the secret strategy of search engines.     The Millionaire Car Salesman Podcast is Proudly Sponsored By: Podium: Elevating Dealership Excellence with Intelligent Customer Engagement Solutions. Unlock unparalleled efficiency and drive sales with Podium's innovative AI technology, featured proudly on the Millionaire Car Salesman Podcast. Visit www.podium.com/mcs to learn more!   NCC: Powered by proprietary solutions such as Intelligent Credit Engine™ and LenderSelect™, NCC transforms the car-buying experience for dealers and their customers. From compliance and lender selection to CRM and desking, to marketing and data mining—NCC integrates them all in a single, seamless platform to deliver better customer experiences, maximum efficiency and maximum profit.   Complete CRM: As an innovative leader in the industry for the last 30 years, Complete CRM is designed to give your dealership the competitive edge in a demanding marketplace. Powered by Complete Credit™ and award-winning desking, Complete CRM™ is the industry's only credit and compliance-enabled CRM that lets dealers achieve maximum profitability on every deal. Built on modern technology, Complete CRM seamlessly integrates credit, compliance, inventory, data mining, lead generation, enterprise functionality, and customized reporting in one tool with a single login.   Dealer Synergy: The #1 Automotive Sales Training, Consulting, and Accountability Firm in the industry! With over two decades of experience in building Internet Departments and BDCs, we have developed the most effective automotive Internet Sales, BDC, and CRM solutions. Our expertise in creating phone scripts, rebuttals, CRM action plans, strategies, and templates ensures that your dealership's tools and personnel reach their full potential.   Bradley On Demand: The automotive sales industry's top Interactive Training, Tracking, Testing, and Certification Platform. Featuring LIVE Classes and over 9,000 training modules, our platform equips your dealership with everything needed to sell more cars, more often, and more profitably!  

On today's episode of The Wholesome Fertility Podcast, I am joined by world-renowned fertility specialist and Harvard-awarded scholar, Gabriela Rosa @dr.gabrielarosa, founder of The Rosa Institute. Gabriela has dedicated her career to helping couples overcome infertility, miscarriage, and failed treatments to create healthy families. With over 20 years of experience, her Fertility Breakthrough Program™ boasts a remarkable 78.8% success rate, even for couples who had previously faced long-standing fertility challenges. In this episode, Gabriela explains why infertility is a symptom of deeper health issues and shares how addressing these root causes not only improves fertility but also enhances overall health. She also delves into her innovative, evidence-based approach that combines modern science and natural medicine to deliver transformative results. Be sure to tune in for this enlightening conversation packed with practical advice and hope for anyone navigating the fertility journey! Key Takeaways: Infertility, miscarriage, and failed treatments are symptoms of deeper health imbalances. Gabriela's Fertility Breakthrough Program™ has helped thousands of couples worldwide overcome complex fertility challenges. Addressing the root causes of infertility leads to better reproductive outcomes and long-term health benefits. Low AMH does not mean no baby—natural conception is possible with the right interventions. Fertility challenges are clues pointing to underlying health issues that need attention. Thorough testing and a personalized approach are key to addressing unexplained infertility. Integrating natural and modern medicine optimizes fertility outcomes and overall health. Ignoring infertility as a symptom can increase the risk of chronic illnesses like diabetes and cardiovascular disease. Fertility is a whole-body process—issues with egg or sperm quality often stem from broader health concerns. Community and support are essential for navigating the emotional challenges of infertility. Guest Bio: Gabriela Rosa @dr.gabrielarosa is a world-renowned fertility specialist, author, and Harvard-awarded scholar. She is the founder of The Rosa Institute and creator of the Fertility Breakthrough Program™, which has transformed the lives of over 140,000 couples in 110+ countries. Gabriela's work focuses on addressing the root causes of infertility using an evidence-based approach that combines modern science with natural medicine. With extensive training in reproductive health, naturopathy, and public health, Gabriela is passionate about empowering couples to achieve their dream of parenthood while improving their long-term health and well-being. Websites/Social Media Links: Website: https://fertilitybreakthrough.com/ Facebook: https://www.facebook.com/FertilitySpecialistGabrielaRosa  Instagram: https://www.instagram.com/dr.gabrielarosa/  Fertility Breakthourgh Instagram: https://www.instagram.com/fertilitybreakthrough/  Fertility Breakthourgh Facebook: https://www.facebook.com/rosainstitutefertilitybreakthrough  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/  Transcript: [00:00:00]  [00:00:04] [00:01:00]  [00:01:47] ​ [00:01:47] **Michelle Oravitz:** Welcome to the podcast, Gabriela. [00:01:55] **Gabriela Rosa:** Thank you so much, Michelle. It's so lovely to be here. [00:01:58] **Michelle Oravitz:** So lovely meeting you. We just [00:02:00] had a really nice pre chat and I would love for you. I always like to hear an origin story. I would love to get your background and how you got into the work that you're doing right now. [00:02:11] **Gabriela Rosa:** And sure. Look, I think if for me, I've been doing this work since 2001. So it feels like a very long time, probably because it is. when I start seeing my patience, babies graduating from university. I'm [00:02:23] **Michelle Oravitz:** Oh my God. That is crazy. Cause you look so young. [00:02:27] **Gabriela Rosa:** Oh, thank you. It must be all those herbs and nutrients, you know, but, it's funny because like, that's exactly last two years ago, I had this experience of like seeing, literally seeing one of my babies graduating from university and thinking, Oh my God, where did the time go? [00:02:44] You know, like, that's just crazy, but, but it's, it's been wonderful. It's been a wonderful journey. don't know that I have. In a way, I think that, you know, we, as, Steve Jobs says, you can't, or said, you can't join the [00:03:00] dots in advance. You know, sometimes you can only join the dots in retrospect. And as I look back, I think, you know, I don't know that I planned to be where I am, but in a way I plan to be exactly where I am, if you know what I mean. [00:03:14] It's a very strange kind of [00:03:17] **Michelle Oravitz:** It found you. [00:03:19] **Gabriela Rosa:** certainly found me, that's for sure. and it was really through my experiences with patients that That it shaped the specific area that we focus on because we really only treat couples who typically have been experiencing infertility, miscarriage, failed treatments, and really have, you know, have tried everything and nothing has worked like that's who we treat. [00:03:41] And it certainly didn't start out that way. My, passion when I first started doing what I do was that I wanted to make sure We had a contribution to making the world a better place, one healthier baby at a time. And I really had in my young mind that I wanted to help as many people who wanted to have a baby to [00:04:00] prepare, to do preconception preparation, to be the healthiest version of themselves because we know epigenetics matters. [00:04:06] We know that the way in which, you know, prospective parents go into a conception attempt and certainly conception in general will. either increase or improve the health of a child or, decrease it, you know, there is no zero net some kind of effect. There's only ever always positive or negative effects. [00:04:26] Neutral effects are generally kind of weighed down to negative effects. So for me, and I'll talk more about that if you want to, but, you know, for me, it was that whole idea that I wanted to ensure That we were making that contribution. And it was interesting because although some people were really interested in being the healthiest that they could be, most people were not, most people are like, Oh, this is just too much work. [00:04:50] Let's just start trying. And if we have a problem, then we can do something about it. And that was never really my attitude towards it because the way that I see certainly the [00:05:00] work that we do. There is another layer to it, which is not so much about the physical and the functional. Although, of course, we address that our program has a 78. [00:05:09] 8 percent success rate for people who previously, you know, were infertile, lots of failed treatments and all of those things. And we validated those results through my masters in public health at Harvard. So we know that, you know, what we're doing certainly makes a difference. But. It really, for me, the undercurrent and the underlayer of why I wanted to do this work was actually for self actualization of the patients who came to us, you know, it was for really being able to reach one's full potential in terms of health and how that impacted other areas their life. [00:05:43] And that's how I wanted to work. And the people who were coming in for preparation really were not into that kind of work. And so I started to see that the people who are more in alignment with the work that I wanted to do and the legacy that I wanted to leave in the world were the people who [00:06:00] were having difficulty. [00:06:01] And so I started to kind of focus more and gravitate more towards, you know, those, challenging experiences and how to help people overcome them and, Transition and almost kind of transmute what they were going through. And about five or six years into it all, I had a patient who really changed the trajectory of my whole career. [00:06:25] And she had been referred to me by a friend who thought that she should have a conversation with me. She had been infertile for 10 years. She had done multiple failed IVF cycles at the time. And even though now I talk about that case and it's kind of like, Every day in the office for me at the time, it was the first time that I was seeing that. [00:06:44] And so I was like, Ooh, I don't know that we can help that kind of sit or that I can help that kind of situation. You know, I don't know that there's much that I can do, but she was really insistent and quite adamant. I actually talked to her the other day and told her this story because she didn't even know. [00:06:57] Yeah. And she was like, Oh my God, that's so [00:07:00] amazing to know. But you know, it's, what I ended up happening was that because she was so insistent at doing something, she said to me, she said, look, it's going to be my last try. I'm not going to do any more treatment after this. You know, I'm getting older. I don't want to continue this. [00:07:15] It's been long enough. So I said, look, that's fine. Let's do what we need to do and we'll see what kind of result we get. And Three months later, after years of nothing working, she was actually, it was about four months later, she was pregnant and I was like, Oh, okay. So there's, there's something here, you know, but then at the same time, I thought, Oh, that's, that's strange. [00:07:33] I actually doubted my own, my own results, you know, I was like, Ooh, I don't know, I don't really know if this is just one of those. Luke situations, you know, one of those kind of like random occurrences. But then there was another patient who came to me not long after her, who was infertile for 19 years and yeah, and then I was really like going, [00:07:54] **Michelle Oravitz:** Wow. [00:07:55] **Gabriela Rosa:** I really don't think that I can do anything for you. [00:07:57] She was 44 by the time she came to me. I [00:08:00] had a conversation with her. I said, look, it's not usually, obviously what walks through my door is not 19 years of infertility, but just recently I had a lady who had been trying for 10 years. We can give it a go and see what happens. And we did that. About five or six months later, she was pregnant. [00:08:15] And so I was like, okay, now to, you know, randomness can occur, but to is a bit like a lot. and so I started to, after we had that, success, so I had that kind of experience. I started to then really decide that, okay, you know what, I'm only going to treat people who have been. Trying for more than two years and nothing has worked. [00:08:37] And I did that for many, many years. And when I finally went to do our study for the for the fertility breakthrough program and its results when I was doing my masters at Harvard, we realized that Yes, we had a 78. 8 percent live birth rate for people who had been infertile for almost four years on average, plus or minus almost [00:09:00] three years. [00:09:00] So it really helped me to realize that, okay, this definitely makes it, you know, what we do and the methodology that we use, and that obviously I've developed over the years. really does make a difference to address these really difficult, complex cases of couples who, and individuals as well, you know, sometimes we do get solo reproduction patients who come to us who have been experiencing FALD, or egg cycle, or IVF cycle, but mostly couples who know that there is more that they kind of intrinsically know there's more they can do, but they don't know what. [00:09:34] And they also are very unclear typically about why it's not working. You know, they have these unexplained diagnosis of either infertility or failed treatment or miscarriage, and they keep being told, Oh, everything is normal. Just keep trying. And we know that clearly, What is normal is that you have sex, you get pregnant, you hold your baby, that's normal. [00:09:59] A [00:10:00] deviation from that tells me that, okay, there's more that we need to ask in terms of what's going on here and certainly more that we need to answer if we're going to get somewhere. So that's how it all started. And I guess that's how it's going, you know, [00:10:13] **Michelle Oravitz:** That's awesome. I mean, those stories are pretty amazing. I mean, really, really like shockingly amazing. And a couple of things came to mind as you were talking about it. And I love the fact that you were saying about really approaching a person that To make them more vital, like to really improve their overall wellbeing. [00:10:33] And rather than just focusing on disease, you're really focusing on their health and seeing them in almost a positive light. And it is actually, we don't really notice this, but it is actually a perspective. of many healthcare professionals or like older types of healthcare, like not older, I guess more like conventional. [00:10:53] Sometimes they'll focus more on the symptoms and we always say like root cause versus symptoms rather than just [00:11:00] focusing on treating disease. It's like treating health and really kind of a more positive way to approach the journey. [00:11:08] **Gabriela Rosa:** You know, what's interesting is that we see these days that fertility, and I say fertility rather than infertility. Fertility is highly medicalized, right? So it's, it's about finding the problem and treating a problem as if The ovaries and the testicles, i. e. the egg and the sperm, were the only parts that make this process happen. [00:11:36] And we know that it's not. And, you know, what's interesting about it, and I think that, you know, to speak to what you're talking about, the issues here are so much greater than where we find ourselves, because it's a, it's a healthcare system problem. The reality of it is that when it comes to prevention, typically public health is focused on [00:12:00] prevention and the healthcare system is focused on the treatment of disease. [00:12:03] And we see that when it comes to fertility a lot and what ends up happening as a result of it is that It really is just focusing on like, it's almost like, you know, you've got a sore finger. Okay, let's chop that off and fix that problem. Hopefully you don't get to chop it off, but you know, that's typically how it, how it's approached. [00:12:24] And so what ends up happening is that the entire context of the human being that is meant to produce the result of, which really fertility is a, is an outcome. But it's also a retrospective outcome. You know that it's you're holding a baby once you are, like whatever happens before that moment happens is essentially a part of what is going to lead to whatever outcome you have. [00:12:51] And so I always talk about it from this perspective. If you are experiencing Challenges in terms of getting pregnant, keeping a healthy pregnancy to term, [00:13:00] these are end results of many biochemical chain reactions that start all the way, you know, way before the result is meant to occur. What IVF tries to do is immediately work from like the immediate part that you can see, i. [00:13:15] e. egg and sperm. But the reality of it is that there's only so much leverage when it's not very much that you can get from only trying to address those cells, as opposed to all of the biochemical pathways that are leading to the creation of the cells in the way that they are. And that's part of why IVF its own, often fails, because one, it's not looking and addressing What are the reasons as to why we need IVF to begin with? [00:13:41] And what is it that we need to do to improve the chances of conception occurring, whether it's via natural conception or via IVF? I also want to really kind of underline and highlight the point that whether we're talking about any kind of reproductive challenge, whether we're talking about [00:14:00] infertility or miscarriage or failed IVF treatments, It's almost like those are clues. [00:14:05] They're not results. They're not the outcome because the outcome of reproduction is a baby. So if we're having failures in that process that are leading us to not hold our baby, it tells us that, okay, the clues that we have are the symptoms that we're experiencing. Infertility, miscarriage, failed treatments. [00:14:26] Those are symptoms. Right, really to a large extent. And what that means is that we need to treat them as such, because if we don't address the red flags that are infertility on its own, miscarriages on its own, and failed treatments on its own, because failed treatments is relevant here, because the that you have an egg and a sperm together, you have an embryo. You have a baby right in that moment. You have a baby when you transfer an embryo for treatment, [00:15:00] you are pregnant at the time of transfer. No matter what you are pregnant. So if you don't see a positive pregnancy test. That tells us that implantation has failed and that tells us that, okay, there's something there that we need to address. [00:15:14] Why is it failing? Most doctors, most providers don't care about it. They literally just say, oh, you know, it's a like, it's a numbers game. It's the luck of the draw. Just keep trying. Everything is normal. Just keep trying. When I hear that, literally, this is why I have so much gray hair. Because when [00:15:30] **Michelle Oravitz:** But you have beautiful skin. [00:15:34] **Gabriela Rosa:** when I hear that, I just go, Oh my God, like, how can we keep believing this lie that everything is normal, just keep trying whilst we're having very clear symptoms, infertility, miscarriage, failed treatment, that things aren't quite right. [00:15:49] What we also know about these symptoms, and I like to call them symptoms because really, That is what they are. They're telling us that there is some imbalance within the system that [00:16:00] often left unaddressed will lead. It's not may lead. It is will lead to other health conditions being developed in the long term. [00:16:09] And we know that being studies about this that show that. For people who have an infertility diagnosis and just bypass it with any other kind of treatment rather than addressing IVF etc, rather than addressing the issue, what happens is that the risk and the rate of all cause mortality in the future is higher. [00:16:35] So people who are diagnosed with infertility who don't treat it. actually die from all other causes, cancer, cardiovascular disease, diabetes, at a higher rate than people who actually address their problems. And this was demonstrated to happen and be true for females and for males. So literally, if you're not addressing infertility as a symptom, [00:17:00] you are digging yourself a hole sooner and at a younger age than you otherwise would want to. [00:17:07] Now, I know that this is unpopular and most people are going to feel very confronted by hearing something like this, but the reality is that, sure, you can go and bypass infertility and the symptoms of infertility and go into IVF and get a baby. But are you going to have the quality of life and the ability to be here to raise that child in the long term? [00:17:29] That's a very important question that people need to ask themselves before they simply just jump onto, you know, overcoming the issue with a band aid and just fixing it as opposed to actually truly addressing the root cause of the problem and finding what is the problem. You know, because there are things, for example, if you have antiphospholipid syndrome, which increases the risk of miscarriage, that's also a marker for cardiovascular disease in the long term. [00:17:59] So you're [00:18:00] literally like, if you are ignoring it for, and just take heparin, take whatever to be able to actually take home a baby and not really addressing the underlying concerns that your body is telling you than a present. Well, You are certainly increasing your risk of cardiovascular disease in the future. [00:18:18] And like that, there are many other examples. I'll give you an example of insulin resistance. You know, like I was diagnosed with PCOS when I was 18, I had to really understand how to take care of my body in the best possible way to have regular cycles, despite being told by a medical doctor that. I probably would never have Children. [00:18:37] I was able to conceive two babies twice, literally one and two kind of attempts later by understanding what it is that I needed to do in a holistic way for my body. Now, had I not done that and just jump bypassed the problem with taking metformin, not that I'm saying it can't be a part of the solution, but it can't be the whole solution, right? [00:18:57] I would have probably at this stage in my life right [00:19:00] now. Have pre-diabetes or have already have diabetes because we know that insulin resistance leads to pre-diabetes, which leads to the development of diabetes and that women with PCOS have and are at highest risk. Now by me ignoring my insulin resistance, yes, I'm increasing the risk of implantation failure. [00:19:21] infertility and diabetes in the long term. And like I said, if I don't address that at the, at the point in the time that it matters to overcome fertility concerns and fertility challenges, I am choosing diabetes in the long term. So, and we know that one of the biggest killers in the world these days is diabetes, cardiovascular disease, and cancer. [00:19:43] And there are many cancers that are associated with the insulin resistance condition, resistance conditions and pre diabetes. So again, you know, I already have a family history of cardiovascular disease, diabetes, and cancer. Do I want to add to that? No, thank you. [00:19:59] **Michelle Oravitz:** [00:20:00] Yeah. I mean, wow. You know, this is such an important topic that you're bringing up and it's something that I don't even think has really been brought up to this level on my podcast and I've been doing this since 2018. I mean, yes, I've talked about how, like I've had people on and say almost like going through the fertility journey saved my life. [00:20:19] I mean, so yes, people have acknowledged it, but to this detail that you're mentioning, I think it's just so important for people to hear. And I think it is important. It's one of those painful truths. And I think it's important for people to face it and acknowledge it because ultimately you can ignore it, but it's going to come back. [00:20:38] It's not like ignoring it makes it go away. [00:20:41] **Gabriela Rosa:** exactly. And I think that that is, you know, if, people take nothing else out of this conversation today, I think what's important is to understand that you cannot bypass infertility and still be healthy in the longterm. You have to work with your body to understand why is it giving you these symptoms? [00:20:58] What is it that you can do about it? [00:21:00] Not just hearing a doctor say, Oh, everything is normal. Just keep trying. And yet having completely either it. Out of range or out of optimal range test results and continue to think that, well, IVF must be the next solution because it is not. IVF can be part of a solution and it's a wonderful part of the solution for couples who really, truly need it. [00:21:23] And truly, it was developed for women. with tubal factor infertility. So people who had blocked fallopian tubes for some reason, it wasn't developed for the variety of fertility concerns or issues and, causes that we have today. So we can't just expect that we are going to bypass the problem and are going to have absolutely no negative effect in the long term. [00:21:48] And I think that that's a really important thing for people to understand is that. Yes, you might use it as a way to support a process, but not without [00:22:00] addressing, and certainly not by ignoring what's causing it to be needed to begin with. I think that one of the biggest things, and for me this is, you know, something that I'm exceptionally passionate about, is helping people get answers. [00:22:15] you know, we even have a full free program that we give to people. That is a four week program. It's called the fertility challenge. It's completely free. It's literally worth thousands of dollars. And what it does is it helps people to understand, okay, let's understand the diagnosis. For you. Let's understand what are the things that are not working in the way that it needs to and change that. [00:22:38] You know, the objective really is to get answers, get clarity, to be able to personalize the implementation of whatever it is that you need to do so you can conceive however it is that you're going to conceive and finally hold the baby. Not continuing to go out and around in circles until you run out of time completely, because that is sadly what [00:23:00] happens to so many women, so many couples, they try, and I talk to them all the time, and it's heartbreaking, you know, people who have been trying for 10 years to have a baby and feel like, gosh, I'm at the end of my rope, I need to figure out how else I can do this, or I'm really come to terms with never having a baby, you know, like this is the decision and the place that so many of the patients who come to Mirat and I so hope and wish that people can actually have this clarity, have these epiphanies way before they are at that stage. [00:23:32] stage where they literally have their back in a corner and there's nowhere else to move. So those are important things for me. I think that it's, you know, getting clarity and getting answers is the number one thing that's actually going to enable you to implement the right strategy in terms of treatment because you can line up. [00:23:54] 10 men with poor sperm morphology. And you can have 10 [00:24:00] reasons as to why that sperm morphology is problematic in all of those different men. Right? So it's not one size fits all. Exactly. I didn't know for somebody, let's say that they have heavy exposures to like, I've had farmers in my program, you know, heavy exposures to heavy metals and, and heat and, you know, all sorts of things. [00:24:20] And then I've got doctors, heavy exposure to radiation and so on. So, you know, it's, it's one of those things that you really have to understand the context specific need for the patient to be able to properly and effectively address it. Otherwise you're literally just trialing and erroring until. [00:24:38] Unfortunately, many people run out of time altogether.  [00:24:42] **Michelle Oravitz:** I think that the biggest problem is that people just don't even know what they don't know. So they go to doctors and then, I mean, I was one of them and people know this, you know, my listeners know this. I've been on the birth control pill and that was like my solution to irregular periods and it was just like, [00:25:00] take this. [00:25:00] And this is the only thing you can do. And apart from this, there's nothing you can do. And that's, um, you know, such a straight statement and such a definitive statement. Statement that I don't know better. So I just believe it. And then until years later, I find different modality and realize, Oh no, there is something I can do. [00:25:17] So like  [00:25:18] **Gabriela Rosa:** There's lots.  [00:25:19] **Michelle Oravitz:** I didn't know. I did not know what I didn't know until I knew. And so this is why I love having people like you on here, bringing light to this because people need to hear this. Cause I think it's going to start to like light up something in their minds. It's like, Oh, wow, this is something that I can really. [00:25:36] Look into that's number one is people don't know what they don't know. But also number two is that they don't even know they can do anything about it. Then there's a lot of things that you could do about it. And you know, there's so many people say like, Oh, there's nothing you can do. There's no cure. And a cure is kind of like a, you know, very definitive word, but treatment. [00:25:56] I mean, there's things that you can do that actually [00:26:00] can impact it. It's just that that is not something that is in the conventional world. [00:26:06] **Gabriela Rosa:** Yeah. And you know what else is interesting, and I think that this is important for people to understand as well, because it's, it's a bugmare of mine, which is when people go to their doctor and the doctor runs some tests and then they go back for results and they literally are told, Oh, we've done all the tests. [00:26:22] And everything is normal. Now, let's peel this back and let's explain what all the tests actually means because all the tests does not mean all of the tests, okay? And everything is normal definitely doesn't mean that if you're still not holding a baby. And let me explain what that, what I mean by that. [00:26:39] When it comes to the fertility guidelines around the world, which is what doctors will most of the time will be following guidelines because they don't want to be seen as being stupid amongst their peers. Okay, so what happens with this? doctor will typically refuse to prescribe or request a test result unless they [00:27:00] feel validated in doing so. [00:27:02] Okay. And the reason for that, and I've had this conversation with doctors, my own providers, as well as colleagues who tell me this, they say, I can't ask for this test because it's not going to be either approved by insurance, or I'm going to be criticized for requesting this test to which I reply. Well. [00:27:22] What is currently in the guidelines when it comes to fertility diagnosis is that you check for patency in the fallopian tubes, so are the fallopian tubes clear, and usually that's tested these days, it used to be an HSG, these days it's by Hycose, ultrasound with fluid in the tubes and, you know, dye spilling through if the tubes are clear. [00:27:45] The other test that is done is typically your kind of general FSH, LH, estrogen, progesterone. Progesterone typically recommended on day 21 of the cycle, which also is not necessarily the right thing because some women have irregular cycles and [00:28:00] lengthened cycles and irregular ovulation. So really progesterone should be occurring seven days post ovulation and not at day 21 of the cycle, particularly if a woman has lengthened cycles or shortened. [00:28:13] cycles. It doesn't mean that a woman is not ovulating in those two instances. It just means that pinpointing ovulation becomes more difficult. And that is pretty much, and then of course, sperm parameters. Most people that come to me, believe it or not, despite years of infertility, have not had a semen analysis done. [00:28:30] or don't have a recent semen analysis that really understands what's going on with sperm right now because sperm changes literally every four months. And so you can have the flu and end up with zero sperm. It actually can happen. And you know, that doesn't mean that that person is azoospermic forever and always, it just means that they've had a severe infection that has wiped out their for a sperm cycle or for a period of time. [00:28:57] So Understanding that the major [00:29:00] things, and some doctors are more thorough and some will prescribe or refer, recommend further tests, but as a bare minimum, they're looking for hormonal balance, looking for ovulation and looking for tubal patiency and sperm parameters. So those are four things. [00:29:15] Out of literally thousands of tests that could be done and that needs to be looked at. And of course, needs to be personalized because testing is also expensive and you don't want to be wasting time doing tests for no reason. So, you know, there is a balance to that. But it's not enough to have four tests and not really exactly know what it is that's being tested. [00:29:37] And your doctor tell you, Oh, you know, we've done all the tests and everything is normal because very little is going to be picked up unless there is some serious major issue. Very little is going to be picked up by those four, you know, four things being tested or four areas being tested. What's going to happen is that you may end up with some clues about what else needs to be tested, but [00:30:00] Typically, it's going to be insufficient to gain a proper diagnosis. [00:30:05] to which what happens from there is that people get diagnosed with unexplained infertility. And hence why unexplained infertility is the major, the biggest category of infertility diagnosis, because more tests have not been done. Now, typically, and this is when [00:30:23] we're  [00:30:23] **Michelle Oravitz:** I mean, that is such a good statement. Keep going. Sorry. [00:30:28] **Gabriela Rosa:** the thing about it is that that's what we're talking about conception and conception attempt failures, which IE infertility is what, how it's labeled. [00:30:38] But when we're talking about miscarriages or implantation failure, it's even worse. Because, guess what? The healthcare system expects that a woman has to have at least three miscarriages before testing is done. Now, really? I mean, I don't know, for anybody who has ever had one miscarriage, it's traumatizing enough. [00:30:58] Waiting to have three [00:31:00] before you actually do any further testing, to me, is pretty extreme. That's why, you know. It's unacceptable. It's, as a woman, I think it's just like, it's ridiculous, right? Now, the other thing then that happens is failed IVF You end up with an embryo. Most people who go into IVF, and it's not everyone, but most people will end up with at least one embryo, and there will be a decision to transfer said embryo. [00:31:23] If it doesn't work, and of course, if the cycle gets cancelled for any other reason before we get to that stage, or even then. after getting an embryo, i. e. embryo doesn't develop, doesn't, you know, there's no blastocysts to transfer, whatever it is. Every single one of those points of failure, so to speak, needs to be questioned and needs to be specifically tested and addressed because otherwise, again, you can end up with the same problem. [00:31:51] Now, In the case of IVF, it's more problematic because it's also extremely costly. In the United States, an average IVF [00:32:00] cycle costs about 17, 000 U. S. dollars. And around the world, you know, the price varies. But let's just go with the United States data. And we look at an average cost of 17, 000. That is whether you get to transfer or not. [00:32:13] you are paying that money. [00:32:15] **Michelle Oravitz:** Yeah. [00:32:16] **Gabriela Rosa:** you have an embryo or not, [00:32:18] you are paying that money. So the thing about it that I questioned is like, okay, and there are published studies that show that in order to have a close to 80 percent live birth rate, cumulative rate for IVF, i. e. having a baby, close to 80 percent cumulative rate of chance of having a baby, you have to have eight IVF cycles. [00:32:39] That's the average. Now imagine, imagine eight times seventeen thousand dollars, I mean for some people that's a house. [00:32:48] **Michelle Oravitz:** Yeah. [00:32:49] **Gabriela Rosa:** Right. So no wonder people can't afford to go and do IVF. No wonder there are so many challenges. But even if you can afford it, would you rather do something else first to [00:33:00] understand what is the cause and address that before going and doing another cycle? [00:33:04] You know, we have so many patients who come to us after failed cycles and go, look, I want to prepare to have another better cycle. Typically, those people end up conceiving naturally. They didn't even need IVF to begin with. And when they do, they end up having one or two maximum cycles afterwards, once you understand what the problem is. [00:33:23] So again, hence the critical importance of understanding what is the problem you are dealing with, rather than just expecting that you are going to be okay with some unexplained diagnosis. for your expertise. [00:33:37] **Michelle Oravitz:** So walk us through, like, if you have certain cases, like the ones that you were mentioning, that are really, really complex and many, many years of dealing with. really being on this journey, what are some of the steps you would take? You had mentioned doing testing and functional testing also just for people listening, if you don't know about it, is a lot more in depth and [00:34:00] detailed than what you'll typically get when you go to the doctor's office. [00:34:03] **Gabriela Rosa:** Yeah, no, I agree with that. And look, the testing piece, it's almost, it's a science and an art, right? Because it's almost like you need to balance. various things when requesting a test, you have to balance what is the return on the knowledge that you're going to gain? What's the time spent? What is the money spent? [00:34:22] What are the things that are actually going to give you a lot to be able to do about it versus not very much for a very expensive test? So there's, so for me personally, and certainly, you know, in the first time method, what we use in the pro in our programs, really, what we're looking at is we kind of go back to the drawing board, we collect all the data. [00:34:42] We really look at everything that the patient brings from their lived experience, whether it's test results, other things that they've done, whatever it is, we collect and analyze all of that information to really first understand, okay, what has been done? Where are the gaps? Where are the places of opportunity? [00:34:58] What are the things [00:35:00] that. we need action that is absolutely urgent. And one of the things that we don't actually need to address because there will be addressed as part of addressing the, you know, some of the basic major root issues, root causes. So it's understanding that nuance that actually ends up being able to direct a path, particularly in those cases that we treat that are very difficult and complex because you can do a thousand tests. [00:35:28] You know, there's thousands of tests that you can actually do. Will you do them? No, no. So then we have to really be able to identify, okay, what are the red flags that if we were to understand more about them? Or where the gaps that if we don't know is going to change the direction of our, say, of our choices, then we're starting to look at those things, you know, in cost effectiveness, cost effectiveness analysis, which is a big [00:36:00] field of science, really, the idea is this, if you are going to treat anyway, don't test. [00:36:07] Right. So for example, and there are pros and cons to this, but you know, there are certain things that you're going to treat anyway. So is there a need to test it? Sometimes there is. But sometimes there really isn't and that's the thing that we really need to kind of balance in the whole scheme of things is the things that are going to be absolutely essential and the things that are not really going to be that important. [00:36:34] **Michelle Oravitz:** And what were some of the protocols or what are the types of ways that you treat people or. What is included in the protocols? [00:36:44] **Gabriela Rosa:** It's depends because it's very personalized, you know, so we will use a blend of medical. treatments and even medical diagnostics, of course. And we then are going to utilize the best of all of the worlds that we have access to, whether it's [00:37:00] naturopathic medicine, integrative medicine, traditional Chinese medicine, lifestyle medicine. [00:37:04] So we then are putting together a very personalized process. That is going to help that individual that is part of that couple. Because like I said, you know, you have 10 different men, you have 10 different reasons. Therefore, we need to understand what is the reason here and what do we then make as recommendations. [00:37:24] My biggest focus always is minimum effective dose. I want to do the least possible to get the biggest resolved. Right. That is my focus. So I'm always assessing and addressing the case from that lens of like, okay, what do I need to touch? What do I have to leave alone? Because there are certain things that, you know, for example, I'll give you an example of heavy metal toxicity. [00:37:46] Heavy metal toxicity is a really tricky one. In some cases, it will increase the risk of miscarriage. Like, hugely. I had patient once who basically had 40 times the, elevated rate of what's kind of acceptable in a [00:38:00] human. And essentially had had 8 miscarriages a result, was coming to me to figure out, okay, why am I having miscarriage after miscarriage, even though I'm getting pregnant, she was only 30. [00:38:10] So we went on to identify that she had really high level of mercury toxicity, which was causing these miscarriages. And there were other factors too. So we addressed all of it and we had to make a decision in her situation to actually go for medical chelation therapy. Because what ended up happening for her with that high level is that she was going to continue miscarrying. [00:38:32] And we also knew that chelation therapy would take a long time because it doesn't work quickly. It took us 12 months of treating her, doing chelation, doing retesting, more chelation, more retesting to actually get to a point where she could start trying to conceive again. So it's not everybody has that kind of time, which means that we might find high heavy metals in a person and have to leave it alone because literally we have two years until this [00:39:00] is all over, right? [00:39:01] So it just depends on the situation and we have to make those critical clinical decisions that are going to really help the outcome that we are looking for. So it's highly personalized. So it's not. I don't have, we have a framework that we make sure that we don't leave things to chance, that we really are, you know, checking off every box, but we don't have a, this is the only way that we do this because we have to ask and answer questions and address and adapt accordingly. [00:39:29] **Michelle Oravitz:** So I guess, my question wasn't specifically like a protocol that's customized, like for all, cause I get it. We do the same thing, but do you use, what kind of tools do you use [00:39:39] **Gabriela Rosa:** Oh, we use all sorts of things from, yeah, from drug therapy to herbal medicines, to nutritional supplementation, to exercise, to sleep, to diet, like, All of the things, you know, so in terms of what it is that we're going to use, we're going to use whatever it is that we need to use. You know, sometimes we find infections that we're not going to waste time [00:40:00] trying to use. [00:40:00] I was just going to go straight to antibiotics. You know, because that's just the thing that's [00:40:04] going to give us the result the fastest. So, again, even the treatment part is going to be very, I guess, personalized to whatever it is that that person needs, because at the end of the day, I want speed.  [00:40:18] **Michelle Oravitz:** Yeah,  [00:40:19] **Gabriela Rosa:** speed and I want effectiveness. [00:40:21] So it's, it's balancing all of those worlds. [00:40:24] **Michelle Oravitz:** definitely have a unique perspective though, in a sense that you use tools that are conventional and, a little bit more alternative and holistic. So it is a really great combination because you can get amazing results with both. Yeah. [00:40:41] **Gabriela Rosa:** way that I see it is like, we really do want to blend the best of both worlds. We don't want to say, Oh no, this is not something that we use. I'm not. Look, honestly, I am not, I'm not a purist. I'm not a purist, you know, like, I don't think that there's only one way to do things. [00:40:57] I think I always am looking for what is the best [00:41:00] way to do something, you know, what's going to get us the outcome that we're looking for, balancing all of the constraints and challenges and situations that we have in front of us. So, but how? And I always say to my patients, I'm completely impartial as to how you get pregnant. [00:41:15] I don't care if we have to use IUI, IVF, you know, like I don't care donor egg. That's not the thing. The thing is, if my patient comes to me and says, look, I'm, I want a baby no matter what. we are going to explore every, every opportunity to be able to do that. Then I also have some patients who come to me and say, I will only try natural conception. [00:41:36] I'm like, okay, cool. Let's explore and make sure that we maximize that opportunity. You know, what are the things that we need to do? But it's, values and preferences of the patient that will determine where we go and what recommendations we will make. [00:41:52] **Michelle Oravitz:** Yeah. I love that. I mean, I think that that ultimately just shows that you're present with your patient because that is [00:42:00] ultimately what it is. It's not a one size fits all because then it's something that you pre craft and just give out. But when you're present with a patient, you're able to really assess what you have in front of you specifically. [00:42:11] One topic that I did want to actually ask you about, you know, to get your thoughts, A lot of times people will come in with like, What they say, quote unquote, low AMH, which as we know, sometimes fluctuates in itself, but people get really hung up on it in response to how their doctors get really hung up on it, and I've seen this my, in my own office is that it really doesn't make as much of. [00:42:38] I guess the challenge is people think it does. I've seen people with very low numbers that were told that they needed egg donor conceive naturally like multiple times after that. So I just wanted to get your thoughts on that. [00:42:50] **Gabriela Rosa:** Yeah, absolutely. It's a great question. And look, you know, what happens is that AMH levels, which measures the ovarian reserve, it's measuring the hormones that are excreted by [00:43:00] the eggs themselves, right? And so the more of AMH you have, the more eggs you're likely to have, the less AMH, the less eggs you're likely to have. [00:43:08] Yeah. Does it mean that if you have low AMH that you can't conceive naturally and what is the best way to conceive? Well, actually, all the science shows that if you have low AMH, typically the best option for conception is actually natural conception or IUI. As opposed to IVF. Most, and this is why most women with lower MH go to their doctors and they refuse to do IVF cycles if they are good doctors. [00:43:35] If they just want to take their money, they might not be that kind of doctor. Right? And so the reality of it is that Low MH in itself does not preclude a woman from conceiving with her own eggs naturally. I see the same thing in my clinic. In fact, our study, our Harvard study shows that even in the very low MH category, the less than one, the one to four is low, less than one is very low. [00:43:59] [00:44:00] We had the majority of patients conceive by natural conception in that category group. So very possible, very doable. However, it's not as easy as it used to be. Thank you. Right. When a woman had higher AMH, and this is also part of the reason why you need to make sure that you're addressing the full context of the patient, because a woman's ovarian reserve is just going to, it's going to decline at the time, no matter what. [00:44:26] And if you're treating the wrong problem, i. e. let's say, for example, we have very poor sperm quantity, quality, you know, all of those things. And you are continually treating the woman because she has low ovarian reserve. Well, you're actually leaving a lot on the table because she probably with a better sperm partner would actually have already conceived. [00:44:50] And so it's about understanding, again, this is where I always say fertility is a team sport. And I say that for a reason. You can't expect that a woman [00:45:00] with lower age is going to conceive with crappy sperm. If you have a lower age, what you need is superhero sperm, right? And so it's, and men's sperm quality decreases over time as women's fertility decreases over time. [00:45:14] So it's a, it's a matter of understanding. What it means, like, for example, if you have just low AMH and your FSH is normal on day two, then you have a much better chance of conceiving and taking home a healthy baby, whether it's naturally or any other way, than a woman who has low AMH and high FSH. [00:45:34] Because then, if you're having high FSH, it's telling you that already on day two, your ovaries are already struggling to release the eggs that are remaining. So that tells me that, again, IVF is definitely not the best option, and you need to figure out, okay, what else is there that you can, what are the levers that you can pull, because probably egg quality is [00:46:00] not going to be enough. [00:46:01] Right? And so then you have to address and adjust treatment accordingly. But just as a full answer to your question, just as a, as a very big summary, Lower MH does not mean that you can't conceive. It does signal the onset of perimenopause. Typically ovarian reserve lowers quite significantly five to ten years before menopause, and particularly for women who smoke, that happens even five years before women who don't smoke. [00:46:30] So it's certainly if you, if you are trying to get pregnant and you smoke, well, you better stop. Right now, because you are definitely almost kind of poisoning your chances of taking a healthy pregnancy to term at any point, like you're literally certainly decreasing your chances by at least five years compared to non smoking counterparts. [00:46:54] And if your partner smokes secondary, you know, kind of smoke is also going to be a problem. [00:47:00] So, and of course, that's going to be a problem for sperm. So there's all of those, those contexts as well that we have to take into account. But yeah, it's, it doesn't necessarily translate that low AMH means no baby or low AMH means that it must be donor egg situation. [00:47:15] We had patients, and again, this is in our analysis, the majority of patients who had low AMH were told that they needed to have donor egg. We, in the entire sample of 544 patients, we only had 5. 6%. actually need donor egg. So, and the majority were consuming naturally. So, you know, I take that with a very large grain of salt. [00:47:38] **Michelle Oravitz:** Yeah. And this is why you have to get many multiple opinions and really do your research and find the right practitioner. Maybe a couple of different practitioners. but I love your approach and I think that a lot of what you're saying, first of all, it makes a lot of sense, but it's also, is research based and empowering for people listening. [00:47:59] [00:48:00] And so for people listening who are interested or want to learn more about your work, what are the things that you offer online, like [00:48:08] **Gabriela Rosa:** Yeah. So [00:48:09] **Michelle Oravitz:** far away, [00:48:10] **Gabriela Rosa:** they can go to my website, which is fertilitybreakthrough. com and they can also search my name, which is Gabriella Rosa, G A B R I E L A R O S A. they will find, I have my book, Fertility Breakthrough, Overcoming Infertility and Recurrent Miscarriage When Other Treatments Have Failed free on YouTube and Spotify. [00:48:29] So they'll be able to get the audio version there. It's also available on Amazon and every other bookseller. And of course, as I mentioned earlier, you know, we have the free fertility challenge program that is designed for couples who want to overcome infertility and miscarriage, and most importantly, want to find answers, you know, and want to know what it is that they need to do and how to personalize their journey so that they can hold their baby sooner, [00:48:53] **Michelle Oravitz:** amazing, and you work one on one as well, right? [00:48:56] **Gabriela Rosa:** our team does absolutely. So, yes. [00:48:59] **Michelle Oravitz:** [00:49:00] amazing, Gabriella, this is an amazing conversation. I've seen you around before. I've looked at your information before we spoke and I was very impressed and this exceeded my expectations. So thank you so much for coming on. [00:49:14] **Gabriela Rosa:** Thank you. Thank you for having me. It's a real pleasure. [00:50:00]       

Dr. Natalie Crawford explains the different types of cysts, including functional and non-functional cysts. She highlights the differences between endometriomas and dermoid cysts, and their respective implications for fertility. Dr. Crawford also covers the potential risks and considerations around surgical removal of cysts. Additionally, she provides guidance on fertility preservation options, such as embryo freezing, for women with a history of ovarian cysts. Natalie answers your questions in this week's FFS - For Fertility's Sake How do I know if I'm ovulating? If the left tube is open and the right tube is proximally blocked, would you repeat an HSG? If I only have egg white cervical mucus on one day, usually the day of or the next day for my LH peak, is this my only fertile day? 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. Air Doctor - Go to AirDoctorPro.com and use promo code AAW to get UP TO $300 off 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

Mit dem Medienpionier Roger Schawinski lief er 2001 den New York Marathon. Mit Joschka Fischer, dem ehemaligen deutschen Aussenminister, verbindet ihn eine enge Freundschaft. Er war Chefredaktor des Tages Anzeigers, der ZEIT und Generaldirektor der SRG. Heute ist der 72-jährige Roger de Weck freier Publizist. Kritiker sehen in ihm einen abgehobenen Intellektuellen, andere loben de Wecks Scharfsinn. Als Spross einer einflussreichen freiburgischen Patrizierfamilie wuchs de Weck in Freiburg, Genf und später in Zürich auf. Er studierte an der HSG und stieg dann in den Journalismus ein, wo er bald Karriere machte. De Weck ist Verfechter eines starken, fundierten und unabhängigen Journalismus und überzeugter Befürworter einer engen Verbindung zwischen der Schweiz und der Europäischen Union. Die Musiktitel: 1. Joe Cocker - N'oubliez jamais 2. Dave Brubeck Quartet - Take Five 3. Angèle - Bruxelles je t‘aime 4. Charles Aznavour - Les enfants de la guerre 5. Max Raabe & Palast Orchester & LEA - Guten Tag, liebes Glück

Timestamps:7:55 - Is Ypsomed just an insulin company?10:12 - Selling B2B and B2C simultaneously18:33 - Doing an IPO in 200420:20 - How to make your stock 7x22:47 - Getting into regional politicsThis episode was produced in collaboration with startup days, taking place this year on May 14th 2025. Click ⁠here⁠ to purchase your ticket.About Simon Michel:Simon Michel is the CEO of Ypsomed, the leading developer and manufacturer of injection systems for self-medication. He is also the head of Swiss Startup Supporters, a new startup days initiative. Simon holds an MA in Media and Communications Management from HSG and worked for the consultancy Arthur D. Little and the telecommunications company Orange Communications SA before joining his father's company, Ypsomed, in 2006.In 1984, a company named Disetronic was founded by the brothers Willy and Peter Michel (Willy being Simon's father), in Burgdorf, Switzerland. Disetronic was the first company to introduce a micro insulin pump to the medtech/pharma market. Besides its infusion systems, Disetronic also specialised in injection systems. In 2003, co-founder and main shareholder Willy Michel sold Disetronic's infusion business to Roche and kept the injection business — that's how Ypsomed was born.Simon first joined Ypsomed as a Business Development Manager of Diabetes Care, and rose through the ranks until he became CEO in 2014. He credits this gradual rise, based on concrete achievements within the company, as the reason for his easy integration in its team. Nowadays Ypsomed focuses on the treatment of chronic diseases such as diabetes, obesity, polyarthritis, Alzheimer and migraines. On 22 September 2004, Ypsomed was registered on SIX Swiss Exchange under the ticket SWX:YPSN.Simon is also affiliated with FDP (The Liberals party) and is a member of Switzerland's National Council. When asked about Switzerland's political strengths and weaknesses, he identified the following strengths: Strong majority support: Switzerland takes an average of 6 years to get a new law approved. This makes its political system quite slow, but this slowness has the advantage of ensuring majority support for many of the laws approved. Strong R&D: The Swiss government invests CHF 10B per year in education and research, out of a CHF 90B budget. This results in a robust education system. Independence and neutrality, which give Switzerland international credibility.Simon also identified 2 weaknesses in Switzerland's political system: Speed: This system is, indeed, quite slow, and unnecessarily so, in Simon's opinion. Left vs Right disagreements: Simon opposes the Swiss left's ideas of rebuilding Switzerland as a state-run operation less reliant on private enterprise. He considers this a political weakness.The cover portrait was edited by ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.smartportrait.io⁠⁠⁠‍Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners.

Timestamps:4:48 - What is ‘speed of trust'?7:40 - Why AI is a trust-breaker12:35 - Cultivating customer trust23:15 - Hubspot taking market share33:43 - Learning from other people's mistakesThis episode was co-produced by the SalesPlaybook, DACHs' leading B2B Sales & HubSpot agency for fast-growing 7-8 figure entrepreneurs to increase pipeline, revenue & sales efficiency. About Manuel Hartmann:Manuel Hartmann is the founder and CEO of SalesPlaybook, a sales agency with 7-figure annual revenue helping clients like bexio, Beekeeper, Skribble, Brame & Urban Connect. He holds an MA in Business Innovation from HSG and worked for companies such as Tesla, Accenture and Onedot before founding SalesPlaybook in 2019.During his chat with us, Manuel discussed “speed of trust”, a concept first developed by Stephen M.R. Covey in his book of the same name. Speed of trust is the speed at which trust is established with clients, employees, and all stakeholders. Manuel applies this concept specifically to sales, where, according to him, trust is currently rather broken, due to practices like sending mass AI-written cold emails and email-bombing prospects who have not opened a salesperson's previous emails. It's easy for us to understand and recognize trust in our personal lives: we do not need a 17 page contract to move in with our best friend — we simply trust that it will work out fine. But how can we scale this, especially in a field where trust needs to be restored? Manuel recommends doing things that don't scale: send postcards, meet people in person. He is also a fan of the 4/7/11 framework, according to which salespeople need to meet a prospect in 4 different locations, spend 7h with the prospect in total (not necessarily consecutively) and have 11 touchpoints with them (email, whatsapp, etc). This framework has been proven to work at a neurobiological level when it comes to creating trust. Finally, Manuel urges salespeople to ask for referrals. Only 10% of salespeople do so, when 90% of happy customers would gladly give a referral — so there's an 80% gap that is ours for the taking.The cover portrait was edited by ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.smartportrait.io⁠⁠Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners.

Zum Rückrunden-Auftakt des Stammtisches by Sparkasse Zollernalb war Siri Schaudt von der HSG Albstadt zu Gast. Gemeinsam mit der Nummer 78 der HSG sprechen wir über die Hinrunde, die Vorbereitung, sowie über ihren persönlichen Karriereweg. Viel Spaß mit der Folge! Unsere Links: Instagram Neckaralb: https://www.instagram.com/match.report.neckaralb/ Instagram Nördlicher Schwarzwald: https://www.instagram.com/match.report.nsw Instagram Zollernalb: https://www.instagram.com/match.report.zollernalb/ Facebook (Sport): https://www.facebook.com/MatchReport-583138828788902 Facebook (Fußball): https://www.facebook.com/match.report.fussball Facebook Zollernalb: https://www.facebook.com/match.report.zollernalb.bytequila Twitch: https://www.twitch.tv/matchreport LinkedIn: https://www.linkedin.com/company/76271113/admin/ Podcast: https://open.spotify.com/show/3T8uyQK4PqkM9ea25FZWvW Blog: https://matchreport.de/ Sportlerfrühstück ist ein Podcast von @Match.Report. sportlerfruehstueck@matchreport.de

Der St. Galler Regierungsrat hat neun Mitglieder des Universitätsrats der HSG gewählt. Darunter vier Bisherige und fünf Neue. Als Präsidenten wählte die Regierung Zeno Staub, CEO der Privatbank Vontobel und ehemaliger Student der HSG. Weitere Themen: · Infoveranstaltung zur Zusammenlegung der Bahnhöfe Bruggen und Haggen in St. Gallen. · Konzessionsänderung Kraftwerk Luchsingerbach. · Freispruch der zwei Kaderleute der Aroser Bergbahnen ist rechtskräftig. · Ostschweizer Unternehmer Walter Fust ist verstorben.

I have Dr Irfana Koita from IVF Matters with me to discuss the various physical investigations available for women's health and fertility. Irfana discusses the different types of scans and when they should be used. Irfana highlights the need for comprehensive fertility investigations to identify potential issues that could affect conception and the importance of addressing these issues before proceeding with treatments like IVF. We also discuss the role of diagnostic procedures in improving treatment outcomes and the significance of patient education in navigating fertility challenges. We discuss: Why transvaginal scans are essential for assessing ovarian function. Why HYCOSY and HSG are important tests for checking fallopian tube patency. Why comprehensive fertility investigations are crucial for effective treatment. How mild endometriosis may not be detected by transvaginal scans. Why diagnostic procedures can impact the success of fertility treatments. Why Hysteroscopy allows for both diagnosis and treatment of uterine issues. Why patient education is vital in managing fertility concerns. This podcast is sponsored by⁠⁠⁠ Invivo Healthcare⁠⁠⁠, the human microbiome company restoring human health and ecology with seamlessly connected testing, supplements and education. 

Timestamps: 13:18 - Splitting shares with your co-founders 24:42 - Have they hit product-market fit? 30:48 - Getting Alex Ilic as an advisor and investor 34:43 - Giving an advisor phantom stocks 38:20 - Getting acquired by BowFlex About Joel Roos & Ben Simon: Joel Roos and Ben Simon are the co-founders of VAY, a startup offering motion tracking technology for fitness and physical therapy. Joel holds a MSc in Robotics Systems and Control from ETH and worked at Rapyuta Robotics before co-founding VAY in 2018. Ben holds an MA in Accounting and Finance from HSG and worked for atfinity and EY before co-founding VAY with Joel. VAY digitizes human movements through human motion analysis, to make products more competitive, immersive, and intelligent. They provide real-time tracking and audio feedback from any device and camera. Their target industry is physical therapy, rehabilitation, and digital health apps. VAY was acquired by Nautilus (now called Bowflex) in 2021 for an undisclosed amount. Alex Ilic is one of their board advisors. The cover portrait was edited by ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.smartportrait.io⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners. ‍

If your doctor has recommended an HSG (hysterosalpingogram), you may be feeling uncertain about what to expect. How does an HSG work? Will it be painful? What might the results mean for your fertility journey? How can you best prepare to make the experience as smooth and stress-free as possible? In this episode of the Baby or Bust Fertility Podcast, Dr. Lora Shahine goes into the details of the HSG test, a diagnostic tool commonly used to evaluate the health of the fallopian tubes and uterine cavity.  She explains the purpose of the procedure, what happens during the test, and why it's an essential step for many people exploring their fertility options. Dr. Shahine also provides insight into common concerns like pain and anxiety, shares practical tips to help you prepare, and makes suggestions for self-care after the procedure. She'll also help you understand the results. In this episode you'll hear: [1:29] Understanding HSG: what & why [5:03] HSG procedure explained [10:21] Complications and precautions [12:16] Preparing for HSG [13:38] Post-procedure insight & tips [17:07] Closing thoughts and additional resources   Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Dr. Natalie Crawford discusses the importance of fertility testing and the impact of early testing on reproductive decisions. She emphasizes that while guidelines suggest waiting a year before testing, individual circumstances may warrant earlier evaluation. Dr. Crawford outlines key tests for fertility, including menstrual history, ovarian reserve testing (AMH and antral follicle count), anatomical evaluation (HSG or saline bubble test), and semen analysis. She also advises that testing should be considered for those with irregular periods, known endometriosis, or low libido. Dr. Crawford encourages proactive testing to make informed decisions and highlights the importance of data in planning future fertility efforts. 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. Calm - Go to calm.com/aaw for 40% off a Calm premium subscription. Air Doctor - Go to AirDoctorPro.com and use code AAW to get up to $300 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

On today's episode of The Wholesome Fertility Podcast, I speak to author of “Carry On” @carryonthebook Shea Bart Andreone @shea_andreone . Shea shares her deeply personal journey through fertility challenges, pregnancy struggles, and the emotional rollercoaster of loss and hope. She discusses her desire to become a parent, the difficulties she faced with hyperemesis gravidarum, and the heartbreak of losing a pregnancy. Ultimately, Shea emphasizes the importance of resilience and the joy of welcoming her children into the world. In this heartfelt conversation, Shea Bart Andreone shares her journey through the challenges of parenthood, including loss, the search for control, and the importance of community support. She discusses her book 'Carry On', which compiles true stories of individuals navigating the complexities of starting a family. The conversation emphasizes the significance of hope and resilience in the face of adversity, and the need for emotional support in healing. Be sure to tune in as you won't want to miss our deeply touching and hope filled conversation!   Takeaways   Shea always wanted to be a parent and started her journey with high hopes. Fertility struggles are common and can be emotionally taxing. Hyperemesis gravidarum is a severe form of morning sickness that can lead to significant health challenges. Shea experienced extreme nausea and weight loss during her pregnancy. The emotional toll of pregnancy loss is profound and can lead to feelings of guilt and despair. Shea's journey highlights the unpredictability of pregnancy and the importance of being adaptable. The desire to have children can drive individuals to persevere through immense challenges. Finding peace is possible, even amidst uncertainty. Loss can lead to discovering new activities that provide control. Writing can be a powerful outlet for processing experiences. Community support is crucial for those facing fertility challenges. The journey of parenthood can be isolating without connection. Stories of others can provide comfort and understanding. It's important to seek out community and support during difficult times.   Guest Bio:   Shea Bart Andreone was raised in Queens, New York, but moved west and loves California. She is a writer of numerous plays, essays, and maintains a blog called Twig Hugger. Shea has written multiple articles for mom and parent-oriented platforms (The Next Family, Motherfigure, LA Parent, Your Teen Magazine, and Chicken Soup For The Soul). Carry On is her first book and she hopes that it can provide hope and comfort to those who are on the fertility journey.    Websites: https://sheabartandreone.com/  Instagram: @carryonthebook @shea_andreone  X: X.comCarryOnTheBook   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,   Shea Bart Andreone (00:01) Thank you. Thanks for having me.   Michelle (00:04) Yeah, it's a pleasure having you and I would love for you to share your story and what got you inspired to write your book Carry On. would love for you to share that with the listeners.   Shea Bart Andreone (00:17) I would love to. So I always loved kids. I always wanted a younger sibling. I wanted to babysit when my parents decided they were never gonna have another child. I'm the youngest with a big age gap. So I took on all things that could keep me around.   Michelle (00:36) Mm-hmm.   Shea Bart Andreone (00:45) kids so that I felt like I could be a big sister or a babysat. And I taught kids and ran day camps and stuff like that. I always knew that I wanted to be a parent and start a family. So when I did finally find the person to do that with, I thought, okay, well, when we get to that moment, it's just gonna be easy peasy and   you know, that's so exciting. We make the decision and we go. And of course, like every listener of your podcast and many, many more people around the world, it doesn't always work that way. So it took me quite a bit of time to figure out what to do. You you're instructed pretty quickly to try for longer and   I just, think I knew something was going to stop me unless I got help, but I, I did see my regular OB at the time and she suggested that we do an HSG, where they flush the iodine up your fallopian tubes. And she discovered that, I, I, you can really feel that.   Michelle (02:04) Not a fun test.   Yeah, it's crazy, but I hear so many things, so many stories, and I just wish doctors would just let people know like what's coming.   Shea Bart Andreone (02:19) Yeah, like exactly what you're gonna feel. Yeah, no, we have to experience it for ourselves. So that resulted in finding out that I had a fibroid right at the opening of my uterus. So I had scheduled the surgery to get it removed and somehow in...   Michelle (02:21) Yeah.   Yeah.   Shea Bart Andreone (02:48) that, well, not somehow. We know how making babies can work. I guess my husband and I were continuing to try and because of the HSG, it pushed the fibroid a little bit out of the way and I was able to actually conceive. But the fibroid and the pregnancy, they were fighting for the blood supply.   Michelle (03:16) So just backing up, were you about to do surgery for it, but then you stopped because you got pregnant?   Shea Bart Andreone (03:22) Yeah, so I scheduled a surgery and then ended up in crazy, crazy pain. like pain I'd never experienced before, like just shocking, like sharp, sharp pain. And I ended up calling the doctor and she said, go to the emergency room. And it was in the emergency room that I found out I was actually pregnant.   Michelle (03:30) Mm.   wow.   Shea Bart Andreone (03:52) And I was told basically, you gotta just kind of deal with this because they didn't know which one would win out. So I waited and I took whatever I could for pain, but not a lot, because I was like, well, I think I had a feeling like, no, no, no, I'm pregnant. Like, this is amazing.   Michelle (04:06) Got it.   wow, you felt it before they confirmed it?   Shea Bart Andreone (04:22) No, no, no. I definitely didn't know when I went in, but once I was, I was very protective. I was like, no, I don't, you can tell me all you want that like, there's a chance this won't stick, but I'm going to protect this. So I was very, very careful. And then in the end, that doctor was really not helpful. And I had like,   Michelle (04:25) Okay.   Yeah.   Mm-hmm. Yeah, yeah. For sure.   Mm-hmm.   Shea Bart Andreone (04:51) crazy pain on the following Monday and ended up like my sister-in-law said, just go to my doctor, just go to my doctor. So I went to her doctor and I had a very like strong clear line in the sand that I would not go to a male doctor. And I felt like at that point I was like, okay, like we all have things on this journey that we think we're not gonna do. And we think we're gonna like,   Michelle (05:09) Mm-hmm.   Yes.   Shea Bart Andreone (05:19) okay, I'm never gonna do IVF or I'm never gonna do IUI and I'm not gonna, and then like, you're like, well, I'm gonna change that. So I started with him and I really do think that because of that situation, I ended up in the right hands. So luckily for me, like that pregnancy ended up sticking.   Michelle (05:22) It's true.   that's great.   Shea Bart Andreone (05:49) and that fibroid eventually just sort of died off. However, within, I think I felt good for like two weeks and then I started feeling symptoms of hyperemesis gravidarum, which is, yeah, a few weeks in, I started feeling severely nauseous and,   Michelle (06:06) Mm-hmm. You mean early in the pregnancy.   Mm-hmm.   Right.   Shea Bart Andreone (06:18) I thought, okay, well, this will pass. This is what they tell people, like, know, morning sickness, but it's not morning sickness. Hyperamesis Gravidarum is like, if I threw up eight times in a day, that was a really good day. And I broke all the blood vessels in my face daily from the pressure of vomiting. And the blood vessels in my eyes were...   Michelle (06:35) Wow, yeah.   Shea Bart Andreone (06:48) Like my, I had bloodshot eyes and just could not remember a time that I liked food. Like it was so awful to me. Like the idea of it, sipping water, anything. And originally, like...   Michelle (07:04) Yeah, that's that's a big thing, too, because people get dehydrated.   Shea Bart Andreone (07:08) Yeah, yeah, and I tried everything. tried like, you know, motion sickness bands and you know, there were lollipops that were supposed to help and ice pops and nothing, nothing, nothing. And I just didn't want anything. And that, you know, began the insane journey of my pregnancy because that led me to lose about 15 pounds.   Michelle (07:18) Mm-hmm.   Wow.   Shea Bart Andreone (07:37) And my doctor didn't quite realize how bad it was. And when he did, he was like, I am giving you medication that is going to stop the, you know, the vomiting for a few days and you have to eat. If you do not gain weight by Monday or stay the same, I have to admit you for a feeding tube. So we took the weekend.   Michelle (07:54) Yeah.   Wow.   Shea Bart Andreone (08:06) And my husband was like, can you think of anything, any food you ever liked? And I was like, pizza.   Michelle (08:18) Ha ha ha ha!   Shea Bart Andreone (08:21) For like kid food, I went to growing up, had, I think was, had Elio's frozen pizza and tater tots. And I was like, I don't even know where that came from, but okay, let's try that. And the medication was so intense that you basically like, you could eat and then you'd fall asleep. And so that started on a Friday and Saturday midday, I woke up and I felt like,   Michelle (08:23) Yeah.   The simple things.   Shea Bart Andreone (08:51) I couldn't stop moving. Like I was very restless. And I felt like this must be what restless leg syndrome is like, but it feels like this for my whole body. And that was crazy because I'd never experienced a situation like that before where you feel like it's out of control. Like you can't say kind of wreaks havoc on your mind because you don't want to keep moving, but you are.   Michelle (08:53) Mm-hmm.   Mm-hmm.   wow.   Shea Bart Andreone (09:21) Yeah.   Michelle (09:21) Yeah, yeah. Is that from, was that from the medication side effect? my God, you poor thing. You got tortured.   Shea Bart Andreone (09:25) Yeah.   It's the yeah, it got worse too. Then I got jaw lock.   Michelle (09:31) no.   no.   Shea Bart Andreone (09:37) So like my entire jaw just locked to one side. And once that started, it didn't let go for 16 hours.   Michelle (09:42) no.   my God.   Shea Bart Andreone (09:51) And the only thing that would help is sometimes I could put all my upper body weight over my husband's shoulder and it would like kind of fall. And at one point in that time it moved to the other side, but it was so uncomfortable and so painful. And I remember walking to use the bathroom at some point and looking at the toilet and thinking, I'd actually rather throw up than this. Like, I'm like.   Michelle (10:01) Mm-hmm.   Mm.   poor thing. my gosh. And was that also from the medication? Wow.   Shea Bart Andreone (10:24) Yeah. And it's interesting how your brain can only focus on one thing at a time, because in the back of my mind, I was like, how could I remain pregnant through all of this? my body is going through so much trauma right now. I don't know how. And   Michelle (10:34) Mm-hmm.   Shea Bart Andreone (10:49) I knew that my husband was thinking the same thing, but we weren't discussing it because I was so distracted by the pain and the discomfort. But I knew that he was calling the doctor and trying to find out like, would this baby be okay? And fortunately he got the answer that like, this, guess what you eat doesn't.   Michelle (11:08) Mm-hmm.   Shea Bart Andreone (11:18) always and what you what medicine doesn't always go fully like you do filter those things out to a degree. And I remember the next, you know, that was over the weekend and I went back and I, I was able to maintain my weight. So he did not have to send me to the hospital. But I remember, like waiting with bated breath to see that ultrasound on Monday morning. And   Michelle (11:46) Yeah.   Shea Bart Andreone (11:46) there was the baby inside with its legs crossed and an arm back and like yeah I've been fine in here.   Michelle (11:55) lounging. That's amazing.   Shea Bart Andreone (12:00) Like, I know you've been in hell, but I'm having a vacation.   Michelle (12:03) I'm sure you tell the story. It's interesting because my mom actually reminded me again. You have stories that you just keep hearing over and over and over again. But truthfully, mean, suffered secondary infertility to conceive me. So I'm kind of a product of secondary infertility. And she's tried and tried and tried. She said every time I get my period, I cry.   Shea Bart Andreone (12:06) Yeah.   Michelle (12:28) And it was really the stories of the people that I treat. It's so crazy how that comes full circle. And I'm kind of like the proof that a woman can go through all of this and still have a baby. And she also had the same thing. I don't know how severe it was, but to the point where she lost so much weight, she was under a hundred pounds and her doctor said, listen, we got to abort this child. You're not going to survive. And she's like, no way.   You know, and it was, it's pretty crazy. You know, you go through this journey and then you advice that you're like, no, no, no, no, no, this is not happening.   Shea Bart Andreone (13:04) Yeah, you get advice and then also like you try again and willingly enter something this crazy because the power and the, you know, the need and the, yeah. Yeah. That desire to have children is, is pretty huge. pretty, it's, it's, it's quite magical and   Michelle (13:10) Mm-hmm.   The belief really, right? The belief in that desire.   Shea Bart Andreone (13:34) wondrous, I think. Yeah. Yeah.   Michelle (13:37) I agree. I think it's meant to be there. Like, I don't think that it's a random thing. People feel that really strong calling and I don't think it's random. It's not just something that was kind of planted there for no reason. I think it's because you're meant to find the baby in one way the other. Like you were saying before about how maybe you don't expect it to be IVF, but maybe it is, and then you can kind of go back and forth. But even with...   egg donor or embryo donor or even adoption. I've had people talk about that and they said I was meant to have that baby. Like it was that calling. just that I was trying to control how it was going to show up.   Shea Bart Andreone (14:17) Yeah, yeah, it's really wild. mean, the things when you listen to other people's stories, sometimes you're like, why didn't you stop? And like, mean, or how did you keep going? How did you persevere? like, I follow someone online who is pregnant right now. And this is the first positive pregnancy test that she's gotten in over eight, like in eight years of trying. While you wait.   Michelle (14:28) Mm-hmm.   I think I saw that one. Yes. It was amazing. It was really, my God, I got the chills with the video that she showed. was like, that was amazing.   Shea Bart Andreone (14:47) Yes, it was amazing!   Yeah, like to see that double line. yeah, that's a long time. And people go through a lot. And it is not something for anyone on the outside to judge or decide or advise on because that desire, like you said, it's pretty wild. Yeah, yeah.   Michelle (14:57) Yeah, after eight years.   Yeah.   It's real.   Shea Bart Andreone (15:22) So in the end, I did get a very healthy baby and a baby girl. did not find out the gender and in the middle of a contraction, my husband, we had names for both a boy and a girl and in the middle of a contraction, my husband goes, I gotta tell you something. I don't like the boy's name. And I was like, I can't talk to you right now.   Michelle (15:45) That's funny. That is so funny.   Shea Bart Andreone (15:52) So for that sake, we were very happy to have a girl. Like we were happy to have a girl anyway. think we admitted to each other we really wanted a girl, but like, obviously we would have been over the moon for anything except that I don't know what we would have named that boy. So, you know, when she was about...   Michelle (15:59) Yeah.   Yeah, that's so funny.   Shea Bart Andreone (16:17) close to three. I wanted some time. I was really, really enjoying just like feeling healthy and raising a baby and not rushed to have another one. And so I thought, okay, well, when she like goes into preschool, then I can try to do this again. And this time I did get pregnant right away. And   was pretty sick right away as well. And my doctor found this team that like sends an IV, like teaches you guys, like a couple to do their own IVs. And I was set up to give myself, to put a port into my belly every morning with an IV that I wore as a pack.   Michelle (17:01) Mm.   Mm-hmm.   Shea Bart Andreone (17:16) that was to help me to stop throwing up. And unfortunately,   I feel like, you know, anything I deal with, like there's research that comes out like a year or two later that like, that could have helped me in that situation, but unfortunately it didn't. But the medicine that was given to me at the time is no longer on the market for pregnancies because it can stop the heart from beating. So in...   Michelle (17:33) wow.   Uh-huh.   my gosh, wow.   Shea Bart Andreone (17:55) you know, at our 12 week ultrasound, which I was hoping to celebrate, was, and talk about like power and instinct. That morning, I felt like something was wrong. And I don't know where that feeling came from, because it's too soon at that point to really feel anything, you know.   Michelle (18:15) my gosh.   Shea Bart Andreone (18:24) moving around, but I just felt like something was wrong. And I remember looking at the sky and it was like this perfect blue and telling myself that no matter what happens today, that sky is still going to be blue. And just to hold on to like, not everything is lost. And I don't, I really don't even know why I felt this like foreboding, foreshadowing feeling. but   Michelle (18:43) Mm-hmm.   Shea Bart Andreone (18:54) know, the doctor was, we were waiting in the room for the doctor and my husband was joking around and I said, I don't know, I don't feel like joking around. you know, when the doctor came in all friendly right away, I said, don't feel, I feel like some, I was very straightforward in a way that I don't think I usually am. And I was right, there was no heartbeat.   Michelle (19:03) Mm-hmm.   Wow.   Mm-hmm.   Shea Bart Andreone (19:21) and I was too far along to like have anything done in the office. So I had to get checked into the hospital and yeah, it was really, really rough and awful because I felt like...   I tried so hard to do the right thing and to like keep everybody healthy. And it was awful doing like, you know, the port and injecting myself every day and all of that. And it still didn't work. So we ended up naming that baby, the name that I...   Michelle (19:43) Mm-hmm.   Mm-hmm.   Mm-hmm.   Shea Bart Andreone (20:08) show is with my, what I thought with my husband, but he didn't really like it. And I said, I know you didn't really like this name, but can I use it for this baby? And in that moment, he said, yep, but why don't you give all the other names that we're not gonna use next time. And that was the first time I heard him agree, like, we'll try again.   Michelle (20:13) you   wow.   Shea Bart Andreone (20:34) I hadn't thought that, like, guess it was, like, it was a lot for me, but I knew I wanted to try, but I kind of felt like, like I said about advice that came from others, like, it felt like everything in the universe was saying, you have gone through enough, take your one child, be grateful and move on. And for him to say, we will try again, it just gave me such a sense of relief that we were on the same page.   But we did agree that no matter what happened, this would be the last time because our daughter couldn't live through that again. And we couldn't, you know, do that. So we were gonna, so we tried again this time with no medication and only an IV for fluid. So I...   Michelle (20:59) Yeah.   Mm-hmm. Yeah.   Mm-hmm.   Shea Bart Andreone (21:24) It's strange, hyperemesis is a weird thing. Like I definitely got it all three times that I was pregnant, but with the first one and the third one, the time of day that I could eat was totally different. I, with this, the last pregnancy, I could eat something in the morning, but once like one o'clock came, that's it. Like the gate was closed. Like there's no more putting any food or liquid into your body.   Michelle (21:30) Mm-hmm.   huh.   Shea Bart Andreone (21:54) so I did what I can, like I did what I could to eat before that time. and you know, we navigated it and, and I had a healthy baby boy. so I, I am very, very grateful and definitely, I'm aware, especially when I talk to others that are in the middle of their story.   Michelle (22:07) amazing.   Mm-hmm.   Shea Bart Andreone (22:24) that   You don't know how your journey is going to end. really don't know how you're going to get to where you get to. But,   I know it's so cliche, like, whatever is supposed to happen, like the end of the story, it works out in the end. Like whether or not you get the biological child or adoption or foster or five dogs.   Michelle (22:56) Yeah. Yeah.   Shea Bart Andreone (22:58) you find peace at some point. I, my heart, yeah, my heart goes out to the people that are still in that journey and they don't have the ending yet.   Michelle (23:02) Yeah, I mean that makes sense.   Yeah, it's the ending. It's, things start to make sense at the end. And then you realize, had it not been for that exact moment, the genetics, all the alignment wouldn't be that exact child that you have. And, you know, obviously when you're holding that child in your hands, you're like, I wouldn't change this for anything. but sometimes it can be really scary because when you're going through it, you're walking into like a dark room, cause you have no idea how things are going to play out.   Shea Bart Andreone (23:37) Yeah. Yeah.   Michelle (23:38) And that the unknown, as we know, is like the scariest things for humans. all, nobody likes that. It's just the unknown. And especially when it comes to such a strong desire that is so primal. Yeah.   Shea Bart Andreone (23:43) Yeah.   Yeah, yeah. And so universal. mean, it's just procreating. That's what we think we're wired. I mean, we are wired and we think that we're meant to do it and it doesn't work out that way for everybody. So in all of that, for me though, especially in the miscarriage part, I felt like   Michelle (23:59) Yep.   Yeah.   Shea Bart Andreone (24:21) I didn't know who to go to and I didn't know where to, like, didn't feel, obviously I had at the time, like a three year old. And so either everyone around me in my circle at the time had a second child already or was trying to. And I didn't, I don't want to go to those people in that time.   So I ended up calling a friend of mine who had also lost several babies at the same week because I needed very specific support at that time. Like someone who really   Michelle (25:00) wow.   Yeah, yeah, yeah, no, that's somebody who can understand.   Shea Bart Andreone (25:09) Yeah, like understand exactly. And I talked to her and then she maybe led me to someone else. And I discovered that each woman that I spoke to had felt such a loss of control with their trajectory of what they had planned.   that they found activities that they could control to keep them a little bit grounded. It's such an ungrounding time. And one of them was like painting pottery, you know, plant pots. One ran a marathon. One was cooking and started to become a chef.   Michelle (25:45) Mm-hmm.   Mm-hmm.   Shea Bart Andreone (26:06) And I realized that there were these like stories of activities that have, and, you know, hobbies or whatnot that came out of this. And I, I was like, okay, I got to find my, activity. So, and, and like I said, like something I can control, something I can, you know, seek from start to finish and have an outcome.   Michelle (26:07) wow.   Shea Bart Andreone (26:36) because I can't do that with a baby.   Michelle (26:36) Mm-hmm.   That's so interesting. This is the first time I've ever heard anybody put it in that way. I find it so interesting and I think that is really powerful.   Shea Bart Andreone (26:48) Yeah, it made sense to me once I realized this common thread. I was like, I get it. So I took up sewing and realized really quickly that is not going to be my thing. was one of those things I was always curious about and I like maybe took an eighth grade and didn't totally understand it. And so I was like, I'm going to try it now. And I was like,   Michelle (26:57) Mm-hmm.   Which that happens too.   Shea Bart Andreone (27:18) Nope, don't have any control over this either. But I was writing and I decided, that is something that I can do and I really love it and it can be an outlet for me. And so I decided to, because I couldn't think about anything else, to compile these stories from people.   Michelle (27:19) Yeah.   Shea Bart Andreone (27:47) and their hurdles and their stories of trying to become a parent. And that is how the book, Carry On, came to be. And it is stories of infertility and adoption and fostering. And most stories in the book have a happy ending, but not all the stories in the book.   Michelle (27:57) Mm-hmm.   Mm-hmm.   Shea Bart Andreone (28:18) And yeah, mean, a lot of them, like when you're in the, if you, before you get to the end of that chapter for that person, you're like, whew. But there, you know, every story has a beginning, a middle and an end. so it's been, it, it, it's been wild to, interview people and learn about people. And you know, it is, because it's.   Michelle (28:29) Mm-hmm.   Mm-hmm.   Shea Bart Andreone (28:47) It's my book and I put it together with all these different people. I thought I was done with it a couple of years ago. And again, talk about control and you think you're going to put a deadline on yourself and it has a life of its own. But I made a fairly new friend in the last few years.   Michelle (28:56) Mm-hmm.   Mm-hmm. Things change.   Shea Bart Andreone (29:17) And we got to know each other over something completely unrelated to fertility. And it was actually like activism against violence for something. we just connected and realized like, we should be friends, but we were so busy focusing on the cause that it took like a couple of months for us to get together and go for a walk before I like.   looked at her and said, so what do you do? Who are you? And she asked the same of me and I said, you I'm working on this book. And she said, if I had known you before, I probably would have been a chapter in your book.   Michelle (29:49) Yeah.   my gosh, wow.   Shea Bart Andreone (30:05) And it took me another couple of months of getting to know her and realizing that like, actually her story really does belong in this book and it is my book. So even though it's been done for a while, I'm adding it. So her story is one of the chapters in the book and she's the one that drew the line in the sand and said, I am never doing IVF. Like that's as far as I'll go.   Michelle (30:16) Mmm. Wow.   Mm-hmm.   Shea Bart Andreone (30:34) And if she didn't do IVF, she wouldn't have her child.   Michelle (30:41) Wow, it's amazing how that happens.   Shea Bart Andreone (30:44) Yeah, and she and her story is really fascinating too because   Like mine, her health was at risk, you know, in order to have her child, but she, you know, went through 20 weeks of pregnancy with twins via IVF and unfortunately she lost those babies. And then, you know, knew what to expect the next time around. But when she wanted a second child,   it was just too much for her to like endure again, but it wasn't an option for her to not have a second child. So her second child is actually adopted from Ethiopia.   Michelle (31:33) my is beautiful.   Shea Bart Andreone (31:36) So it's a pretty amazing story.   Michelle (31:40) That's amazing. That's so beautiful. I had a guest, a previous guest, Dr. Lisa Miller. She wrote The Awakened Brain. She has an incredible story and it was, she was struggling to conceive for years with her husband. She had a voice in her head that kept saying, would you adopt if you had a child? If you were able to conceive, would you adopt? And she kept saying no. And then,   Shea Bart Andreone (31:48) yeah.   Michelle (32:04) one day randomly they saw something on TV. think they were either, I don't know if she was in hospital or a hotel. I don't remember exactly what it was, but like the TV wouldn't change. And it was stuck on this channel of a child that didn't have parents and her heart just blew wide open.   and her husband as well. And they're like, that's it. We're adopting. The second they decided to adopt and they got everything in order, she conceived. And she was meant to have her adoptive child. It was like something was calling her in that direction. She kept putting it off. And then all of sudden, boom, like in the right time, it was like, that was it. And then what happened was she heard that voice again in her mind.   if you were able to conceive naturally, would you still adopt? And she said, absolutely yes. Like after she decided and saw the child and it was just so powerful and she was getting all kinds of crazy signs. There was a duck that left an embryo in her door. It was right after she had a challenge conceiving. was just, it was so crazy. Like all these weird signs and it just tells you that they were part of a very cosmic intelligence.   there's got to be some kind of order that we're part of because it can't you can't explain that otherwise. There's something else. There's some other kind of divine intelligence. Yeah, yep.   Shea Bart Andreone (33:31) Yeah, whatever you want to call it, it's out there. So did she end up adopting a child and having a biological child?   Michelle (33:40) Yep. Yep. And she feels that her adoptive child is her child. Like that was the child she was meant to have. And then also her child and they were also meant to be together. It's amazing. It's just so wild on so many levels,   Shea Bart Andreone (33:56) Yeah, yeah, I just met someone I did a panel for a fertility expo and the woman sitting next to me had dealt with secondary infertility and had no issue getting pregnant with her first child and then her second child just she could not get pregnant, could not get pregnant and they had been on a list for fostering.   kids and I didn't go like she wasn't ever planning to adopt but just to help other people and to take in another child and she was thinking she was going to get like a teenager and somehow they were called randomly like two years ago with a newborn that was available and so she has raised that you know baby since birth and   Michelle (34:29) Mm-hmm.   Mm-hmm.   Shea Bart Andreone (34:52) now is trying to adopt the baby. of course, two years, you know, year and a half into having that baby, she did get pregnant and now has three children.   Michelle (34:55) wow.   Wow. wow. you just don't know how and that's the part of relinquishing control. Like we know we have the desire and the desire is there for a reason. We just, we almost have to rely on that divine intelligence for the how. I think that that's what it is. And when we fight that, that's where I feel like it doesn't stop like you from having it eventually, but it stops the process. It delays it. think when we fight   Shea Bart Andreone (35:17) Yeah. Yep.   Michelle (35:30) that divine intelligence, that flow that's trying to move you in a certain direction.   Shea Bart Andreone (35:34) Yeah, it's really true. And also, I don't know why I keep coming back to this today, but that middle part of the story, you have to find a way to be uncomfortable in that disequilibrium and manage it, because it's not going to stay like that. It won't. Yeah.   Michelle (35:50) Mm-hmm.   Right. This too shall pass.   Shea Bart Andreone (36:01) Even like in every situation, every, like this week, my daughter was expecting to get, she had worked really, really hard for a slot and an opportunity to do something. And they were looking at 10 people and knocking it down to six. And she ended up in the bottom four and did not get that opportunity. And I'm shocked. She's shocked, she's devastated.   Michelle (36:28) Mm.   Shea Bart Andreone (36:30) And as a parent, have that like, don't really want to be more upset for them. Like there's a fine line. You got to balance like your own emotions before you like, you know, and I just like the last couple of days, I've been like, okay, what's going to happen next? Because somehow something is going to make this better. Like, and I know something will happen. Like, but I feel like I'm on the edge of my seat sort of waiting for news.   Michelle (36:37) Mm-hmm.   Yep.   Mm-hmm. Yep.   Shea Bart Andreone (37:00) and that is familiar to me for like, you know, all the waiting and the waiting and the waiting of like, well, what's going to happen? Something is going to happen. Something exciting at some point. And you might have some pretty upsetting moments along the way, but something is going to happen.   Michelle (37:21) Yes, I actually remember hearing, I don't remember where it was, but it was a rabbi who said that there was like a saying that everything in the end works out. And if it's not working out or everything in the end is good. And if it's not good, it's not the end. And I'm like, I love that. Yeah.   Shea Bart Andreone (37:36) at the end. Yeah. Yeah. Yep. Yeah, I definitely feel that way.   but we get like, it's so global. It's so like, you know, whatever your politics are, you can feel like, shoot, you know, that happened. You know, like, we feel this universally, like many, many times, and it shifts, things shift. And then, yeah, and the story ends.   Michelle (38:03) They do.   Yes. Yeah. Things definitely shift. I'm also kind of into Kabbalah right now, like, cause it's very similar to quantum physics. And I love that, how Joe Dispenza talks about that. But I find that a lot of like ancient traditions teach about, and these are things that aren't necessarily, you don't need to see them as like a religion per se. It's actually a way of life. It's almost like a science of life. And they talk about how, things do come up.   It is really for your soul to evolve. And sometimes those difficult things, like the second we react to them, then we sort of block ourselves off from the light and that like wisdom. But when we allow them, and this is, you know, they talked about it in Zen Buddhism, that's truly going with the flows. Like even when things are not comfortable, if you just allow for it to move and don't fight it.   with the non-resistance, then it actually helps to grow your soul, your spirit, your personality, your mind, your ability to handle things. It's pretty wild, but in some senses that   challenge   is what helps us. And the same thing if you look at a butterfly or even like a plant coming out of a seed and that hard shell and that fighting and that   challenge   of trying to get through. so it's painful, but they do it in that   That aspect of it, the difficulty, the challenge is really what helps us to become more of ourselves.   Shea Bart Andreone (39:44) Yeah, to get to the other side.   Michelle (39:46) Yeah, it's pretty wild. But like you said, it's universal. It could be applied to anything in your life. It could be applied to anything, to getting a job, to marrying the right partner. And it's very similar and also just any kind of challenges that happen in your life. And I've seen it so many times, just like you, like so many stories of people that had they looked at their history and said, okay, well, since I've never gotten pregnant,   Shea Bart Andreone (40:01) Yeah.   Michelle (40:12) before, like the one we just spoke about eight years of never getting pregnant, you could look at the history and say, based on the history and since it's been so long, that's going to probably be my future. And logically, it makes sense to think like that, but it's not necessarily the case for many people.   Shea Bart Andreone (40:15) Yeah.   Yeah. Yeah, and that belief of holding and hope, hope is like.   Michelle (40:35) Mm-hmm.   Shea Bart Andreone (40:38) That's such a challenging topic because it is the first thing to go, I think, when you're challenged and faced with a big hurdle to overcome. It's hard to think you can hold on to any sort of hope, but that's pretty much the key.   Michelle (41:00) Yeah, it is. it's so interesting that it's so hard because the journey by itself, you're also faced with a lot of professionals that are giving you stats and numbers. And sometimes when you go into that, that's like a hope killer. It'll immediately say, well, I guess you can't really do it because look at your numbers are terrible. And based on this, it's just not possible for you. And so many people still conceive despite that and have healthy   children, know, births. So it's interesting how also the journey, the fertility journey just happens to be one that you're faced with a lot of hope killers in general. And so having to really stay grounded and really stay close to that desire and keep that like in your heart.   is very challenging. and you mentioned something that was actually really powerful. And I think that that is something that everybody should be given as a resource is just community connecting with people that know exactly what you're going through. And having that support is tremendous. And it's just nowadays, it's getting better than it used to. I feel like it used to be worse. Now we have social media.   We have lots of groups, we're connecting. And I think that that's huge. And I think that people who go through miscarriages doctors should be required to give them resources because you're dealing with a traumatic event and then you're sent home. And I think that that is not right. It's, it's like unethical to not provide support for people going through that.   Shea Bart Andreone (42:44) I agree, and I think that is a big flaw in our medical community, like our medical world. takes, I mean, I don't want to be, put anybody in boxes, but the majority of the people who become doctors are very cerebral and understand the logistics of the physical body and don't always necessarily take into account the emotional side.   Michelle (43:13) Mm-hmm.   Shea Bart Andreone (43:14) I would say most for me of the doctors that I have seen don't handle the emotional stuff very well. And I think we're learning that mental health is such a massive, massive element that cannot be ignored and needs the attention. And I do think when you said it's getting better community wise, it is, from what it start like...   There, know, hundreds of years ago and in other countries still today, community is everything surrounding people. And I would say Western medicine has, you know, unfortunately kind of cut that out. And like even in other countries, I think it's France where you're, once you have a baby, you're, you're provided with physical therapy for the woman who gave, you for you as a woman.   Michelle (43:49) Yeah, it's just true. Yeah.   Shea Bart Andreone (44:12) You're given attention to heal yourself. And here we're sent home. You just had a baby. Bye. You're good. Not even 24 hours of any instruction. If you adopt a baby, you have to go through many, many, many hours of training. But on the other side, if you just birthed your own baby, you're sent home. Good luck.   Michelle (44:20) Yeah.   Mm-hmm. Yeah.   Shea Bart Andreone (44:39) So yeah, would say lack of community is still huge. And yes, you can find that online, but...   Michelle (44:49) Right. It's not the same as actually having a physical community.   Shea Bart Andreone (44:52) Yeah, and we still don't provide that for each other. And there's no wonder to me why doulas and midwives and lactation consultants and postpartum doulas are in such high demand. And unfortunately, that's a luxury.   Michelle (45:13) Mm-hmm. Right, right. It's a luxury and it's expensive. Not everybody can afford it.   Shea Bart Andreone (45:17) Yeah, but I understand the need for it. It makes perfect sense to me because it's like we're thrown into this dark tunnel without any light provided. It would be nice for someone to sit by your side and tell you how it's going to go. And yes, mothers and sisters and friends can do that to an extent, but yeah, it feels like there's a need.   Michelle (45:21) Yep.   Shea Bart Andreone (45:47) And yes, you can Google anything and you will find out.   Michelle (45:51) It's not quite the same. Actually, if anything, it gives you more anxiety. It's so important. And I think that it's true. I, as you're talking, I'm like, this is basically the building blocks of society. Like if you have a good foundation that's done with love and wisdom and carries on like traditions and history that people have learned from and can teach it. I mean, it feels like almost there's a gap because   Shea Bart Andreone (45:54) Yeah.   Michelle (46:21) It used to be that way really back in the day. And then there was this gap with industrial age and we've sort of gotten more separated and now we're thirsting for it. And there is a very big demand for that.   Shea Bart Andreone (46:35) Yeah, yeah. So that I, you know, not that a book can can cover that, but I feel like the aspect of why I chose to write this is just if it could help one person not feel as alone as I felt before I started finding these people. That's the goal because   I just, think even people who can find access to other people sometimes are afraid to like make that like leap to go find a support group or talk to other people. Like, you know, I have a friend right now, a very close friend dealing with cancer and she has three kids and there are so many groups available to them to...   Michelle (47:25) I'm sorry to hear that.   Shea Bart Andreone (47:33) speak to others who are dealing exactly with what they're dealing with, but they don't want to go. Yeah. I, you know, whatever way someone can find that community, whether it's through a podcast or, you know, or a group in the park or a Facebook group or, you know,   Michelle (47:37) Mm-hmm. Yeah, yeah. It's so personal.   Shea Bart Andreone (48:01) or in a book, just hope for people that they find people to connect to so they don't feel alone.   Michelle (48:09) Yeah. I love that you wrote this book. think having stories is so powerful and just knowing these true stories and that people went through them and then you can relate to the challenges and then you can see how it ends for some people. I think that it's so powerful not to feel alone. I think that that's the big key is just not feeling alone. And like you said, the key is hope.   So for people who are listening to this, and I'm sure a lot of people are going to be wanting to look at this book right now, how can they find the book? How can they find out more about you?   Shea Bart Andreone (48:44) My website is sheabartandrioni.com and the book is available on Amazon. It's also available in certain bookstores. You can walk into your local bookstore and order it through them if they don't have it. And the book is called Carry On and the subtitle is True Stories of the Heartbreak and Wonder of Trying to Start a Family.   Michelle (49:15) Well, first of all, I really enjoyed this conversation with you today, Shay. This is really so heartfelt and it just, it was so symbolic of like the power of the human spirit and going through that and just everything that you shared today and opening up and I really appreciate you coming on. I really, really enjoyed   this conversation with you   Shea Bart Andreone (49:36) Thank you. Thank you. was nice to meet you.   Michelle (49:40) same. And also just for the listeners, if you guys want all of the links that Shay just mentioned are going to be in the episode notes, so you don't have to memorize everything that you just heard. You could just go back to the episode notes. So thank you so much for coming on today, Shay.   Shea Bart Andreone (49:55) You're most welcome.  

Timestamps: 2:08 - An infamous meeting with Japanese business people 12:13 - A sock subscription in the 90s? 19:50 - Getting raw materials from all over the globe 37:51 - Tracking customer metrics in the 90s 39:33 - Bootstrapping in e-commerce  This episode was co-produced with EO Zürich. Check out their upcoming event, Entrepreneurs Summit 2025. About Samy Liechti: Samy Liechti is a co-founder and the former CEO of BLACKSOCKS, the Swiss e-commerce sock company that invented the “sockscription” back in 1999. He holds a BA in Business Administration from HSG and worked for marketing agencies like Leo Burnett, Burson-Marsteller and Wirz before starting BLACKSOCKS in 1999. It all began when Samy found himself at a tea ceremony, after a business meeting with some Japanese clients, where he had to take off his shoes, and embarrassingly found he was wearing mismatched socks. The solution to the problem of forgetting to replace old socks was, in his mind, an online sock subscription — but it was 1999: if you sold socks, you did it on catalogs or through the phone; e-commerce was still called e-business back then, and vanishingly few people ever bought anything online. To make matters even more difficult, Samy's co-founder quit after a few months. But none of these deterrents could stop Samy, and 6 months after the official launch of the company, BLACKSOCKS had already 1000 customers. 20 years in, some of their sock models have been sold millions of times.  In 2023 BLACKSOCKS was acquired by Rohner Socks, and Samy left the company.  The cover portrait was edited by ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.smartportrait.io⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. ‍ Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners.

Timestamps: 8:48 - Building a startup in tissue engineering 11:23 - Building a foodtech venture studio 15:49 - The underrated challenge of making phone calls every day 23:44 - Why having an analytical mind is crucial 26:41 - The importance of mentorship  This episode was co-produced with the ⁠⁠Female Founders Initiative⁠⁠. The conversation originally took place at the Rise Up Summit 2024. Answer our quick questionnaire about entrepreneurial skills here. About Lida Ahmadi & Adam Korczak: Lida Ahmadi is the founder of Sproutd, a foodtech venture studio partnering with corporates to tackle current food system challenges. She holds an MA in Accounting and Finance from HSG and co-founded Snäx in 2018 (acquired by FELFEL in 2023) before beginning her new venture in 2024. Adam Korczak is the co-founder and CEO at Treeless, an ETH Zurich Spin-off developing microorganism-based cellulose materials with the goal to end plastic pollution. He obtained his education in Biomedical/Medical Engineering at ETH and incorporated the company in 2023. During their chat with Merle, Lida and Adam reflected on the skills which have bolstered their unique founder journeys. The abilities needed to build a successful startup were not always what this pair of founders expected: Lida recalls being surprised and feeling challenged by the need to develop her analytical mind and to gain the habit of making data-based decisions, and Adam remembered how difficult it was at first to have to make such a inordinate amount of phone calls every single day.  Both founders value the technical skills they learned in school, but most of all they appreciate how their education taught them resilience — the ability to cope with stress. Adam continues to scale Treeless successfully and Lida is currently working on a new project that is still in stealth mode. Resources Mentioned: ⁠Thinking Fast and Slow, Daniel Kahneman⁠ (Lida Ahmadi)The cover portrait was edited by ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.smartportrait.io⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. ‍ Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners.

Timestamps: 10:13 - Deep Tech Nation's ambitious goals for Switzerland  13:48 - Venture Hub Switzerland  19:07 - What's the Scaleup Booster? 27:35 - How is Deep Tech Nation financed? 38:12 - Do all Swiss startups need to make it big? This episode was co-produced with the Deep Tech Nation Switzerland Foundation. About Joanne Sieber: Joanne Sieber is the CEO of the Deep Tech Nation Switzerland Foundation, which acts as a catalyst for the Swiss innovation ecosystem. She holds an MA in International Management from HSG. Prior to joining the Deep Tech Nation Switzerland Foundation in 2023, Joanne worked in a number of industries, from microcredit to consultancies, and even ran her own sandstone business. The Deep Tech Nation Switzerland Foundation is financed in part by their founding partners, UBS and Swisscom, and in part by their corporate partners, like SwissRe, Rolex and SIX. Their mission is to help Switzerland successfully commercialize Swiss innovation, through growth financing (covered by their Venture Hub Switzerland, which collaborates with Swiss pension funds) and by working to change the regulatory framework surrounding these questions. They want to make Switzerland the number 1 deeptech nation worldwide, and have committed themselves to help raise CHF 50B in VC capital for Swiss startups and to help create 100K jobs in Switzerland within the next 10 years. The cover portrait was edited by ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.smartportrait.io⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners.

After having an HSG (hysterosalpingogram) due to infertility, Wyn was diagnosed with having a left-sided unicornuate uterus. A unicornuate uterus is a rare condition in which the uterus is smaller than normal and only has one fallopian tube. Common complications from a unicornuate uterus include infertility, IUGR (intrauterine growth restriction), and preterm labor. Wyn had two unsuccessful IVF treatments followed by two miraculous natural pregnancies! Her first pregnancy ended in an unexpected Cesarean due to a fever and tachycardia in her baby. Her placenta was difficult to remove during the surgery and she was told she had placenta accreta. The OB who performed her surgery also said she had “very interesting reproductive anatomy”.Wyn deeply longed for the opportunity to try for a VBAC and experience physiological birth. Her original midwife supported her decision to VBAC and Wyn made sure to prepare physically and emotionally. At 41 weeks and 1 day, she went into spontaneous labor, declined cervical checks and other interventions she wasn't comfortable with, consented to the things she felt good about, and pushed her baby out soon after arriving at the hospital. Wyn also shares her experience with taking Needed products during her pregnancy and postpartum period this time around. Her strongest advice for other women preparing for VBAC is to find a supportive team and really listen to what your intuition is telling you to do. Needed WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, everybody. Welcome to the show. We have our friend, Wyn, from Alaska with us today. She's going to be sharing her VBAC story and Wyn has a pretty unique– and maybe Wyn, you can tell me more. Maybe it's not as unique as it feels but a pretty unique situation where you had a diagnosis of a unicornuate uterus. Tell us a little bit more about that. I feel like we hear some uterine abnormalities. I'm quoting it where it's bicornuate and all of these different things and people say, “Oh, you can't have a vaginal delivery with this type of uterus or this shape of uterus,” but tell us more about what it means for you and what it meant for you back then. Wyn: Yeah, so they found it through an HSG test where they shoot dye up through your uterus and through your fallopian tubes. Basically, just one-half of my uterus formed. I guess when the uterus is forming, it's two tubes that connect and open up so just the one half formed so I have a left-sided with a left fallopian tube. I have both ovaries so you can still conceive but there are less chances because you have just one side. Then once you get pregnant, there are higher chances of miscarriages because the blood flow is less. Intrauterine growth restriction and preterm labor are common and then a lot of time, the breech position is common as well. Meagan: With this one, you did experience IVF as well, right? Wyn: Yep. Meagan: Yeah, we'll have to hear more about that too because there are a lot of people who are getting pregnant via IVF which is amazing but there are some things that come with IVF as well. So we want to talk a little bit more about that before we get too deep into things. I do want to do a Review of the Week, then we'll let Wyn start sharing away. This review is from I think it's Amir, I think. It says, “This podcast was my constant source of reassurance and inspiring stories throughout my last two pregnancies. I achieved my VBAC in 2021 and was so empowered with so much knowledge and mental strength going into this birth because of The VBAC Link. I had my second section in 2022 which was not what I wished for but I do plan on having more children and know that VBA2C (vaginal birth after two Cesareans) is a possibility for me because of this podcast. I continue to listen to your inspiring stories each time I hop in the car and I'm so grateful for all that you share. I hope to share my own redeeming story with you in time too.” Well, Amir, thank you so much for your review. I also wanted to mention that for Amir, not only does VBAC after two Cesareans apply, but there are even risks that are lower because she has had a vaginal birth. So if you have had a vaginal birth and then you want to go on to VBAC, your chances are even higher for a VBAC and lower for things like uterine rupture. I wanted to throw that tip out there. But if you have not left us a review yet, please do so. We love them so much. You can leave it on Google or wherever you listen to your podcasts or you can even email them. Okay, Wyn. Let's get going into this story. Wyn: Okay, thank you. Thank you for having me. I feel like it's come full circle. I listened to The VBAC Link Podcast a lot throughout my pregnancy and even before that and I still do today. So I hope that maybe a little detail from my story resonates with somebody and helps them as well. Meagan: 100%. Wyn: Yeah. A little back story, before I got pregnant, we did try for a while and my cycles were regular. I was healthy. I didn't see anything wrong but we went in and got the test done with bloodwork and they suggested the HSG test. I saw my original OB then I had a second opinion with another one. Both said it was still possible but that IVF was probably going to be more likely. And of course, this is all happening in February and March of 2020. Meagan: Right as the world is in chaos. Wyn: Yeah, so I started researching IVF options. We live in Alaska so there isn't a reproductive endocrinologist here and I found a clinic. Our closest option was Seattle or Portland. I found a clinic in Portland that was willing to work with us. In August 2020, I went down for my first transfer or egg retrieval and transfer. That was a chemical pregnancy or early miscarriage. But also, that was the closest I had ever been to being pregnant. It was a little bit hopeful at the same time. We regrouped and went down in October and had another transfer that didn't take at all. We decided to take the rest of the year off and revisit it after the beginning of the year. That brings me to my first pregnancy which was a little miracle and I got pregnant the cycle after my failed transfer naturally without IVF. Meagan: Yay!Wyn: That was very exciting. I was a little bit in shock like, How can this happen? Because it had been a couple of years of trying. I went back to the second OB who I had a second opinion from. We didn't really vibe very well. I went in early at 6 weeks because I was nervous and she was like, “Why are you here so early?” So I didn't end up rebooking with her but I rebooked with a midwife who some of my friends had seen during their pregnancies and explained my situation and she got me in that week. We did an ultrasound and saw a little heartbeat. It was going well. She had me come in the next week too to just make sure things were progressing and everything was good. Meagan: Yay. So it was IVF treatment, IVF treatment, and spontaneous?Wyn: Yep. Meagan: Yay, that's awesome. Wyn: It was pretty exciting and just gave me some renewed faith in my body too that maybe it could do it. Meagan: Yeah. Wyn: So pregnancy went smoothly. I felt great. I loved being pregnant and I was measuring small consistently from about 30 weeks on about 2-4 weeks behind. I wasn't really worried about it because I figured I had a small uterus but they suggested a growth scan. I went ahead and did that and baby was all fine. She was small and we didn't know it was a she. We didn't find out but then my husband and I did some birth prep. We watched The Business of Being Born and that solidified my desire for a non-medicated birth. I was okay being in the hospital because there were unknowns with the uterus and I just wanted to experience it all. I wanted to experience everything without medication. I have a low tolerance to medication so I didn't want anything to derail the birth. I made it to 40 weeks. I made it to my due date because it's common that you go into preterm labor with a unicornuate uterus but I made it to my due date so that was exciting. I was feeling anxious to meet my baby but I was feeling good. I was just listening to whatever the midwife told me or suggested because I was a little bit nervous so she offered a membrane sweep and I thought, Okay, I'll go ahead and do that. It's not medicated. But still, it was an intervention that I learned later. Then we did a non-stress test at 40.5 weeks and she started suggesting induction. I went into my 41-week appointment and I still didn't want to do any medication but she offered the Foley bulb which he offered to put in there at the office and I would just come back the next day if it didn't come out or if it started things then it started labor. Meagan: Then great, yeah. Wyn: Yeah. She went to put it in and my water broke. Meagan: Oh, change of plans. Wyn: Yep. Yeah. It was just a trickle. It wasn't huge. She sent us home and told us to rest and to come back in the next morning. Come in if labor progressed or come in the next morning to start more induction since my water was broken. I went home and relaxed. I woke up about 2:00 in the morning to my water fully breaking everywhere and contractions started pretty instantly. I had adrenaline and I didn't ease into it. They were 5-6 minutes apart, full-on contractions. Within a couple of hours, they were closer like 3-4 minutes so we went ahead and went to the hospital. There was a lot of rushing around and a lot of nurses coming in and out. I was in my own little world. I was stuck on the bed because they wanted to have the fetal monitor on. I was holding on for the non-medicated. I declined the IV because I thought that would be that much easier. Meagan: Easier access, mhmm. Wyn: But I had spiked a temperature from my water breaking. I couldn't keep any Tylenol down so we went ahead and did the IV which took over an hour to get in because I have bad veins and lots of people tried and they eventually got an ultrasound to find a vein. Meagan: I was going to say for anyone who may have harder veins or situations like that, you can ask for the head anesthesiologist if there are multiple and for an actual ultrasound and it can really help them and get that in a lot faster. Wyn: I wish they had started that sooner. I was just being poked. Meagan: Lots of pokes, mhmm. Wyn: Yeah, and trying to labor through at the same time. They got that in. It didn't really calm down. The baby's heart rate was elevated to 170-180. It wasn't really slowing down at all. Our midwife seemed a bit concerned and started suggesting a C-section. Yeah, just laying there, I was ready to give up. I didn't want to, but she checked me and I was only 5 centimeters so I wasn't even close to getting there.They prepped me for surgery. I went in and baby girl was born in the morning at 8:50. Of course, they took her straight away to the warmer then I didn't get to hold her until the recovery room. I was still shaking from medication. Basically, the birth was completely the opposite of what we had hoped for. Meagan: What you had planned, yeah. Wyn: Then later, the OB who did the surgery came in and told me that I have very interesting reproductive anatomy. He confirmed it was a left-sided unicornuate uterus. There was a small horn on the right side and my uterus, I guess, was really stretched out and almost see-through. Meagan: A uterine window. Wyn: Then the placenta was really attached and they had to work to get that out. They labeled that as placenta accreta. I was advised not to labor again if we ever had another baby and just to plan a C-section. I felt like I went through all of the stages of grief after and in postpartum for my birth. First, I was in denial because I just blocked it out. I was happy to have my baby. Then you add the sleep deprivation and postpartum hormones and I was a bit angry at myself for not advocating but also just all of the suggestions. Baby wouldn't have changed anything. It was just a lot of what if's. Meagan: Which is hard. It's hard to what if this and what if that. Sometimes those what-ifs come up and we don't get answers. Wyn: Yeah, but it just fueled my fire to try for a VBAC. Meagan: Mhmm. Wyn: So that was my first birth and C-section then our second pregnancy which again, we felt like our little girl was a miracle so we just didn't know if we would be able to conceive again naturally or if we would have to go through IVF. We waited a little bit and another little miracle came in September 2023.Meagan: Yay. Wyn: Yeah, that was pretty exciting. Of course, I had been researching VBAC from 6 months postpartum with my daughter. I felt like my best option for a physiological birth or as close to it would be at home. I didn't want to fight the whole time in the hospital so I contacted two home birth midwives and they were both very nice and informative. They felt like I could VBAC but neither were comfortable supporting me at home with my previous birth– Meagan: And your uterus, yeah. Wyn: They both suggested I go back to my original midwife. I was a little upset at first that they wouldn't support it but I also understood. I made an appointment with my original midwife. I went in with my guard up and ready to fight for the VBAC. She surprised me and was actually supportive of it. She said that we would just watch and see how things would go. She said there wasn't any reason why we couldn't try. I was a bit surprised but wondered if she remembered all of the details or had looked at my records. I just went with it at first but eventually, we talked about everything that happened during the birth. She got second opinions from people in her office and it was okay. Meagan: Awesome. Wyn: Yeah. I also reached out and hired a doula, Dawn, who was a wealth of information and super supportive. We met regularly. She gave me exercise assignments and movements for labor and positioning. She was just there to help me debrief after each appointment with my midwife. If anything was brought up, she gave me information or links so I could feel confident going forward. That was really cool. I saw a chiropractor and did massage. I drank Nora tea from about 34 weeks on. I just tried to cover all my bases to get the best outcome. This pregnancy, I actually grew quicker and was measuring ahead, not behind. A growth scan was suggested again, but I respectfully declined because I felt like everything was okay. I was just trying to lean into my intuition and I didn't want to get a big baby diagnosis that could possibly–Meagan: Big baby, small uterus. Yeah. I don't blame you. Wyn: Yeah. Eventually, I ended up evening out at 37 weeks and was measuring right on. I just was a little bit quicker I guess. So I made it to my due date again at 40 weeks and I was offered a membrane sweep. I was offered a cervical check. I declined everything. I was doing good. I knew I went over with my daughter so I was prepared to go over again. 40.5 weeks, induction was brought up. I said I wouldn't talk about it until 42 weeks. Meagan: Good for you. Wyn: We scheduled a non-stress test again at 41 but I didn't make it to that because I was starting to have cramping in the evenings. I wouldn't consider them contractions but they were noticeable. Things were happening. I was trying to walk every day and just stay mentally at ease to keep my body feeling safe. So at 41 weeks exactly, I was having cramping in the evening. That was a bit stronger. I was putting my daughter down. My husband and I watched a show. I didn't say anything to him or anything because I didn't want to jinx it. We went to bed at 11:00. I fell asleep and slept really hard for an hour and a half. I woke up to contractions starting again full-on. I thought my water broke but I don't think it was. I think it was just bloody show originally. Meagan: Yeah.Wyn: I got up. I sat in the bathroom for a little bit and I was just super excited that it was starting on its own. I held out. I tried to time contractions a little bit at first. I knew it was happening so I just moved around the house quietly. I went and laid with my daughter for a half hour while she was sleeping because that was going to be our last time as the three of us. Yeah. I kept moving around for another half hour or so. By then, I needed the extra support. I woke my husband up. We texted our doula, Dawn, and she told me to hop in the shower for a little bit and she would get ready and head over soon.She made it about 3:30 AM and I think I was in pretty full-blown labor. I was mostly sitting on the toilet laboring in there but I came out to the living room when she came and I was on all fours. I made a music playlist. I had the TENS unit. I had all of these coping skills prepared and I didn't use anything. Meagan: You were in the zone. You were in the zone. Hey, but at least you were prepared with it. Wyn: Yeah, so about 4:45-5:00 in the morning, she suggested if we felt ready that maybe we would head into the hospital. My body was kind of bearing down a little bit wanting to push. We called my mom to come over and stay with our daughter. We called our midwife. She actually lives in our neighborhood. We called to give her a heads-up to get ready to meet us at the hospital. We got there at about 5:45. They did intake and called a nurse to bring us up to the room, and that nurse was our only real hurdle in the birth. She was not really supportive of natural birth or physiological birth. She made a couple of comments. She was trying to force me to get checked to admit me. I was obviously in labor because I was kind of pushing. I declined all of that. Eventually, she ended up not coming back in. She switched out with another nurse or maybe they told her to switch out, I'm not sure but that was nice that she removed herself from the situation. Meagan: I was going to say, good for her for realizing that her views didn't align with your views and that she probably wasn't needed at that birth. I don't love when people are that way with clients of mine or whatever, but for her to step away, that says something so that's really good. I'm glad she did for both of you.Wyn: Yeah, before she left, she was trying to get an IV too. She couldn't get an IV. I don't know. Meagan: She was frustrated and you're like, “Yeah, you could go.” Wyn: So yeah. Again, I was noticing all this going on but I was in my own little world. We got there. Our midwife, Christina, showed up. She asked if she could check me. I didn't want to have cervical checks but because I was getting pushy, she didn't want me to not be fully dilated and start pushing. I let her check and she said, “You're complete and baby is right there. Lean into it. If you want to push, start pushing.” I couldn't believe it. I prepared for labor. I had a moment that I had to wrap my mind around it because I couldn't believe we were already there to start pushing.I had requested my records so I was able to see all my time stamps. At about 6:30 was when she checked me. I pushed for about a half hour and the baby was born at 7:09 in the morning. It was exactly 41 weeks and 1 day, the same as my daughter. Meagan: Wow, and a much faster and much better experience. Your body just went into labor and was allowed to go into labor. You helped keep it safe to do what it wanted to do. Wyn: Yeah. Yeah. I was really excited to just be able. My body just did it all on its own which was pretty awesome. It was a pretty awesome feeling. Meagan: Very, very awesome. Do you have any tips for people who may feel strongly about not getting cervical exams or not getting IVs or doing those things but may have a pressuring nurse or someone who is like, “You have to do this. You have to do this. Our policy is this.” Do you have any advice on standing up for yourself and standing your ground?Wyn: Yeah, be respectful but also just be really strong. I had my husband and my doula backing me up. We prepared for things like that. I had a birth plan that had my wishes on it so just yeah, standing strong and keep in with what you want. But also be ready to switch gears. Like I said, I didn't want a cervical check but when my midwife got there and suggested it, I felt like, okay. I can go ahead with that. Meagan: You felt like it was okay at that point. That's such a great thing to bring up. You can have your wishes and desires. You can be standing your ground and then your intuition may switch or your opinion may switch or the situation may switch. You can adapt with how it's going or change your mind at any point both ways. You can be like, “I do want this and I actually decided I don't want this anymore. I changed my mind.” We ask in our form, “What's your best tip for someone preparing for a VBAC?” You said, “Find a great support team. Research all of the facts to make informed decisions and really lean into your motherly intuition.” I feel like through your story, that's what you did. You learned the facts. You said even before you became pregnant, right? Your baby was 6 months old and you were starting to listen to the podcast and learn more about VBAC and what the evidence says and the facts then you got your support team. You just built it up. You knew exactly what you needed to do so you felt confident in saying, “No. I don't want that IV” or “No, I don't want that cervical exam for you to admit me. I'm going to have this baby with or without that cervical exam.” I think the more you are informed, the more likely you feel confident in standing your ground. Wyn: For sure. Meagan: Yeah, for sure. Well, oh my goodness. Huge congrats. Let's just do a little shoutout to your midwife and your doula. Let's see, it's Christina? Where is she at again?Wyn: Interior Women's Health in Fairbanks, Alaska. Meagan: Awesome. So great of her to support you with a more unique situation too. She was like, “Let me do some research. Let me get some opinions. Okay, yes. We're good.” I'm so glad you felt that support. Then your doula, Dawn, yes. Where is she again? Oh, Unspeakable Joy. Wyn: Yes. Yeah. Meagan: That is so awesome. I'm so glad that you had them. We love doulas here as I'm sure you have heard along the podcast. We absolutely love our doulas. We have a VBAC directory as well so you can find a doula at thevbaclink.com/findadoula. Then last but not least, in the form, you said that you took Needed. Wyn: Yes, I did. Meagan: Yes. Can you share your experience with taking Needed through pregnancy? Did you start before pregnancy? Wyn: Yeah. Right as I got pregnant with my second one, I took the prenatal. I took the probiotics and I still take them today postpartum. Then also, the electrolytes or the mineral packets and the nighttime powder that my husband and I take. We put it in our tea every night. Meagan: It's amazing. It really is so amazing, huh? It's kind of weird because I don't have to finish it. I'm just sitting there sipping on it and I can just feel everything relax. I have a busy brain. I call it busy brain and my busy brain is a lot more calm when I take my sleep aid. Wyn: Yeah. I slept amazingly through pregnancy. Normally with my first, I had a lot of insomnia. It was very nice. Meagan: Yeah. Then the probiotics, I want to talk about probiotics in general. We never know how birth is going to go. We could have a Cesarean. We may have a fever and have to be given antibiotics or Tylenol or whatever it may be. If we can have a system that is preloaded essentially with probiotics, it really is going to help us and our gut flora in the end so no matter how that birth outcome it, that probiotic is so good for us because we never know what we are going to get or what we are going to receive in that labor. I'm excited. Wyn: Yeah, what is that stuff that they test you for? Meagan: Group B strep?Wyn: Yeah, yeah. Sorry. I didn't want that because I didn't want to have an IV. Meagan: So, so important. I love it. They usually test for that around 36 weeks so really making sure that you are on the pre and probiotic. What I really love is that it is pre and pro so it really is helping to strengthen our gut flora so much. With GBS, with group B strep, they like to give antibiotics in labor. It's sometimes a lot. They like to give rounds every 4 hours so you really could be impacting your gut flora. I love that you took that. You didn't even have group B strep. Well, thank you so, so much for sharing your story. Is there any other advice or anything else you would like to share with our listeners today?Wyn: Yeah, just again, find your support team and lean into your own intuition. You know what is right for your body and your babies. Meagan: It's so true. I mean, from day one of this podcast, we've talked about that intuition. It is powerful. It is powerful and it can really lead us in the right path. We just have to sometimes stop and listen. Sometimes that's removing yourself from a situation. Go into the bathroom and say, “I have to go to the bathroom.” Go to the bathroom, close your eyes, take a breath, and hear what your intuition is saying. It is so powerful. I couldn't agree more. Thank you so much.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

Timestamps: 6:05 - The value chain of insurance companies  14:26 - Why having a strategy is essential 20:22 - Is Switzerland digitized enough? 24:22 - Is digitization a generational issue? 35:15 - Being a board member at smzh This episode was co-produced with smzh. About Andreas Krümmel: Andreas Krümmel is the former CEO at Generali Switzerland and a current board member at SMZH, an independent partner in all matters related to finance, insurance, real estate, tax and law, for both private and corporate clients. He holds an MBA from HSG and spent 20 years working in insurance, for companies like Winterthur Group, AXA and Generali.  During his chat with Silvan, Andreas discussed his key leadership principles (which boil down to simplifying things to the maximum, and listening before deciding), reminisced over Switzerland's slow digitization process from the 80s until now, and reflected on the role insurtech startups are playing in today's landscape. The cover portrait was edited by⁠ ⁠⁠⁠⁠⁠www.smartportrait.io⁠⁠⁠⁠⁠⁠. Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners. ‍

Wanting more information on tubal testing that avoids radiation exposure? 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 for an episode reviewing the ins and outs of alternative tubal testing procedure using ExemFoam. The docs discuss with Rhianne Christopherson, APRN, FNP-C, of Full Moon Fertility, how this test differs from a more traditional HSG and its potential advantages. They also talk about in-person vs telemedicine appointments, remote monitoring and how the team impacts your fertility care. Join us for another episode of Fertility Docs Uncensored. Have questions about infertility?  Visit FertilityDocsUncensored.com to ask our docs. Selected questions will be answered anonymously in future episodes.

Presented in partnership with Fertility and Sterility onsite at the 2024 ANZSREI meeting in Sydney, Australia.  The ANZSREI 2024 debate discussed whether patients with unexplained infertility should go straight to IVF. Experts on both sides weighed the effectiveness, cost, and psychological impact of IVF versus alternatives like IUI. The pro side emphasized IVF's high success rates and diagnostic value, while the con side argued for less invasive, cost-effective options. The debate highlighted the need for individualized care, with no clear consensus reached among the audience. View Fertility and Sterility at https://www.fertstert.org/ TRANSCRIPT: Welcome to Fertility and Sterility On Air, the podcast where you can stay current on the latest global research in the field of reproductive medicine. This podcast brings you an overview of this month's journal, in-depth discussion with authors, and other special features. F&S On Air is brought to you by Fertility and Sterility family of journals in conjunction with the American Society for Reproductive Medicine, and is hosted by Dr. Kurt Barnhart, Editor-in-Chief, Dr. Eve Feinberg, Editorial Editor, Dr. Micah Hill, Media Editor, and Dr. Pietro Bordoletto, Interactive Associate-in-Chief. I'd just like to say welcome to our third and final day of the ANZSREI conference. We've got our now traditional F&S podcast where we've got an expert panel, we've got our international speaker, Pietro, and we've got a wonderful debate ahead of us. This is all being recorded. You're welcome, and please think of questions to ask the panel at the end, because it's quite an interactive session, and we're going to get some of the best advice on some of the really controversial areas, like unexplained infertility. Hi, everyone. Welcome to the second annual Fertility and Sterility Journal Club Global, coming to you live from the Australia and New Zealand Society for Reproductive Endocrinology and Infertility meeting. I think I speak on behalf of everyone at F&S that we are so delighted to be here. Over the last two years, we've really made a concerted effort to take the podcast on the road, and this, I think, is a nice continuation of that. For the folks who are tuning in from home and listening to this podcast after the fact, the Australia and New Zealand Society for Reproductive Endocrinology is a group of over 100 certified reproductive endocrinologists across Australia and New Zealand, and this is their annual meeting live in Sydney, Australia. Today's debate is a topic that I think has vexed a lot of individuals, a lot of patients, a lot of professional groups. There's a fair amount of disagreement, and today we're going to try to unpack a little bit of unexplained infertility, and the question really is, should we be going straight to IVF? As always, we try to anchor to literature, and there are two wonderful documents in fertility and sterility that we'll be using as our guide for discussion today. The first one is a wonderful series that was published just a few months ago in the May issue, 2024, that is a views and reviews section, which means there's a series of three to five articles that kind of dig into this topic in depth. And the second article is our professional society guideline, the ASRM Committee Opinion, entitled Evidence-Based Treatments for Couples with Unexplained Infertility, a guideline. The format for today's discussion is debate style. We have a group of six experts, and I've asked them to randomly assign themselves to a pro and a con side. So I'll make the caveat here that the things that they may be saying, positions they may be trying to influence us on, are not necessarily things that they believe in their academic or clinical life, but for the purposes of a rich debate, they're going to have to be pretty deliberate in convincing us otherwise. I want to introduce my panel for today. We have on my immediate right, Dr. Raewyn Tierney. She's my co-moderator for tonight, and she's a practicing board-certified fertility specialist at IVF Australia. And on my immediate left, we have the con side. Going from left to right, Dr. Michelle Quick, practicing board-certified fertility specialist at IVF Australia. Dr. Robert LaHood, board-certified reproductive endocrinologist and clinical director of IVF Australia here in Sydney. And Dr. Clara Bothroyd, medical director at Care Fertility and the current president of the Asia Pacific Initiative in Reproduction. Welcome. On the pro side, going from right to left, I have Dr. Aurelia Liu. She is a practicing board-certified fertility specialist, medical director of Women's Health Melbourne, and clinical director at Life Fertility in Melbourne. Dr. Marcin Stankiewicz, a practicing board-certified fertility specialist and medical director at Family Fertility Centre in Adelaide. And finally, but certainly not least, the one who came with a tie this morning, Dr. Roger Hart, who is a professor of reproductive medicine at the University of Western Australia and the national medical director of City Fertility. Welcome, pro side. Thank you.  I feel naked without it. APPLAUSE I've asked both sides to prepare opening arguments. Think of this like a legal case. We want to hear from the defence, we want to hear from the plaintiffs, and I'm going to start with our pro side. I'd like to give them a few minutes to each kind of introduce their salient points for why we should be starting with IVF for patients with unexplained infertility. Thanks, Pietro. To provide a diagnosis of unexplained infertility, it's really a reflection of the degree investigation we've undertaken. I believe we all understand that unexplained infertility is diagnosed in the presence of adequate intercourse, normal semen parameters, an absence ovulatory disorder, patent fallopian tubes, and a normal detailed pelvic ultrasound examination. Now, the opposing team will try to convince you that I have not investigated the couple adequately. Personally, I'm affronted by that suggestion. But what possible causes of infertility have I not investigated? We cannot assess easily sperm fertilising capability, we cannot assess oocyte quality, oocyte fertilisation potential, embryonic development, euploidy rate, and implantation potential. Surely these causes of unexplained fertility will only become evident during an IVF cycle. As IVF is often diagnostic, it's also a therapeutic intervention. Now, I hear you cry, what about endometriosis? And I agree, what about endometriosis? Remember, we're discussing unexplained infertility here. Yes, there is very good evidence that laparoscopic treatment for symptomatic patients with endometriosis improves pelvic pain, but there is scant evidence that a diagnostic laparoscopy and treating any minor disease in the absence of pain symptoms will improve the chance of natural conception, or to that matter, improve the ultimate success of IVF. Indeed, in the absence of endometriomas, there is no negative impact on the serum AMH level in women with endometriosis who have not undergone surgery. Furthermore, there is no influence on the number of oocytes collected in an IVF cycle, the rate of embryonic aneuploidy, and the live birth rate after embryo transfer. So why put the woman through a painful, possibly expensive operation with its attendant risks as you're actually delaying her going straight to IVF? What do esteemed societies say about a diagnostic laparoscopy in the setting of unexplained infertility? The ESHRE guidelines state routine diagnostic laparoscopy is not recommended for the diagnosis of unexplained infertility. Indeed, our own ANZSREI consensus statement says that for a woman with a minimal and mild endometriosis, that the number of women needed to treat for one additional ongoing pregnancy is between 3 and 100 women with endometriosis. Is that reasonable to put an asymptomatic woman through a laparoscopy for that limited potential benefit? Now, regarding the guidelines for unexplained infertility, I agree the ASRM guidelines do not support IVF as a first-line therapy for unexplained infertility for women under 37 years of age. What they should say, and they don't, is that it is assumed that she is trying for her last child. There's no doubt if this is her last child, if it isn't her last child, sorry, she will be returning, seeking treatment, now over 37 years of age, where the guidelines do state there is good evidence that going straight to IVF may be associated with higher pregnancy rates, a shorter time to pregnancy, as opposed to other strategies. They then state it's important to note that many of these included studies were conducted in an area of low IVF success rates than those currently observed, which may alter this approach, suggesting they do not even endorse their own recommendations. The UK NICE guidelines, what do they say for unexplained infertility? Go straight to IVF. So while you're listening to my esteemed colleagues on my left speaking against the motion, I'd like to be thinking about other important factors that my colleagues on my right will discuss in more detail. Consider the superior efficacy of IVF versus IUI, the excellent safety profile of IVF and its cost-effectiveness. Further, other factors favouring a direct approach to IVF in the setting of unexplained infertility are what is the woman's desired family? We should not be focusing on her first child, we should be focusing on giving her the family that she desires and how we can minimise her inconvenience during treatment, as this has social, career and financial consequences for those impediments for her while we attempt to help her achieve her desired family. Thank you. APPLAUSE I think the young crowd would say that that was shots fired. LAUGHTER Con side? We're going to save the rebuttal for the time you've allocated to that, but first I want to put the case about unexplained infertility. Unexplained infertility in 2024 is very different to what it was 10 and 20 years ago when many of the randomised controlled trials that investigated unexplained infertility were performed. The armamentarium of investigative procedures and options that we have has changed, as indeed has our understanding of the mechanisms of infertility. So much so that that old definition of normal semen analysis, normal pelvis and ovulatory, which I think was in Roy Homburg's day, is now no longer fit for purpose as a definition of unexplained infertility. And I commend to you ICMART's very long definition of unexplained infertility, which really relies on a whole lot of things, which I'm going to now take you through what we need to do. It is said, or was said, that 30% of infertility was unexplained. I think it's way, way less than that if we actually look at our patients, both of them, carefully with history and examination and directed tests, and you will probably reduce that to about 3%. Let me take you through female age first. Now, in the old trials, some of the women recruited were as old as 42. That is not unexplained infertility. We know about oocyte aneuploidy and female ageing. 41, it's not unexplained. 40, it's not unexplained. 39, it's not unexplained. And I would put it to you that the cut-off where you start to see oocyte aneuploidy significantly constraining fertility is probably 35. So unexplained infertility has to, by definition, be a woman who is less than 35. I put that to you. Now, let's look at the male. Now, what do we know about the male, the effect of male age on fertility? We know that if the woman is over 35, and this is beautiful work that's really done many years ago in Europe, that if the woman is over 35 and the male is five years older than her, her chance of natural conception is reduced by a further 30%. So I put it to you that, therefore, the male age is relevant. And if she's 35 and has a partner who's 35 years older than her or more, it's not unexplained infertility. It's related to couple age. Now, we're going to... So that's age. Now, my colleagues are going to take you through a number of treatment interventions other than IVF, which we can do with good effect if we actually make the diagnosis and don't put them into the category of unexplained infertility. You will remember from the old trials that mild or moderate or mild or minimal endometriosis was often included, as was mild male factor or seminal fluid abnormalities. These were really multifactorial infertility, and I think that's the take-home message, that much of what we call unexplained is multifactorial. You have two minor components that act to reduce natural fecundability. So I now just want to take you through some of the diagnoses that contribute to infertility that we may not, in our routine laparoscopy and workup, we may not pick up and have previously been called unexplained infertility. For instance, we know that adenomyosis is probably one of the mechanisms by which endometriosis contributes to infertility. Chronic endometritis is now emerging as an operative factor in infertility, and that will not be diagnosed easily. Mild or minimal endometriosis, my colleagues will cover. The mid-cycle scan will lead you to the thin endometrium, which may be due to unexpected adhesive disease, but also a thin endometrium, which we know has a very adverse prognostic factor, may be due to long-term progestin contraception. We are starting to see this emerge. Secondary infertility after a caesarean section may be due to an isthma seal, and we won't recognise that unless we do mid-cycle scans. That's the female. Let's look at the male. We know now that seminal fluid analysis is not a good predictor of male fertility, and there is now evidence from Ranjith Ramasamy's work that we are missing clinical varicoceles because we failed to examine the male partner. My colleagues will talk more about that. We may miss DNA fragmentation, which again may contribute via the basic seminal fluid analysis. Now, most of these diagnoses can be made or sorted out or excluded within one or two months of your detailed assessment of both partners by history and examination. So it's not straight to IVF, ladies and gentlemen. It's just a little digression, a little lay-by, where you actually assess the patient thoroughly. She did not need a tie for that rebuttal. LAUGHTER Prasad. Thank you. Well, following from what Professor Hart has said, I'm going to show that IVF should be a go-to option because of its effectiveness, cost-effectiveness and safety. Now, let me first talk about the effectiveness, and as this is an interaction session, I would like to ask the audience, please, by show of hands, to show me how many of you would accept a medical treatment or buy a new incubator if it had a 94% chance of failure? Well, let the moderator please note that no hands have been raised. Thank you very much. Yet, the chance of live birth in Australian population following IUI is 6%, where, after IVF, the live birth is 40%. Almost seven times more. Now, why would we subject our patients to something we ourselves would not choose? Similarly, findings were reported from international studies that the hazard ratio of 1.25 favouring immediate IVF, and I will talk later about why it is important from a safety perspective. Cost-effectiveness. And I quote ESHRE guidelines. The costs, treatment options have not been subject to robust evaluations. Now, again, I would like to ask the audience, this time it's an easy question, how many of you would accept as standard an ongoing pregnancy rate of at least 38% for an average IVF cycle? Yeah, hands up. All right, I've got three-quarters of the room. OK. Well, I could really rest my case now, as we have good evidence that if a clinic has got an ongoing pregnancy rate of 38% or higher with IVF with single embryo transfer, then it is more effective, more cost-effective, and should be a treatment of choice. And that evidence comes from the authors that are sitting in this room. Again, what would the patients do? If the patients are paying for the treatment, would they do IUI? Most of them would actually go straight to IVF. And we also have very nice guidelines which advise against IUI based on cost-effectiveness. Another factor to mention briefly is the multiple births, which cost five to 20 times more than singleton. The neonatal cost of a twin birth costs about five times more than singletons, and pregnancy with delivery of triplets or more costs nearly 20 times. Now, the costs that I'm going to quote are in American dollars and from some time ago, from Fertility and Sterility. However, the total adjusted all healthcare costs for a single-dom delivery is about US$21,000, US$105,000 for twins, and US$400,000 for triplets and more. Then the very, very important is the psychological cost of the high risk of failure with IUI. Now, it is well established that infertility has a psychological impact on our patients. Studies have shown that prolonged time to conception extends stress, anxiety, and depression, and sexual functioning is significantly negatively impacted. Literature shows that 56% of women and 32% of men undergoing fertility treatment report significant symptoms of depression, and 76% of women and 61% of men report significant symptoms of anxiety. Shockingly, it is reported that 9.4% of women reported having suicidal thoughts or attempts. The longer the treatment takes, the more our patients display symptoms of distress, depression, and anxiety. Safety. Again, ESHRE guideline says the safety of treatment options have not been subjected to robust evaluation. But let me talk you through it. In our Australian expert hands, IVF is safe, with the risk of complications of ectopic being about 1 in 1,500 and other risks 1 in 3,000. However, let's think for a moment on impact of multiple births. A multiple pregnancy has significant psychological, physical, social, and financial consequences, which I can go further into details if required. I just want to mention that the stillbirth rate increases from under 1% for singleton pregnancies to 4.5% for twins and 8.3% for higher-order multiples, and that multiple pregnancies have potential long-term adverse health outcomes for the offspring, such as the increased risk of health issues through their life, increased learning difficulties, language delay, and attention and behavior problems. The lifelong disability is over 25% for babies weighing less than 1 kilogram at delivery. And please note that the quoted multiple pregnancy rates with IUI can reach up to 33%, although in expert hands it's usually around 15%, which is significantly higher than single embryo transfer. In conclusion, from the mother and child safety perspective, for the reason of medical efficacy and cost effectiveness, we have reasons to believe you should go straight to IVF. We're going to be doing these debates more often from Australia. This is a great panel. One side, please. Unexplained infertility. My colleagues were comparing IUI ovulation induction with IVF, but there are other ways of achieving pregnancies with unexplained fertility. I'm going to take the patient's perspective a little bit here. It's all about shared decision-making, so the patient needs to be involved in the decision-making. And it's quite clear from all the data that many patients with unexplained infertility will fall pregnant naturally by themselves even if you do nothing. So sometimes there's definitely a place in doing nothing, and the patient needs to be aware of that. So it's all about informed consent. How do we inform the patient? So we've got to make a proper diagnosis, as my colleague Dr. Boothright has already mentioned, and just to jump into IVF because it's cost-effective is not doing our patients a justice. The prognosis is really, really important, and even after 20 years of doing this, it's all about the duration of infertility, the age of the patient, and discussing that prognosis with the patient. We all know that patients who have been trying for longer and who are older do have a worse prognosis, and maybe they do need to look at treatment quicker, but there are many patients that we see that have a good prognosis, and just explaining that to them is all they need to achieve a pregnancy naturally. And then we're going to talk about other options. It's wrong not to offer those to patients, and my colleague Dr. Quick will talk about that in a moment. Look, we've all had patients that have been scarred by IVF who've spent a lot of money on IVF, did not fall pregnant, and I think the fact that they weren't informed properly, that the diagnosis wasn't made properly, is very frustrating to them. So to just jump into IVF again is not doing the patients a justice. And look, there are negatives to IVF. There's not just the cost to the patient, the cost to society. As taxpayers, we all pay for IVF. It's funded here, or sponsored to some degree, and it's also the family and everyone else that's involved in paying for this. So this is not a treatment that is without cost. There are some harms. We know that ovarian hyperstimulation syndrome still exists, even though it's much less than it used to be. There's a risk of infection and bleeding from the procedures. And we can look at the baby. The data still suggests that babies born from IVF are smaller and they're born earlier, and monozygotic twinning is more common with IVF, so these are high-risk pregnancies, and all this may have an impact on the long-term health of the babies somewhere down the track at the moment. That is important to still look out for. But I come back to the emotional toll. Our colleagues were saying that finishing infertility quicker helps to kind of reduce the emotional toll, but the procedure itself does have its own toll if it doesn't work, and so we've got to prepare patients, have them informed. But at the end of the day, it's all about patient choice. How can a patient make a choice if we don't make a proper diagnosis, give them a prognosis and offer them some other choices that exist? And running the anchor leg of the race for the pro side. IVF in couples with unexplained infertility is the best tool we have in our reproductive medicine toolkit for multiple reasons. Professor Hart has clarified the definition of unexplained infertility. As a reflection of the degree of investigation we've undertaken. He's explained that IVF is often importantly diagnostic as well as therapeutic, both demonstrating and overcoming barriers to natural conception. Dr Stankiewicz has convinced us that IVF is efficient, safe and cost-effective. My goal is to show you that IVF is the correct therapy to meet the immediate and big picture family planning goals for our patients with unexplained infertility. More than 80% of couples with defined unexplained infertility who attempt IVF treatment will have a baby. In Australia, ANZSREI data shows us that the average age of the female patients who present with primary unexplained infertility is over 35 years. And in fact the average is 38 years. We're all aware that the average age of first maternity in Australia has progressively become later over the past two decades. Currently it stands in the mothers and babies report at 32 years. If the average age of first maternity is 32 years, this means that at least 50% of women attempting their first pregnancy are over 32 years. Research I conducted in Melbourne University with my student Eugenie Pryor asking university students of their family planning intentions and aspirations demonstrated that most people, male and female, want to be parents and most want to have more than one child. However, in Australia, our most recent survey shows that births are at an all-time low, below replacement rate and falling, with an ever greater proportion of our population being unable to have the number of children they aspire to and an ever growing proportion seeking assisted reproductive care. Fertility declines with age. Factors include egg quality concerns, sperm quality concerns and the accumulation of pathologies over time. Adenomyosis, fibroids, endometriosis are concerns that no person is born with. They exist on a spectrum and progress over time and may be contributing factors for unexplained infertility. Our patients, when we meet them, are the best IVF candidates that they will ever be. They are the youngest they will ever be and they have the best ovarian reserve they will ever have. They will generate more euploid embryos now than they will in years to come. The sooner we get our patients pregnant, the sooner they will give birth. It takes nine months to have a baby, 12 months potentially to breastfeed and wean and of course most patients will need time to care for a young infant and recover prior to attempting another pregnancy. IVF and embryo banking may represent not only their best chance of conception with reduced time to pregnancy but also an opportunity for embryo banking to improve their cumulative live birth rate potential over time. By the time our 38-year-old patient returns to try to conceive for a second child, she will undoubtedly be aged over 40. Her chance of live birth per cycle initiated at IVF at this stage has reduced phenomenally. The ANZSREI dataset from our most recent report quotes that statistic to be 5%. Her chance of conception with an embryo frozen at 38 years, conversely, is one in three to one in four. There is no room for doubt that IVF gives couples with unexplained infertility not only the most effective treatment we have to help them have a baby, but their best opportunity to have a family. Last but certainly not least, Dr. Quick, to round out the con sides arguments before we open up for rebuttal. And I'll make a small plea that if you have questions that you'd like to pose directly to the panel, prepare them and we'll make sure we get to them from the audience shortly. Thank you. So, whilst we have heard that we may be bad doctors because we're delaying our patients' time to pregnancy, I would perhaps put it to you that unexplained infertility is a diagnosis which is made based on exclusion. So perhaps you are the bad doctors because you haven't looked hard enough for the cause of the unexplained infertility. So, in terms of the tests that we all would do, I think, we would all ensure that the woman has an ovarian reserve. We would all ensure that she has no structural anomaly inside the uterus. We would all ensure that her tubes are patent. We would all ensure that she has regular cycles. We would ensure that he has a normal semen analysis. I think these are tests that we would all do when trying to evaluate a couple for fertility who are struggling to conceive. And therefore, the chance of them getting pregnant naturally, it's never going to be zero. And one option therefore, instead of running straight to IVF, would be to say, OK, continue timed intercourse because the chance of you conceiving naturally is not actually zero and this would be the most natural way to conceive, the cheapest way to conceive, the least interventional way to conceive. And whether that be with cycle tracking to ensure appropriate timed intercourse, whether that be with cycle tracking to ensure adequate luteal phase support. When you clear the fallopian tubes, we know that there are studies showing an improvement in natural conception. Lipidol or oil-based tubal flushing techniques may also help couples to conceive naturally. And then you don't have this multiple pregnancy rate that IVF has. You don't have the cost that you incur with IVF, not just for the couple but to Australian society because IVF is subsidised in this country. You don't have the risks that the woman goes through to undergo IVF treatment. You don't have the risks that the baby takes on being conceived via IVF. And so conceiving naturally, because it's not going to be zero, is definitely an option for these couples. In terms of further tests or further investigations that you could do, some people would argue, yes, we haven't looked hard enough for the reason for infertility, therefore we know that ultrasound is notoriously bad at picking up superficial endometriosis. We know that ultrasound cannot pick up subtle changes in the endometrium, as Dr Boothroyd referred to chronic endometritis, for example. So these patients perhaps should undergo a hysteroscopy to see if there is an endometrial issue. Perhaps these patients should undergo a laparoscopy to see if there is superficial endometriosis. And there are meta-analyses showing that resecting or treating superficial endometriosis may actually help these couples conceive naturally down the track and then therefore they avoid having more interventional treatment in order to conceive. There is also intrauterine insemination with or without ovarian stimulation, which may improve their chances of conceiving naturally. And that again would be less invasive, less intervention and cheaper for the patient. And we know that therefore there are a lot of other treatment options available to help these couples to conceive. And if it's less invasive, it's more natural, it's cheaper, that ends up being better for the patient. Psychologically as well, which the other side have brought up, even with Dr Stankiewicz's 38% ongoing pregnancy rate, that also means that 62% of his patients are not going to be pregnant. The psychological impact of that cannot be underestimated because for a lot of patients, IVF is your last resort. And when you don't get pregnant with IVF, that creates an issue too for them. Embryo banking, which was also brought up, what happens when you create surplus embryos and what's the psychological impact of having to deal with embryos that you are then not going to use in the future? So therefore for those reasons we feel that IVF is not your first line treatment for couples who are diagnosed with unexplained infertility. There are many other ways to help these couples to conceive. We just have a multitude of things to unpack. And I want to start off by opening up an opportunity for rebuttal. I saw both sides of the panel here taking diligent notes. I think all of us have a full page worth of things that kind of stood out to us. Since the pro side had an opportunity to begin, I'm actually going to start with the con side and allow the con side to answer specific points made by the pro side and provide just a little bit more detail and clarity for why they think IVF is not the way forward. My learned first speaker, wearing his tie of course, indicated that it was all about laparoscopy and IUI, and it's way more than that. I just want to highlight to you the paper by Dressler in 2017 in the New England Journal of Medicine, a randomised controlled trial of what would be unexplained infertility according to the definition I put out, the less than 35 ovulatory normal semen analysis. And the intervention was an HSG with either oil-based contrast or water-based contrast. And over the six months, there was clear separation, and this is an effective treatment for unexplained infertility or mild or minimal endometriosis, however it might work. And there's probably separation out to three years. So as a single intervention, as an alternative to IVF, the use of oil-based contrast is an option. So it's not just about laparoscopy and IUI. I guess the other thing the second speaker did allude to, fairly abysmal success rates with IUI being 6%. That is a problem, and I would like to allude to a very good pragmatic trial conducted by Cindy Farquhar and Emily Lu and their co-workers in New Zealand that really swung the meta-analysis for the use of clomiphene and IUI to clinical efficacy. And they reported a 33% chance of live birth in their IUI and clomiphene arm. I'm going across to Auckland to see what the magic is in that city. What are they doing? The third speaker did allude to the problem of declining fertility, a global problem, and Australia is not alone. We have solved the problem to date, which we've had for 40 years, with immigration. But Georgina Chambers' work shows beautifully that IVF is not the answer to the falling fertility rates. It is a way more complex social problem and is probably outside the scope of today's discussion. So those are my three rebuttals to our wonderful team. Thank you very much. So... You can't bury them. We'll give them an opportunity. Thank you for the opportunity. So I'd like to address some of the points that my learned debaters on the opposition raised. The first speaker really suggested quite a few things that we probably omitted, like endometritis, failing to examine the male. I think things like that... I think, at a good history, that is essential what we do as part of our investigation. We're looking for a history of cesarean section, complications subsequent to that. We're doing a detailed scan, and that will exclude the fact that she's got a poor endometrium development, she's got a cesarean scar niche. A good history of a male will allude to the fact that he has some metabolic disorder, degree of hypogonadism. So we're not delaying anything by these appropriate investigations. Adenomyosis will be raised. I talked about a detailed gynaecological examination. So I honestly think that a very... As my opening line was, a detailed gynaecological scan, obviously with a very good history taken, is essential. We're not delaying her opportunity to go straight to IVF if we've addressed all these factors. The second speaker talked about shared decision-making, and we'd all completely agree with that. But we have to be honest and open about the success, which my second speaker talked about, the success of the treatment we're offering. And one thing we should sort of dwell on is it's all... It's a fundamental description of the success of treatment is probably all about prognostic models, and that who not model, that's the original model about the success of conception, is really... Everything flows on from that, which basically talks about a good prognosis patient. 30% chance of live birth after a year. That's what they talk about, a good prognosis patient. Perhaps the rest of the world is different to your average Australian patient, but if we talked about that being a good prognosis, you've got a one in three chance of being pregnant by a year. I think most of our patients would throttle us. So that is what all the models are sort of based on, that being a good prognosis patient. So I completely agree with the second speaker that we do have a shared decision. We have to be honest with our patients about the success. We have to be honest about giving them the prognosis of any treatment that we offer. But really, as my third speaker was talking about, it's about giving the patient the opportunity to have a family, minimal career disruption, minimal life disruption. We have to be honest and talk about the whole picture. They're focused on the first child because really they can't think beyond that. We're talking about giving them the family that they need. The third speaker spoke very eloquently about the risks associated with the treatment we offer. I believe we offer a very safe service with our IVF, particularly in Australia, with our 2% twin pregnancy rate. We talk about the higher risk of these pregnancies, but they perhaps don't relate to the treatment we're offering. Perhaps, unfortunately, is the patient, if she's got polycystic ovary syndrome, if she's more likely to have diabetes, premature delivery, preeclampsia. So I think often the risks associated with IVF and potentially the risks associated to the child born from IVF perhaps don't relate to the treatment of IVF per se. It may well be the woman and perhaps her partner, their underlying medical condition, which lead those risks. So I strongly would encourage you to believe that you take a very good history from your patient, you do a thorough investigation, as I've alluded to, looking for any signs of ovulatory disorder, any gynaecological disorder by a detailed scan, checking tubal patency and a detailed history and the similarities from the man, and then you'll find you're probably going straight to IVF. APPLAUSE I'd like to talk a bit about the embryo banking and having been in this field for a long time, as a word of caution, we're setting a lot of expectations. I remember going to an ASRM meeting probably 10 years ago where they had this headline, all your embryos in the freezer, your whole family in the freezer, basically expecting that if you get four or five embryos frozen that you'll end up with a family at the end. We all know that for the patient, they're not a percentage, it's either zero or 100%. And if all the embryos don't work, they don't have a family at the end, you know, it didn't work for them and their expectations haven't been met. And the way we talk about the percentages and that we can solve the patient's problems, that we can make families, it doesn't always happen. So the expectations our position is setting here, we're not always able to meet and so we're going to end up with very unhappy patients. So this is just a warning to everyone that we need to tell people that this doesn't always work and sometimes they'll end up with no success at all. And from that point of view, I think the way it's presented is way too simplistic and we've got to go back to looking at the other options and not promising things we can't always deliver. So just taking into account all our esteemed interlocutors have said, we don't necessarily disagree with the amount of investigations that they described because nowhere in our argument we said that as soon as the patient registers with the receptionist, they will direct it to an IVF lab. I think to imply so, we'd be very rich indeed. Maybe there are some clinics that are so efficient. I don't know how it works overseas, but certainly not in Australia. The other point that was made about the cost of IVF and our, again, esteemed interlocutors are very well aware from the studies done here in Australia that actually every baby that we have to conceive through IVF and create and lives is actually more than 10 to 100 times return on investment because we are creating future taxpayers. We are creating people that will repay the IVF treatment costs over and over and over again. So I'll put to you, Rob, that if you are saying that we can't do IVF because it costs money, you are robbing future treasurers of a huge amount of dollars. I hope the American audience is listening. In America, we call embryos unborn children in freezers in certain parts and here they're unborn taxpayers. Con side, final opportunity for rebuttal before some audience questions and one more word from the pro side. Well, actually, Dr Stankiewicz was very happy to hear that you're not going to send your patients straight to the IVF lab because we've managed to convince you that that's not the right thing to do. I clearly have forgotten how to debate because I did all my rebuttals at the end of my presentation but essentially I'll recap because when we're talking about IVF, as we're saying, the chance of pregnancy is not going to be 100% and so there is a psychological impact to IVF not working. There is a psychological impact to banking embryos and creating surplus embryos that eventually may not be used and they were my main rebuttal points in terms of why IVF was not the first-line treatment. Thank you. So we've heard from the opposition some very valid points of how our patients can be psychologically impacted when fertility treatment is unsuccessful. I will again remind you that IVF is the most successful fertility treatment we have in our treatment armoury. We are most likely to help our patients have a baby with IVF. The cumulative pregnancy rates for IVF have started back in the late 70s and early 80s in single-digit percentages. We now, with a best prognosis candidate, have at least a one-in-two chance of that patient having a baby per embryo transfer and in our patients with unexplained infertility, the vast majority of our patients will have success. We also heard from the negative team about the significant chance of pregnancy in patients with expectant management. You're right, there's not a 0% chance of natural conception in patients who have unexplained infertility, but there is a not very good chance. We know from data that we've had for a really long time, going back as far as the Hutterite data, to today's non-contradictory models, which tell us that a couple's chance of conception per month in best prognosis candidates is one in five. If they've been trying for six months, it's one in ten. If they've been trying for 12 months, it's only 5%, and if they've been trying for 24 months, it's less than 1%. So it may not be zero, but it isn't very good. In terms of our team reminding us of the extended ICMART definition of unexplained infertility, we don't argue. When we say someone has unexplained infertility, we make the assumption that they have been comprehensively diagnosed by a robust reproductive endocrinologist, as everyone in this room is. And I would say one closing rebuttal. IUI success rates have been the same for the last 50 years, whereas IVF success rates continue to improve. Why would you offer your patient a treatment from 50 years ago when you can offer them one from today? Thank you. APPLAUSE I'm going to take a personal privilege and ask the first question, in hoping that the microphone makes its way to the second question in the audience. My colleagues on the pro side have said IVF, IVF, IVF. Can you be a little bit more specific about what kind of IVF? Do you mean IVF with ICSI? Do you mean IVF, ICSI, and PGT? Be a little bit more deliberate for us and tell us exactly how the patient with unexplained infertility should receive IVF. As I said in my statement, I think it's a diagnostic evaluation. I think there is an argument to consider ICSI, but I think ICSI does have some negative consequences for children born. I think perhaps going straight to ICSI is too much. I think going straight to PGTA perhaps is too much, unless there is something in their history which should indicate that. But we're talking about unexplained infertility. So I believe a standard IVF cycle, looking at the opportunity to assess embryonic development, is the way to go. I do not think you should be going straight to ICSI. I think the principle of first do no harm is probably a safe approach. I don't know whether my colleagues have some other comments, but I think that would be the first approach rather than going all guns blazing. I can understand, though, in different settings in the world, there may have... We're very fortunate in Australia, we're very well supported from the government support for IVF, but I think the imperatives in different countries may be different. But I think that approach would be the right one first. We'll start with a question from the audience. And if you could introduce yourself and have the question allowed for our members in the audience who are not here. It's Louise Hull here from Adelaide. The question I would like to put to both the pro and con team is that Geeta Mishra from the University of Queensland showed that if you had diagnosed endometriosis before IVF, you were more likely to have a pregnancy and much less likely to have high-order IVF cycles. Given that we now have really good non-invasive diagnostics, we're actually... A lot of the time we can pick up superficial or stage 2 endometriosis if you get the right scan. We're going to do IVF better if we know about it. Can you comment on that impacting even the diagnosis of unexplained infertility? Thanks. I'd love to take that. Can I go first, Roger? LAUGHTER Please do. Look, I'd love to take that question. It's a really good question. And, of course, this is not unexplained infertility, so this is outside the scope here. And I think, really, what we're seeing now, in contrast to where we were at the time of the Markku study, which was all... And the Tulandy study on endometrioma excision, we now see that that is actually damaging to fertility, particularly where there is ovarian endometriosis, and that we compromise their ovarian reserve by doing this surgery before we preserve their fertility, be it oocyte cryopreservation or embryo cryopreservation. So I think it's a bit outside the scope of this talk, but I think the swing of the data now is that we should be doing fertility preservation before we do surgery for deeply infiltrated ovarian endometriosis. And that would fit with Gita's findings. A brief response. Thanks very much, Louise. Yeah, we're talking about unexplained infertility here, and my opening line was we need a history, but a detailed gynaecological ultrasound. I think it's important it's a really good ultrasound to exclude that, because the evidence around very minor endometriosis is not there. I agree with significant endometriosis, but that's not the subject of this discussion. But I do believe with very minimal endometriosis there is really no evidence for that. Janelle MacDonald from Sydney. I'm going to play devil's advocate here. So everyone is probably aware of the recent government inquiry about obstetric violence. I'm a little concerned that if we are perceived to be encouraging women to IVF first, are we guilty as a profession of performing fertility violence? That's just digressing a little bit, just thinking about how the consumers may perceive this. I think our patients want to have a baby, and that's why they come to see us, and that's what we help them to do through IVF. I'm not sure the microphone's working. And just introduce yourself. I'm from Sydney, Australia. Can I disagree with you, Roger, about that question about minimal and mild endometriosis? I'm 68, so I'm old enough to have read a whole lot of papers in the past that are probably seen as relics. But Mark Khoo published an unusual study, because it was actually an RCT. Well, sorry, not an RCT. It was a study whereby... Well, it was an RCT, and it was randomised really well. It was done in Canada, and there were about 350 subjects, and they were identified to have stage 1 or stage 2 endometriosis at laparoscopy. And the interesting thing is it was seen as an intervention which didn't greatly increase the chance of conception, but it doubled the monthly chance of conception. So there was clearly a difference between those patients who didn't have endometriosis and those that had stage 1 and stage 2 endometriosis. So the intervention did actually result in an improvement. One of the quotes was, well, I heard since then, well, it didn't make much difference. But when you realise that infertility is multifactorial, there were probably other factors involved as well. So any increase like that in stage 1 and stage 2 endometriosis sufferers was clearly beneficial for them. So I wouldn't disagree with you completely, but I do think you've got to take it on board that there is some evidence that surgical intervention can help. And certainly in those patients whereby the financial costs of IVF are still quite, even in Australia, astronomical. Many patients can get this through the public sector or the private sector treatment of their endometriosis laparoscopically very cheaply or at no cost. Thanks, Dr Persson. So you're right that there was also a counter-randomised controlled trial by the Grupo Italiano which was a counter to that. And actually did not show any benefit. But I believe the Marcu study demonstrated an excess of conception and with treatment of minima and endometriosis of about 4% per month for a few months. So absolutely, that shared decision-making. Personally, I wouldn't like a laparoscopy to give me an extra 4% chance of a natural conception for four months, which I think the data was. So basically, the basis to my statement that I said without going into great detail was a review article published by Samy Glarner recently in Reproductive Biology and Endocrinology. And their conclusions were what I basically said, that from looking at all the data, there is no real evidence of intervention for minor endometriosis. We're not talking about pain or significant diagnosed endometriosis on the outcomes of IVF, ovarian reserve, egg quality, embryo development, and euploidy rate. So that was the basis of my... I hate to disagree... I hate to agree with my opponents in a debate, but I'm going to... But there is actually a new network analysis by Rui Wang and some serious heavyweights in evidence-based medicine that pulls together the surgical studies. And the thing that made the most difference to this of mild and minimal endometriosis from a fertility point of view, not pain, is the use of oil-based uterine contrast. And I commend that paper to you, which fits with exactly what Roger is saying. Hi, my name's Lucy Prentice.  I work in Auckland. And I just wanted to point out the New Zealand perspective a little bit. Where we come from a country with very limited public funding for IVF. I'm currently running an RCT with Cindy Farquad directly looking at IVF versus IUI for unexplained infertility. And I'd just like to point out that both the ASRM and ESHRE guidelines, which are the most recent ones, both suggest that IUI should be a first-line treatment with oral ovarian stimulation. We have no evidence that IVF is superior based on an IPD meta-analysis published very recently and also a Cochrane review. And although we would love to be able to complete the family that our patients want from IVF and embryo banking, that option is really not available to a lot of people in New Zealand because of prohibitive costs. We know that IUI with ovarian stimulation is a very effective treatment for people with poor prognosis and unexplained infertility. And I also would just like to add that there's not a cost-effectiveness analysis that shows an improvement in cost-effectiveness for IVF. There's also never been a study looking at treatment tolerability between the two, so I don't think that you can say that IVF is a treatment that people prefer over IUI. So I may turn around and shoot myself in the foot based on our results that will be coming out next year, but I think at the moment I don't think you can say that IVF is better than IUI with ovarian stimulation for unexplained. We have time for two more questions from the audience, and we have two hands in the back. Now we can. It's the light green. OK. Hossam Zini from Melbourne. Thank you very much for the debate. It's very interesting. The problem is that all of the studies that have been done about comparing IUI to IVF, they are not head-to-head studies. The designs are different. They are having, like, algorithmic approach. For example, they compare three or four or five cycles of IUI to one cycle of IVF. But about 10 years ago, our group at the Royal Women's Hospital, we have done a study, a randomized control study, to compare IUI to IVF head-to-head, and we randomized the patients at the time of the trigger who only developed, so we did a low stimulation to get two to three follicles only, and that's why it was so hard to recruit lots of patients. So the criticism that was given to the study that it's a small sample size, but we end up with having IVF as a cost-effective treatment. Our IVF group had a live birth rate about 38%, and on the IUI, 12%. And with our cost calculations, we find out that the IVF is much more cost-effective than the IUI. But I believe that we all now believe in individualized kind of treatment, so patients probably who are younger than 34 years old probably wouldn't go straight to IVF. Maybe I'll do a laparoscopy and a histroscopy first, okay, and we may give them a chance to achieve a natural conception in the next three months or so. Patients who are older than 35, 37 years old probably will benefit straight from IVF. But again, in day-to-day life cases, we will not force the patient to go straight to IVF. I will talk to her and I'll tell her, these are your options, expectant treatment. This is the percentage that you would expect. IUI, this is what you expect. IUI with ovulation induction, this is what you expect. IVF, this is what you expect. And then she will discuss that with her partner and come back to me and tell me what she wants to do. Thanks. I saw a hand show up right next to you, so I'll add one more question given our time limitation. Thanks so much, Kate Stone-Mellon. I'd like to ask our panel to take themselves out of their role playing and put themselves in another role where they were the head of a very, very well-funded public service, and I'd like to ask the two sides what they really think about what they would do with a patient at the age of 35 with 12 months of unexplained infertility. Well, can I say that? Because that's my role in a different hat. LAUGHTER So, yeah, I run the state facility service in Western Australia. We looked at the data, because obviously that's what we're doing, IUI, IVF, and unfortunately we stopped doing IUI treatment. The success rate was so low. So we do go straight to IVF with unexplained infertility. Disappointing, as I'm sure you hear that, Kate, that we do. We looked at the data. Yeah, I think that I would still offer the patients the options, because some people don't want to do IVF. Even though it's completely free, they may not still want to do the injections and the procedure and take on the risks of the actual egg collection procedure. I don't know, religious issues with creating embryos. Yeah, I would still give patients the option. We have time for one more question in the back. We'll take the other ones offline afterwards. We'll get you a microphone just to make sure our listeners afterwards can listen. Following on from the New Zealand experience, which I've experienced... Hello? Yeah. From the New Zealand experience, and having worked here extensively and in New Zealand, you're not comparing apples with apples, Claire. That unexplained couple in New Zealand will wait five years to get funding and currently perhaps another two years to get any treatment. That's then an apples group compared to the pilot group who may, in fact, walk past the hospital and get treatment. The other thing about this, I think, that we need to forget, or don't forget, is the ethics of things here, two of which is that the whole understanding of unexplained infertility needs research and thinking. And if it wasn't for that understanding of what is the natural history of normal and then the understanding of pathology, we wouldn't do a lot of things in medicine. So if we have got a subgroup here that's unexplained, it's not just to the patient, we have a responsibility to future patients and ourselves to be honest and do research and learn about these factors. Now, it doesn't answer the debate, but it is something that's what drives the investigation and management of unexplained delay. And, for example, at the moment, there's quite a discussion about two issues of ethics, one about the involuntary childlessness of people that don't get to see us but don't have those children that they wanted to have because they didn't want to undergo treatment, or it was the involuntary childlessness of a second or subsequent child. And that's quite a big research issue in Europe, I realise, at the moment. And the final thing is about the information giving. The British case Montgomery 2015 has changed consent substantially, for those of you from England, that all information given to patients must include and document the discussion about expectant management versus all the different types of treatment, for and against and risks. And we're not currently doing that in IVF in this area, but if you read about what's happened in England, it's transformed consent in surgery. And I think a lot of our decision-making isn't in that way. So there are a couple of ethical principles to think about. Wonderful questions from the audience. Since we're coming up at the end of our time, we typically end the debate with closing remarks, but we'll forego that for this debate. And I'd actually like to just poll the audience. After hearing both the pro and the con side's arguments, by a show of hands, who in the audience believes that for the patient with unexplained infertility, as defined and detailed here broadly, should we be beginning with IVF? Should we be going straight to IVF? So by a show of hands. And I would say probably 50% of the room raised their hand. And those who think we should not be going straight to IVF? It feels like a little bit more. 40-60, now that I saw the other hands. Well, I'm going to call this a hung jury. I don't know that we have a definitive answer. Please join me in a round of applause for our panelists. In America, we would call that election interference. I wanted to thank our panelists, our live audience, and the listeners of the podcast. On behalf of Fertility and Sterility, thank you for the invitation to be here at your meeting and hosting this debate live from the Australian New Zealand Society for Reproductive Endocrinology meeting in Sydney, Australia. Thank you. This concludes our episode of Fertility and Sterility On Air, brought to you by the Fertility and Sterility family of journals in conjunction with the American Society for Reproductive Medicine. This podcast was developed by Fertility and Sterility and the American Society for Reproductive Medicine as an educational resource and service to its members and other practicing clinicians. While the podcast reflects the views of the authors and the hosts, it is not intended to be the only approved standard of living or to direct an exclusive course of treatment. The opinions expressed are those of the discussants and do not reflect Fertility and Sterility or the American Society for Reproductive Medicine.    

I'm joined by Mary Bruno, Creighton Practitioner, author, and fo-founder of FAbM Base, to discuss restorative reproductive medicine (RRM) in-vitro fertilization (IVF), and IUI from a personal perspective in her own fertility journey and her insights and training as a Creighton Pracitioner to many clients. We discuss various aspects of the process of navigating treatment options for infertility diagnoses and what it looks like to work with a practitioner or instructor to identify the workups and treatments necessary for healing and restoration of the reproductive system. This episode is part of an ongoing series of conversations I'm having with guests to explore varied aspects of IVF and RRM. GUEST BIO: Mary Bruno is a Catholic author and speaker, cofounder of the non-profit FAbM Base (fabmbase.org), and Creighton Practitioner who stumbled upon a vaginismus diagnosis nine long years after she was married. As a life-long practicing Catholic and ½ of a marriage prep mentor couple, it shocked her to discover how much she didn't know about sex and marriage and set off to gain wisdom and knowledge through the Catechism, conversations with other women, her pelvic floor physical therapist who specializes in sexual dysfunction, and her trauma-certified counselor to help prepare herself and you for healthy sexual intimacy throughout marriage. She has been married for 11 years and lives in Louisiana with her amazing husband and adorable daughter who they adopted the day she was born. SHOWNOTES: The Institute for Restorative Reproductive Medicine: https://www.iirrm.org A Comparison of Standard (ART) versus Restorative Reproductive Medicine (RRM) – The Institute for Restorative Reproductive Medicine by Dr. Whittaker: https://iirrm.org/grand-rounds-a-comparison-of-standard-art-versus-restorative-reproductive-medicine-rrm/ (Dr. Whittaker says in the course that a survey from the Cleveland Clinic found ~45% said they wanted additional surgical training during their fellowship) Processes of IVF, IUI, and more: https://my.clevelandclinic.org/health/treatments/22457-ivf Selective HSG vs. regular HSG and more restorative surgical techniques: https://naprotechnology.com/surgical/ Vivify Women's Health & Fertility (licensed in many states to provide telehealth for NaProTechnology): https://vivifyfertilityhealth.com/ External Resources for Fertility Awareness (scroll down for links to some trusted surgeons): https://fabmbase.org/resources/external-resources/#hfaq-post-703 SHOP MY AMAZON STOREFRONT: https://amzn.to/3MRxbTCDISCOUNT CODES: 20% OFF PROOV TEST STRIPS: https://proovtest.com/?wly=5789320% OFF YOUR FIRST OLIVE & JUNE MANI KIT: http://fbuy.me/v/bridgetbusackerbc10% OFF YOUR TEMPDROP: http://www.tempdrop.com/discount/managingyourfertility3 MONTHS FREE & 20% OFF YOUR HALLOW SUBSCRIPTION: hallow.com/managingyourfertility10% OFF YOUR ODER AT EMBER CO: https://www.theember.co/?ref=91010% OFF YOUR ORDER AT BE A HEART: beaheart.com/managingyourfertility10% OFF YOUR ORDER AT ABUNDANTLY YOURS: abundantlyyours.org/bridget 10% OFF YOUR MENTIONABLES ORDER: https://www.shopmentionables.com/?snowball=FERTILITY10&utm_source=snowball&utm_medium=affiliate-program&utm_campaign=FERTILITY10DISCLOSURE: This description may include affiliate links for products or services mentioned in the podcast. If you purchase products or services at these links I receive a small commission for the referral. I appreciate your support of my business!

Timestamps: 7:54 - From China to Mexico  16:20 - The plastics lobby 22:52 - Finding out your product already exists 36:33 - The Noriwear business model 43:04 - VC money or grants? Click here to apply to join our Founders Slack. About Jessica Farda: Jessica Farda is the co-founder and CEO of Noriware, a cleantech startup producing sustainable packaging materials based on seaweed. She holds a BA in International Affairs from HSG and founded her company in 2021, straight out of university.  The Noriwear idea came during a trip to Mexico, where Jessica for the first time found herself thinking more deeply about seaweed and its possible applications. Later on her research led her to discover plenty of interesting facts about this marine plant, such as that there are over 12'000 species of seaweed, that seaweed are divided into reds, greens and browns (which grow in different parts of the planet), and that some types of seaweed grow 1 meter per day without any need for freshwater, fertilizer or land. Further research then led Jessica to discover that polysaccharides can be extracted from seaweed, with which plastic granules can be made.  At first, it was difficult to be taken seriously in the biotech/cleantech world, considering her background was in business and international affairs — but Jessica persisted, speaking to research paper authors, ETH professors and just about anyone she could find, until she was serendipitously connected to a polymers engineer, Stefan, who later became her co-founder. Nowadays Noriwear produces Norifilm, a flexible packaging material that can be used for dry goods of any kind. It offers the texture and stability of a conventional plastic film, but differs in its durability and footprint on the environment. It also becomes entirely transparent when placed on an object, and after usage decomposes like a fruit, leaving no residual waste. While the Noriwear team plans to expand their technology to other applications in the packaging industry, their focus now is on reducing the waste generated by plastic cups and packaging films.  Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners.

This episode is all about how to survive your HSG. Otherwise known as a hysterosalpingogram. That's a big scary word so let's break it down! Hystero = uterus Salpingo = tube Gram = picture of Hysterosalpingogram (HSG) is basically a picture of your fallopian tubes. I prefer a gentle tube test with Exemfoam. I like to think of the fallopian tube as the embryo transport system. It's where the egg and sperm come together and it's how the embryo will travel to the uterus. Part of fertility screening is not just for FSH, estradiol, and AMH for women. It's not just to see how fast the swimmers are swimming. It's also important to make sure that the fallopian tubes are open! It's the “T” in the tushymethod.com In today's episode of The Egg Whisperer Show, I'm talking more about HSG.  Do you have questions about IVF?Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, August 19th, 2024 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom.   Read the full show notes on Dr. Aimee's website Subscribe to my YouTube channel for more fertility tips!  Subscribe to the newsletter to get updates Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org.

Timestamps: 1:55 - Leaving corporates for Anybotics 5:30 - Why LinkedIn matters for sales  10:34 - Best content form on LinkedIn 26:29 - The virality of videos on LinkedIn Click here to apply to join our Founders Slack. About Enzo Wälchli: Enzo Wälchli is the CCO at Anybotics, a company providing autonomous robotic inspection solutions, and LinkedIn's #1 Swiss voice in robotics. He holds an MA in Accounting and Finance from HSG and previously worked at Sulzer and Hilti Schweiz before joining Anybotics in 2021.  Enzo has 70K+ followers on LinkedIn, where he posts cool robotics content and also shares some insights into Anybotics' journey. He's firmly convinced that every salesperson should be using LinkedIn to connect with prospects. This doesn't mean that you need to go around shooting connection requests and sending cold messages — on the contrary, if you post interesting content consistently, prospects will come to you, which is of course a much better starting point for a sales discussion. Enzo thinks making it big on LinkedIn is relatively simple. Considering that the vast majority of LinkedIn users don't post anything but merely consume content, if you start posting, you're already one step ahead. And then you just need to keep posting, consistently, every day. It doesn't matter if at first you post low quality content, because any piece of online content gets forgotten after a week anyhow: it only matters that you stay consistent and improve over time. If you can find a niche topic like robotics, all the better. Enzo also recommends striking a balance between highly viral content (like cool robot videos) and actually meaningful content (such as his behind-the-scenes perspective on Anybotics). A viral post might have incredible stats, but it probably won't get people to follow you, whereas consistent meaningful content will.  Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners.

In this episode of the Egg Whisperer Show, which originally aired on the Fertility Docs Uncensored podcast (hosted by Dr. Abby Eblen, Dr. Susan Hudson, and Dr. Carrie Bedient). Dr. Aimee discusses the significance of checking fallopian tubes as a vital part of fertility evaluations.   The panel delves into the various methods used for tubal testing, including what Dr. Aimee likes to call the 'Gentle Tube Test' using ExEm Foam, HSG (hysterosalpingogram), and ultrasound using FemVue. The conversation covers the mechanics of how sperm and egg meet to conceive, the prevalence and implications of tubal blockages, and the importance of ensuring that fallopian tubes are open and functional.    Dr. Aimee also addresses common misconceptions and fears about these procedures, offering insights into how patients can best prepare and what to expect.   Find Dr. Aimee's website here: https://www.draimee.org/   Fertility Docs Uncensored podcast can be found here: https://www.fertilitydocsuncensored.com/episodes/   Do you have questions about IVF, and what to expect? Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, August 19th, 2024 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom.   Subscribe to my YouTube channel for more fertility tips! Join Egg Whisperer School Checkout the podcast Subscribe to the newsletter to get updates   Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org  where you can schedule a consultation.

Welchen Einfluss haben Schwankungen des Blutzuckers bei Diabetes Typ 1 auf die Vitlität der Nerven? Und wie beieinflussen Lebensgewohnheiten allenfalls die spätere Entwicklung der Krankheit? Eine Pilotstudie des Kinderspitals in St. Gallen und der HSG soll Antworten liefern. Weitere Themen: * Vor dem Jubiläums-Schwingfest in Appenzell sind sämtliche Hotelzimmer ausgebucht. Viele Private bieten Zimmer an * Erste Bilanz zum Unwetter in St. Moritz: Viel Sachschaden aber keine Verletzten * Brand in Bischofszell verursacht starken Rauch. Personen wurden nicht verletzt.

Dr. Natalie Crawford discusses testing your fertility and if and when it's something that you should do. She explains the different types of fertility testing including testing of ovarian reserve like AMH levels, anatomy like HSG tests of the fallopian tubes and uterus, and semen analysis for male partners. She also discusses how fertility and chances of pregnancy decline with age and the implications for family planning and choices around fertility preservation. Women should be informed about their fertility earlier so they can make the best decisions for their family goals and timeline. The episode aims to help women understand their bodies and fertility so they can advocate for themselves. Natalie answers your questions in FFS - For Fertility's Sake. 1.Is there any harm in taking COQ10 for males and females if we have been TTC for 9 months? 2.What is the likelihood that transferring a single embryo will result in twins? 3.Can primary ovarian failure lead to elevated cholesterol due to lack of estrogen? 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. 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

Timestamps: 1:17 - Why Matthias started BreezeLabs 4:01 - The Breezelabs team & being an ETH spin-off 6:21 - Dealing with indirect competition 7:25 - Handling the unknown as a founder 8:31 - Fundraising through the Swisspreneur Syndicate About Matthias Heuberger: Matthias Heuberger is the founder and CEO of BreezeLabs, a startup developing a new way to track sports performance. He holds an MA in International Affairs from HSG and previously worked for Zurich Insurance Company and CSS Versicherung before starting BreezeLabs in 2022. By using the built-in microphone in your headphones to record the audio signal during your runs, BreezeLabs delivers breathing rate tracking without any additional hardware. Their sophisticated AI models are capable of groundbreaking precision and accuracy in detecting breathing signals, which enables you to match your training plan precisely with the state of your body, thereby maximizing training efficiency and bringing you closer to achieving your ultimate performance goals. They're currently raising a maximum of CHF 500K through the Swisspreneur Syndicate. Check out our dealflow page to learn more about the deal.

Fallopian tube assessment is one of the most important evaluations during your fertility evaluation. There are several ways it can be done. 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,  and their guest, Dr. Aimee Eyavazzadeh, as they discuss tubal evaluation. Learn how your tubes are assessed with HSG (hysterosalpingogram), ultrasound using FemVue, and the new kid on the block ExEm Foam. Each test differs in important ways. Understand your choices. During this podcast, you will learn about the physiology of the fallopian tube and pathological changes that interfere with your ability to conceive. Tubal blockage occurs when the tube connects to the uterus and at the far end of the tube. Understand why the location of the blockage is important and what can be done to improve conception. You will not want to miss this episode. 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 

If you've struggled to get pregnant, grappled through multiple IVF cycles, experienced a loss, or delivered early, you know first hand that pregnancy is NOT always blissful. Unfortunately for some, the process of building a family can border on traumatic.  If this is the case for you or someone you know, the information and insights from Parijat Deshpande could shed some light on how to work through the anxiety that lives alongside infertility and high-risk pregnancy.  Parijat is founder of Ruvelle, bestselling author, speaker, and high-risk pregnancy consultant. In this episode of Baby or Bust, Dr. Lora Shahine dives deep with Parijat into anxiety before and during a high-risk pregnancy and learning how to calm your nervous system so you can move through the trauma that causes your anxiety. In this episode you'll hear: [3:30] Meet Parijat Deshpande - she's been through it all [8:15] An evolutionary benefit of anxiety in pregnancy  [10:41] Calming your nervous system when you're anxious Learning to acknowledge your feelings Recognizing what's going on in your body [15:19] Tips for “completing the threat cycle” (calming down) [21:33] Dr. Shahine answers a question from a YouTube listener about the HSG procedure [25:00] Learning more about somatic trauma work [30:04] Using somatic therapy to improve pregnancy outcomes [32:50] Parijat's business Ruvelle - support for high-risk pregnancy [35:56] Leaning into hope and ways to connect with Parijat Resources mentioned:  ruvelle.com IG - @healthy.highriskpregnancy Pregnancy Brain by Parijat Deshpande Delivering Miracles Podcast What Women Need to Know About Pregnancy Anxiety episode on Delivering Miracles Podcast Dr. Lora Shahine on Delivering Miracles Podcast | Episode 54 Dr. Lora Shahine on Delivering Miracles Podcast | Episode 69 Stay Up to Date in Fertility News and Events:  Weekly Newsletter Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books  

Dr. Natalie Crawford discusses why and when it may be time to do IVF. IVF allows us to profoundly change your body and it's environment. It's important to remember that the two things that predict IVF success are your ovarian reserve or number of eggs and your age. So timing plays a key role in this decision and it also comes down to why you are in this position. Natalie answers your questions in FFS-For Fertility's Sake I'm doing IVF and my body is not responding to the medications to stop me from ovulating. Is this common or normal? We are doing IVF to avoid passing on a genetic disease. We're not ready to start yet, but when should we start? We want four kids. Do I need an HSG after having an ectopic pregnancy treated with methotrexate? 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

Timestamps: 1:30 - Working for neon 10:22 - Why you should start investing 15:41 - Start investing with findependent 21:44 - Fee structure 36:26 - 5 principles for personal finance Click here to enjoy three months of NordPass Business for free by using the code “swisspreneur”.  About Matthias Bryner: Matthias Bryner is the founder of findependent, an app to make investing transparent, easy and beneficial for everyone, regardless of prior knowledge. He holds an MA in Banking and Finance from HSG and interned at Credit Suisse and at neon before starting findependent in 2018.  findependent allows you to open an account online within approx. 15 minutes, easily select an optimally-tailored investment solution and get started with as little as CHF 500. Thanks to their investment app, findependent users are always informed transparently about their investments, earnings and fees.  But first things first: why should you start investing? Basically, because of inflation and the compounding effect. Inflation rises at least 1% or 2% every year, which means that over the long run your savings will be significantly devalued. Similarly, if you start investing now, even if you invest only a little bit each year, this compounds over time and will make a significant difference in your life later on. findependent encourages its users to invest in ETFs, which is basically like buying a very small percentage of the world economy, instead of investing in a specific stock. This derisks your investment. And even if the numbers in the market fluctuate daily, their overall historical tendency is upwards, so you can rest assured that your money is being put to good use. findependent currently has 12'000 customers. Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners.

Timestamps: 1:25 - Starting a business with your twin 5:19 - The PetTech market  9:46 - From prototype to finished product 15:33 - Building a startup as a student 19:00 - Fundraising through the Swisspreneur Syndicate  Click here to apply to join our Founders Dinner in Bern on May 30th. About Oliver Widler & Denis Widler: Denis Widler is the co-founder and Head of Business Relations at Flappie, a startup building an AI-powered cat door with integrated prey detection. He holds a Master's degree in Business Innovation from HSG. Oliver Widler is Denis' twin brother and the co-founder and Head of Technology at Flappie. He holds a Master's degree in Mechanical Engineering from ETH.  Denis and Oliver started Flappie together in 2022 motivated by their personal experience growing up with furry friends who would bring “gifts” home. This got them thinking about a product that could prevent such unpleasant surprises, and with his engineering background Oliver devised a cat door which immediately recognizes when your cat tries to bring presents (e.g., mice, birds) into the house. Once recognized, the cat door locks automatically, and the cat (including the prey) stays outside until it returns with no prey. The Widler brothers think the time is ripe for their product, considering that ⅓ of households globally have cats and that 81% of Gen Z live with cats. It seems they've been proven right: their product has been featured in over 200 media outlets since inception.  They're currently raising CHF 1M in funds, 500K of which they already have in soft commitments, and 50K of which are being raised through the Swisspreneur Syndicate. Check out our deal flow page to learn more. Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners.

This Day in Legal History: Sirhan Sirhan ConvictedOn this day in legal history, April 17, 1969, Sirhan Sirhan was convicted of one of the most high-profile crimes of the 20th century—the assassination of Senator Robert F. Kennedy. Kennedy, a leading candidate for the Democratic nomination for President of the United States, was shot on June 5, 1968, at the Ambassador Hotel in Los Angeles, shortly after delivering his victory speech in the California primary elections. Sirhan, a 24-year-old Palestinian immigrant, was apprehended at the scene.The trial of Sirhan was a watershed moment in American legal and political history. It highlighted the growing tensions in the United States and the world over issues like the Vietnam War and the Middle East conflict. Sirhan's defense team attempted to argue diminished capacity, claiming that Sirhan was mentally unstable at the time of the shooting. They presented evidence suggesting that Sirhan was psychologically unable to cope with his intense feelings of anger and alienation, stemming primarily from his strong objections to Kennedy's pro-Israeli views.Despite these arguments, the jury found Sirhan guilty of first-degree murder, and he was sentenced to death. However, his sentence would not be carried out. In 1972, the Supreme Court of California effectively overturned the death penalty in the state, ruling it unconstitutional, which automatically commuted the death sentences of all death row inmates, including Sirhan, to life imprisonment.Sirhan's case continued to evoke debates about political violence, justice, and capital punishment. The commutation of his death sentence to life imprisonment came during a period of intense scrutiny and reevaluation of the death penalty in the United States, reflecting broader societal shifts. His continued imprisonment has been punctuated by numerous parole hearings, during which the severity of his crime is re-examined alongside his behavior and reform while in custody.Sirhan Sirhan's conviction and subsequent legal journey through the penal system serve as a grim reminder of the turbulent times during the late 1960s in the United States and represent a significant chapter in the nation's legal history. The assassination and the trial that followed had a lasting impact on American legal practices and the political landscape, highlighting the intersection of mental health issues and the criminal justice system.A recent legal battle ended with a $101 million jury verdict against Walmart Inc. in favor of London Luxury, a textile vendor. The verdict was reached in Arkansas, close to Walmart's headquarters, concerning a breached contract for over $500 million in personal protective equipment during the COVID-19 pandemic. The case was represented by the Manhattan litigation boutique Holwell Shuster & Goldberg (HSG), which took over after London Luxury parted ways with two larger law firms. This lawsuit received financial backing from Bench Walk Advisors, who invested over $5.1 million in the case among other suits.Walmart, represented by Jones Day and at least two other firms, has expressed disagreement with the jury's decision and is considering an appeal. The spokesperson from Walmart claimed that the verdict was not supported by evidence and emphasized the company's commitment to fair business practices.The litigation was originally filed in Westchester, New York, early 2022 but was moved to federal court in Fayetteville, Arkansas. The decision followed a 10-day jury trial. HSG, known for handling significant cases on contingency and alternative fee arrangements, benefitted from external funding which is becoming a common strategy among plaintiff-side lawyers to manage litigation costs.Litigation finance, a growing $15.2 billion industry, involves investors funding lawsuits in exchange for a portion of any financial awards. Bench Walk's investment in the Walmart case was aimed at covering trial costs, highlighting the evolving dynamics and risks associated with such financial strategies in litigation.Walmart's $101 Million Loss Is Win for Firm, Funder Behind SuitUS Senator Bob Menendez is set to present a defense strategy in his bribery trial that involves distancing himself from actions potentially taken by his wife, Nadine Menendez, according to newly unsealed court documents. The couple is accused of accepting various bribes, including cash, gold bars, and a car, in exchange for facilitating business and governmental interests. The documents reveal that Senator Menendez might testify that he was unaware of the true nature of the gifts, suggesting that his wife withheld information from him which led him to believe nothing unlawful was occurring.This defense strategy emerged during a legal request for separate trials for the senator and his wife, indicating a significant shift from their previously united front. The judge granted this request after Nadine Menendez needed to undergo surgery, leading to separate trial dates for the senator and his wife. The trial for Senator Menendez and two businessmen is set for May 6, while Nadine Menendez's trial is scheduled for July 8.The case also involves allegations that Senator Menendez acted as a foreign agent for Egypt, further complicating the charges against him. The decision to potentially expose confidential marital communications during the trial highlights the complex dynamics of the legal strategy and the personal stakes involved. The Menendez legal team's move to request separate trials underscores the challenges of defending a joint case while maintaining marital privileges and the strategic legal positioning that may influence the outcomes of their respective trials.Bob Menendez Poised to Blame His Wife in Bribery Case DefenseMichael Cohen, former attorney and fixer for Donald Trump, has shifted from a loyal supporter to a key witness in the first criminal trial of a U.S. president. The trial, which began recently in New York, revolves around allegations that Trump concealed payments made to the porn star Stormy Daniels to maintain her silence about a past sexual encounter. Cohen, who facilitated a $130,000 payment to Daniels prior to the 2016 election, claims Trump directed these actions. Trump has pleaded not guilty to the charges, dismissing the allegations and labeling Cohen a "serial liar."This is not Cohen's first testimony against Trump; he has previously testified in a civil fraud trial concerning the Trump Organization's asset valuations. In that trial, Cohen admitted to manipulating property values on Trump's directive, which resulted in Trump being ordered to pay $454 million in penalties and interest. Furthermore, Cohen's history includes a three-year prison sentence for this payment and other offenses, including tax fraud and lying under oath about the Trump Organization's Russian business dealings.Cohen's role in Trump's legal saga underscores a dramatic transformation from a close presidential confidant to an outspoken critic, a change catalyzed by federal investigations into his activities. Despite his controversial past, including admitting to lying during legal proceedings, Cohen's insights are central to the prosecution's case. His involvement illustrates the complex dynamics and potential risks in relying on testimony from figures with compromised credibility. The outcome of this trial could have significant legal and political ramifications, reflecting Cohen's intricate and troubled relationship with the former president.Trump's ex-fixer Michael Cohen to be key witness in hush money criminal trial | ReutersMy column this week discusses the importance and implications of introducing an open-source tax credit for software developers. Open-source software, valued at $8.8 trillion, is fundamental to both private and governmental technology systems. These projects often start as hobbyist pursuits by individual developers and require long-term maintenance from a broader community, which currently lacks sufficient incentives. The proposed tax credit would allow developers to deduct expenses related to their voluntary contributions to open-source projects, including a portion of the time they dedicate, aiming to motivate broader participation and enhance project oversight.The idea of such a tax credit is not new, having been previously proposed at the state level. However, economic reliance on open-source software has only increased, highlighted by incidents like the XZ security breach, which underscore the risks of exploiting these resources without adequate compensation to the contributors. The proposed tax credit, potentially worth up to $2,000, would recognize the contributions of developers by helping to offset their financial costs, thus encouraging more significant investment in the security and enhancement of open-source projects.The broader impact of the tax credit includes not only financial benefits for developers but also societal acknowledgment of the value of their contributions, akin to charitable efforts in other professional fields. This recognition could help alleviate financial barriers and align developers' interests with wider societal benefits, promoting a more robust and secure open-source software ecosystem.However, implementing such a credit faces challenges, particularly in quantifying individual contributions and valuing developers' labor. In the column I suggest using the mean hourly wage for software developers as a baseline for these calculations and stresses the importance of designing this policy with inputs from various stakeholders to mitigate risks like fraud.Modern tools like GitHub and GitLab provide traceable records of contributions, making it feasible to verify and quantify individual efforts within open-source projects. This proposed tax credit aims to correct a significant oversight in our technological infrastructure, incentivizing valuable contributions that enhance the security and viability of open-source software in an increasingly digital world.Open-Source Tax Credit Would Better Compensate Tech Developers Get full access to Minimum Competence - Daily Legal News Podcast at www.minimumcomp.com/subscribe

Timestamps: 3:50 - Being part of the Groupon story 13:05 - Getting a climate wake-up call 15:47 - From working for Shell to climate tech 17:46 - The problem Manoj is solving 20:19 - Pros and cons of hydrogen About S. Manoj Harasgama: S. Manoj Harasgama is a serial entrepreneur and startup investor. He's been the founder/MD at Treatwell, Unleash12, a venture capital company and JOIN.com, and is currently working on a stealth ClimateTech venture. He holds an MA in Accounting and Finance from HSG and an M.Sc. in International Management from CEMS (RSM & HSG) and has worked both at the HQ for corporates like Shell and Adidas as well as at well-known scaleups like usgang.ch and Groupon. Nowadays he's working on a climate venture that has yet to fully launch, which has developed a technology that is ready for market today and allows gas turbines to run on zero carbon fuels like hydrogen. Were their tech to be applied, a 100 megawatt turbine, today emitting up to 600'000 tons of CO2 every year, would eliminate emissions and emit zero CO2. This is particularly impactful considering that gas emissions make up around ⅓ of all fossil fuel emissions. Next to being a serial entrepreneur, Manoj also invests in promising early stage startups, and is a guest lecturer on Growth and Entrepreneurship at universities like the ESADE Lull University in Barcelona, the Technical University Munich and the Rotterdam School of Management.  Don't forget to give us a follow on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠,⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, so you can always stay up to date with our latest initiatives. That way, there's no excuse for missing out on live shows, weekly giveaways or founders' dinners.

Have you ever wondered why you need all of those tests? And why the timing of them is so important? Listen as the Fertility Docs, Dr. Carrie Bedient from the Fertlity Center of Las Vegas, Dr.Abby Eblen from Nashville Fertility Center, and Dr. Susan Hudson from Texas Fertility Center take a deep dive into the questions listeners have about fertility tests. These ladies will discuss the basic tubal assessment tests, like the saline sonogram and the hysterosalpingogram (HSG). You will hear about antimullerian hormone and the role it plays in treatment decision making. Tests more pertinent to in vitro fertilization are discussed such as the Reciptiva assay. The Reciptiva assay is a newer test that looks at an inflammatory marker in the endometrium and may be of interest if you have nad endometriosis in the past. Male partners are not left out. The Sperm QT has been available for a couple of years and may help determine if his swimmers have the right stuff.Check out this episode to hear about these tests. 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 Theralogix and Cicero Diagnostics and Needed

On today's episode, I'm going to talk about five things you should look into if you're experiencing fertility challenges. And some of these things may actually provide answers if you have been diagnosed with unexplained infertility. It's important to note that this episode is not meant to give any medical advice and it is not meant to override what your healthcare provider has diagnosed you with or has advised you to do, but it is something that may help uncover a lot of questions that you have. So, staytuned. In this episode I will go over: -Common ways to uncover hidden reasons for unexplained infertility. -Why your gut can be a key factorin your fertility health. -What type of doctor you should choose to get baseline tests Click here to save your spot in the Winter Cohort of The Wholesome Fertility Transformation! https://www.michelleoravitz.com/Fertility-Transformation-Group-Coaching Pick up your free e-book mentioned in the podcast here: https://www.michelleoravitz.com/making_the_clean_choice_for_fertility For more information about Michelle, visit www.michelleoravitz.com   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    Before I get to today's podcast episode, I have an exciting announcement to make. Over the past few months, I've been working very hard to create a program that gives you the main things you've been asking for. Hands on support for me, access to my proven foundational framework, and community and accountability. Most importantly, I've created this program to take you off the roller coaster of your fertility struggles and give you the tools to transform your fertility in just eight weeks.  I am honored to introduce you to The Wholesome Fertility Transformation.  A live eight week coaching program  designed to guide you through a proven, evidence based method of my signature program called The Wholesome Fertility Method. And that is the framework, but it will also provide hands on support with me to help you improve your chances of conceiving. So  I'll be running this program only four times a year, and each cohort is aligned with seasons, winter, spring, summer, and fall. Because each season only supports 10 people, it will have limited spots available. I will be putting a link on the episode notes that you can find it, and if you're interested, I would definitely do it as soon as possible because I am limiting the amount of people because I want to make it an intimate experience for all the participants so that I'm really able to help each individual. This program not only includes coaching calls, but it also has an initial onboarding call with me, which is a one on one. So it definitely. is catered to customize your specific needs and your specific questions. And I'm so excited to announce this. It is the first time ever that I'm doing this and it is open for a limited time. So if you are interested and you've been listening to this podcast , and you feel aligned with the things that I've been sharing, this will be that times a thousand so it really is my heart and soul poured into a program. It's also something where I will be there live with you to walk you through and help you to absolutely boost your chances of conceiving. And I work very hard to make sure that everybody I work with gets the most benefits and gets the outcome they signed up for. So I look forward to seeing you there!   [00:00:00] Welcome to the Wholesome Fertility Podcast. On today's episode, I'm going to talk about five things you should look into if you're experiencing fertility challenges. And some of these things may actually provide answers if you have been diagnosed with unexplained infertility. Now, this episode is not meant to give any medical advice and it is not meant to override. What your healthcare provider has diagnosed you with or has advised you to do, but it is something that may help uncover a lot of questions that you have. So, stay tuned. So the following five things I'm going to be talking about are things that I think can help uncover, especially if you have been diagnosed with unexplained infertility. Number one, I'm going to talk about testing. So hopefully you guys have already been tested, but this is something that sometimes I do get patients and they're experiencing fertility challenges and to my surprise, they [00:01:00] haven't gotten baseline tests, which can really help a lot. Especially just to rule out anything major. So number one, I do suggest that everybody get baseline tests with their doctors. And most of the time. Either your OB will cover these tests, and a lot of times they do. A reproductive endocrinologist is a better choice just because they specialize in reproductive medicine. And the OBs usually do understand a little bit, but they're not as well versed as a reproductive endocrinologist. And typically a reproductive endocrinologist will pay a little more attention to things like your thyroid and more anything really that has to do with fertility. So they are types of doctors that I recommend going to if you are experiencing fertility challenges, just because you're going to get a lot more of a [00:02:00] thorough workup. And some of these baseline tests they usually do are day two, three of your period. And typically blood is drawn during that time. And they check for lots of different hormones, but that's where they find out your FSH and how high it is. And if that means that your ovaries aren't responding as well. And then they also check typically a full thyroid panel. So basically it's a bunch of different hormones that give a lot of insight to the doctor to figure out what's going on. And again, this is a baseline and typically this is really where a lot of doctors will start. Another thing that they will recommend, and it is a little bit more of a procedure, but it's not terrible. It's not like they put you under, but an HSG to make sure that your tubes are clear. Again, it's a, bit of a procedure, it's not the most comfortable thing in the [00:03:00] world. But once it's over, typically, you should feel fine. And I do highly recommend doing that because You could look into everything and not figure out why things aren't working But then when you find out if your tubes are partially or fully blocked it's important for so many reasons because you need to know if that's the reason why you're not conceiving and then it can also lead you into Looking into other things like was there pelvic inflammation, or you can also look into possibly endometriosis, like what could it be that's possibly blocking your tubes? And that can kind of lead you into a whole host of other things, but things that are actually really important to look into. And also, if it's partially blocked, it can cause an increased chance of ectopic pregnancy, which is dangerous. And that's something that you really want to look into. So, those [00:04:00] are the reasons why I think it's really important to look into an HSG, because everything that you're doing, taking care of yourself, you can go to acupuncture, you could do lots of different natural ways of trying It's not going to make a difference if your tubes are blocked. So that's something that's really important to look into. Typically they'll also do an ultrasound and that's where they'll look at like your number of follicles and how they're growing. If there are too many, which typically you'll see with PCOS and they call it polycystic ovary. And the cysts are actually lots of follicles that are growing, but they're not fully maturing and not fully ovulating. So, that will also give you insight on which direction you should go into. And then also, let's not forget about the men, a semen analysis, and they also do ultrasounds, and they look into the sperm and how they're operating, if they're Shape is optimal, and that typically will be the morphology, the look at the number, [00:05:00] is it high enough to make a difference, and also the motility, how they move, and how much semen there is. Sometimes they can be dehydrated and not have enough seminal fluid. So all those things are definitely important to look at and then with an ultrasound They'll look to make sure that all the parts are okay and like with women they'll look at like the tubes and men Sometimes they'll see that there's a varicose cell, which is basically An enlarged vein that can cause issues with the sperm as well so it's important to really just get baselines for everybody and typically that will be covered with insurance and But that really, it depends on the office, it depends on the state, I don't know, like, or it depends on the type of insurance you have, but typically labs. Are covered by insurance and so that's number one. You really want to rule out like the big stuff and that is with mainstream medicine [00:06:00] conventional medicine baseline testing you want to make sure that You just rule out like all the big things. So that's number one I think everybody should be doing this regardless if you end up wanting to get IVF or not I think a lot of people get hesitant about going to a fertility clinic because they think That that means they're going to do IVF. They may suggest IVF. You don't have to say yes or no you could just go and get the tests One thing that I can say is they will know what they're doing as far as the testing goes So it is important to at least just gather information and they will be better to go to them for information when it comes to fertility Then your OB because your OB does a bunch of other things, but they're not specifically specialized in fertility You want somebody who's specialized and really understands what it means and what the body's supposed to do And what is out of whack and what are things that are like red flags to pay attention to? So that's something that I definitely [00:07:00] suggest Number two, connected to testing, but functional testing, so that's a little bit different. It's a little bit more detailed, so for example, the Dutch test, that's something that I run. It stands for Dried Urine Test for Comprehensive Hormones, and it really is an amazing test. I love it. And all you have to do is really urinate at a certain time of the month, and that basically, they'll have you urinate at different times of the day so that they can see how your hormones fluctuate. That's really why this test is so superior is because Usually when you go and get tests, it's one snapshot at one time of the day and this test will take those snapshots throughout the day throughout to see like what is your waking cortisol and are you waking up enough? Do you possibly have signs of adrenal fatigue and sometimes [00:08:00] even though we're not diagnosing, sometimes you will see patterns that typically happen with low thyroid, but what that could do is it can alert. The person that you're working with or, you know, as a practitioner to go and get further tests done with your doctor. And also we can look into progesterone. So perhaps you might need progesterone. It also looks into how your estrogen is metabolizing in your body. And if you're estrogen dominant, if you have the right type of estrogen, your, your body's really processing it correctly. It also looks at your melatonin at night, which is really important. It's important for many different reasons, and it also looks into your DHEA and confirms if you're ovulating. So there's so many things that it does, and it even looks into certain nutrients that you have in your body. Like glutathione or B12. So, do you need to supplement with [00:09:00] more glutathione? It gives the practitioner a little more detail and a little bit more guidance on how to treat you more specifically. So, I highly recommend the Dutch test at least once. to really get a clear picture of what's happening in your system. And then if it is imbalanced, I would definitely suggest doing it again after a couple of months of implementing certain diet and supplement regimens and lifestyle suggestions that your practitioner gives you. So that's definitely something that I would look into. So another thing that I highly suggest from functional testing is food sensitivity tests. Because that's going to help you understand if there are certain foods that are irritating your system. If you are sensitive to foods that can cause inflammation, it basically is going to drain your body because when your body is resistant to something and it's causing kind of like a hyper immunity, then it's going to drain the energy of your body. And we don't [00:10:00] want that. That's number one. Number two, if you do end up getting more inflamed, then you're not going to be able to absorb nutrients correctly. You want your nutrient absorption. to be as efficient as possible because you want your energy, which happens from nutrient absorption. You want your energy to be as efficient as possible because conception takes a lot of energy. High energy is required for reproduction to occur. So that is definitely something that I would highly recommend and I think is very important. So related to that, I would definitely recommend, if you can, gut testing as well. And that you could do at home from a functional test for gut. And typically, you'll get a small sample of the stool. It's not as bad as it seems. You just take a little like sample of your poop. While you're wiping and then you send it you put it in a little vial and you [00:11:00] send it in and what that does is they check your microbiome, and they can also look at factors that contribute to inflammation in the body and I've worked with people for months and then once we started to do, we've done a gut test. like months later, my patient decided she wanted to do it. Not everybody wants to do it because it is costly, but her choice to do it actually helped me as the practitioner to see, to get more insight on shifting our supplements. And I'll be honest, that was huge. It was a key factor and it really did change a lot because she ended up getting pregnant. Like shortly after so it definitely helped lower the inflammation. We got a little bit of a better Insight on what was going on in her gut and the guts really important when it comes to fertility health Something else I recommend. This is another test which is often [00:12:00] ignored or Maybe not even ignored people don't even know about it And that is vaginal microbiome testing. So, basically, it's a swab in the vagina and you basically send it in and it tests for the microbiome of the vagina. Like, basically, if also not just the microbiome but also the acidity. And what they found is that there is a correlation, which is fascinating, with inflammation in the uterus. and an imbalanced vaginal microbiome. And there's also a correlation between unexplained infertility and an imbalance of vaginal microbiome. And it's also linked with frequent miscarriages, and it's also linked with failed IVF transfers. So that is really, that was blew me away when I saw it. I remember going to Megasporobiotic, the company that makes it, it's [00:13:00] a probiotic that I highly recommend and the company that makes it, they're called Microbiome Labs, and I went one weekend and saw a bunch of speakers, one of which was Dr. Jolene Brighton, and she talked about this. She talked about the importance of vaginal microbiome, and I was floored because I couldn't believe it. I couldn't believe What it was connected to and all of the things, I mean, just to think that women are going through months and months and months and months and not even realizing that this is the case or if they're trying to prepare their body for a transfer and not realizing that they need to protect themselves and, and make sure that this is not an issue because they're spending so much money. So that was fascinating. And another thing that I found fascinating was once I started learning more about this and implementing it. I had one patient who was doing her retrieval and transfer in Spain, and so she already did the [00:14:00] retrieval. She had eggs, and she was going to go for her transfer in Spain. In Spain, it is commonplace to check the vaginal microbiome, and they actually always give vaginal suppositories, so that would be the solution if there is an issue, is vaginal suppositories that are probiotics. And that should start to regulate it. So she was getting ones from Spain. I was really fascinated. And interestingly enough, she ended up getting pregnant. So it was a successful transfer, but I thought it was so fascinating that that is something that is so ignored really in the US. So that's something that I started. to a lot of my patients who are having unexplained infertility, frequent miscarriages or any kind of imbalance that seems to point in that direction. So that's something that I definitely suggest looking into. And what these tests can do is provide more insight on what's going on, more clarity, [00:15:00] really, to understand. So you're not guessing, and you're not trying so many different things for so long, almost like a shot in the dark, without realizing, like, really what's going on. And the difference with functional testing, I mean, the, I guess the con is that they're out of pocket. They're not really covered by insurance, but they're a lot more sensitive to things that are often missed in conventional testing. So that I definitely recommend doing if you can. And then number three. Look into your energy. So I touched on this a little bit on the functional testing about energy and how important it is to have energy when it comes to conception. Conception is a very energy dependent process on your body and it needs a lot of fuel. A lot of fuel. And often times, We are having energy leaks that we [00:16:00] don't even realize are going on. And ask yourself, are you energy deficient? So, typically, if you feel especially after eating, you feel really drained, there might be something that you need to look into with your digestion. Or are you feeling drained at the end of the day? Are you getting enough sleep? Are you sleeping solid throughout the night? Or is it disrupted? It's not even about quantity, it's more about quality when it comes to sleep. Are there things or relationships that are draining you emotionally? I'll be honest, emotions are incredibly taxing if there are like certain negative emotions that you're feeling or sadness or frustration with certain relationships and sometimes you might need to really Make those boundaries firm so that you are not exposing yourself to things that are very energy draining Especially when you're going through this journey. So in this [00:17:00] journey, I always tell my patients my clients It's important to protect yourself. It's important to protect your personal energy and You shouldn't have to feel bad about it. So like if it means learning to say no, then that's what it means you have to learn to say no because ultimately, this is more important and it takes priority over everything and sometimes that means you have to draw firm boundaries around yourself and you're around your spouse and just really protect your own energy and not be around certain relationships or certain people or certain things that can drain that energy. So, it's really important to look into your energy and I highly suggest Even starting to journal could be like a little energy journal prompt looking into what is draining you Are there certain things that you feel like you're putting up with and just writing a [00:18:00] list and I remember doing that one time Because I had a coach that was telling me to do that Like what are the things that you are putting up with? I think that is such a great question What are things that you're putting up with because we all have things that we put up with and then just writing a list and then you can obviously Take out the ones that you can't not put up with. I mean, there's certain things that you just can't avoid. Okay. So that those are important things that you really can't escape, but then ask yourself, what are the things that you really don't need to be putting up with and how are ways that you can shut that down or close it off so that you won't have to put up with it? Because little by little, all that does is it really sheds light. on what it is in your life that's like sucking little bits of energy. So it could be little leaks. It doesn't have to be big. And I'll be honest, I'll give you one example, having a pile of clutter in the corner of your [00:19:00] room that you're like, you know, I'll get to this one day. living with that, every single time you see that clutter, it's going to leak a little bit of energy. So sometimes just taking that day out of your weekend and just saying, this is what I'm going to do. I'm going to actually take care of this list. I'm going to get rid of these things that have been hanging over my head. And that is a way to close an energy leak. Creating boundaries with people that drain you. That is another way. Setting boundaries at work, that's another way. I mean, there's little things. Expressing yourself for something that has not been expressed or you've been afraid to express. It might be uncomfortable, but that's another way that you can protect your energy. Because when you are holding onto something that you're not expressing and that needs to be said, That could be draining your energy. That's just like holding on to something that's like slowly brewing and sucking your energy. So forgiveness, that's another way of protecting your energy. Letting go of something, letting go of [00:20:00] certain resentments. I know it's very simplistic and it's not something that's going to happen overnight in certain cases, but these are things to just keep in mind because it's almost like a great example is like iPhone. All the things that are running in the background. Make it less energy efficient. It's not going to function as well So what are the things that are lying in the background of your life and they could be on all levels that are making you? Drained so those are things to keep in mind. Are you also over exercising and then I'm going to actually go into eating because that Definitely can impact if you're overeating that is not energy efficient if you're under eating that is not Energy efficient. So that takes us into number four, which is, are you eating enough or are you overeating? Are you eating what is good for your body? Are you eating energy rich foods? Are you eating processed foods, which are pretty much dead food in a package? [00:21:00] And yes, there are some freeze dried foods that are not so bad and they are made from whole foods. from real grown foods and they don't have tons of ingredients that you can't pronounce. So those are not so bad. They're kind of like in the middle, but are you eating things with lots of processing? Basically food that has no life or are you eating whole foods things that are nourishing your body? Things that your body's compatible with because it could be something that's grown that your body just doesn't respond well to. And that kind of takes us back. See, this is kind of everything's connected. It takes us back to the functional testing, the food sensitivities. Are you eating things that are right with your body? And truthfully, you can figure that out without necessarily having to do a test. Sometimes just writing a journal of how you feel when you eat certain foods, or even just paying attention. Like, you know what, whenever I eat dairy, I have diarrhea. Well, that can't be [00:22:00] good. So like things like that, like how does my body Feel. Do I get really bloated after I eat bread? I was bloated for years and years and years and I ignored that. And eventually I quit gluten and my energy shot up. So that's another thing. So like, are you eating the right foods? Are you eating a variety of foods? So the gut microbiome loves, again, we're making another connection. The gut microbiome loves variety. Trying to, you know, eating different things, eating different fibers, different like really the rainbow when it comes to your vegetables and your fruits and having healthy fats, having seeds, nuts, you know, things that feel good to your body and give you energy and also not overstuffing yourself because then your body can't absorb correctly your food. Are you taking time to chew when you are eating? When you're taking time to chew, you're helping your digestive system. You're pretty [00:23:00] much preparing it so that it's almost like that sous chef. You're the sous chef for your body's kitchen. And when you're chewing it, and properly chewing it, you're preparing it so that it's able to cook well and transform into nutrients that your body can use. So doing that plus obviously the chewing, but as you're chewing longer, you're also mixing in that amazing enzyme rich saliva. which is also helping your digestion. So those are things that are really important to do. Making sure that you have a really good proper diet that is nourishing for your body. And I'll be honest, the diet alone can make such a difference for fertility health. Just the diet alone. So, on to number five, and this is The last one, and it's a very important one, is your home clean of toxic ingredients? [00:24:00] And I'm going to mention something before I even go into this. Nobody's going to get it 100%. So don't try, because that can cause a whole other level of OCD that I've seen. However, it is important enough, and it really does make a difference, that It is important enough to bring up. There are many ways that Endocrine disruptors can come into our life and one of them which I see a lot is plastics If you can avoid all plastics and not just the ones that say BPA free Really try to avoid all plastics that being said if I'm away And I'm pretty because I know all of this stuff. It does make me a little OCD, I guess, but if I'm away and all I can have is a plastic bottle of water, I have a plastic bottle of water. It's not like you have to do things 100 percent all the time because you don't want to stress yourself out. It can be. too overwhelming. [00:25:00] But if you can, instead, at home at least, you can get yourself a container, a bottle that is glass or stainless steel, and then you can look into like green pan or like more non toxic I honestly, sometimes I'll just, green pan I'll have if I want to do something that's nonstick for certain foods, but for the most part, I will have stainless steel. I just cook with stainless steel. Those are great. There's a little trick to not making it stick. You can actually put the stainless steel. Pan on the fire or like the stovetop for a little while. You let it get to a certain level. One of the ways you can test is you could take a drop of water and put it in. If the drop of water creates a bead. You can wipe it off really quick, and then that is a perfect temperature. Then you can put the oil, and you can put even a chicken, and it will not stick. So the trick with that, with making it non stick, is to [00:26:00] let it heat, kind of like a fun fact, let it heat to a certain point. I actually remember seeing that online. You could find information, you can even Google on YouTube if you really want to see exactly how to do it. You Google or you search on YouTube how to make a stainless steel pan non stick. And so that is the simplest way to have clean products. Ceramics are good too, so you have to just be aware of that and then there are certain ones that have been tested with less, the ceramics as far as plates, not having lead because there have been tested products that have shown that they do. So those are things that you can look into. And then, ingredients for products. There's many ways. There's ewg. org. You know, there's certain ways that you can look it up so that it's not as overwhelming. There are definitely ingredients that can be endocrine disruptors [00:27:00] to make it simple so that it's not as overwhelming I actually created an e book so you could check that out I'm going to put it in the episode notes and it's called making the clean choice for fertility where I really outline Everything there. It'll also direct you to websites and resources where you can look up certain ingredients to see or products themselves to see what their rating is. So that's going to help a lot as well. So just to simplify it without getting into the details of unpronounceable words. That could be really overwhelming. Just check out my ebook cause it's free. It's got all the information and I will cover pretty much like the big ingredients to avoid and what to look for and how to make it really simple and easy. And the truth is once you do that, once you start to just. Change the ingredients of your products, then it's just going to get easier because you're just [00:28:00]reordering and then you just stay on one specific pattern. So it's not as hard as it seems. It becomes second nature, I promise. So those are the five things that I highly recommend looking into if you're trying to conceive. I think everybody should look into it and that is why I created this episode. I do hope you enjoy this episode and if you have any questions for me, you can always feel free to find me on Instagram. I'm there every day. You can DM me and my Instagram handle is at the wholesome lotus fertility. So thank you so much for tuning in today. Have a beautiful day.  

«Zukunft der sozialen Sicherung - Haben wir auf Sand gebaut?» war am 14. Dezember Thema einer Podiumsveranstaltung im Rahmen des 125-Jahr-Jubiläums der Universität St. Gallen. Das «Echo der Zeit» war als Medienpartnerin mit dabei. Die Aufzeichnung dieser Veranstaltung gibt es hier zum Nachhören. Teilnehmerinnen und Teilnehmer der Diskussion: * Prof. Dr. Martin Eling, Professor für Versicherungswirtschaft, Dekan der School of Finance, Universität St.Gallen * Matthias Müller, M.A. HSG in Law & Economics, Rechtsanwalt bei Homburger AG, Präsident Jungfreisinnige Schweiz, Mitglied Vorstand FDP Schweiz * Paul Rechsteiner, Rechtsanwalt, ehem. Ständerat, ehem. Präsident der Kommission für soziale Sicherheit und Gesundheit und ehem. Präsident des Schweizer Gewerkschaftsbunds * Hagr Arobei, Assessment-Studentin an der Universität St. Gallen und Vorstand Event- und Partnership Healthcare Club * Dr. habil. Rita Kesselring, Associate Professor of Urban Studies, School of Humanities and Social Sciences, Universität St. Gallen * Wolfgang Sunderkamper, Fachperson Information und Dokumentation, Bibliothek der Universität St. Gallen

In today's episode, our eloquent hosts discuss some intimate topics including fertility and infertility, and some not so intimate ones, such as Usher's Vegas concert series ant the Dolby live, and migraines.It's a fun wild one! Join the ride! 

This episode is all about how to survive your HSG. Otherwise known as a hysterosalpingogram. That's a big scary word so let's break it down! Hystero = uterus Salpingo = tube Gram = picture of Hysterosalpingogram (HSG) is basically a picture of your fallopian tubes. I like to think of the fallopian tube as the embryo transport system. It's where the egg and sperm come together and it's how the embryo will travel to the uterus. Part of fertility screening is not just for FSH, estradiol, and AMH for women. It's not just to see how fast the swimmers are swimming. It's also important to make sure that the fallopian tubes are open! It's the “T” in the tushymethod.com In today's episode of The Egg Whisperer Show, I'm talking more about HSG. Read the full show notes on Dr. Aimee's website   Do you have questions about IVF?Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, September 25th, 2023 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom. Subscribe to my YouTube channel for more fertility tips!  Subscribe to the newsletter to get updates Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org.

Ectopic pregnancies may be rare, but given how devastating and dangerous they can be, taking steps to prevent them is never a bad idea! For those worried about ectopic pregnancies, remember they generally amount to only 1-2 percent of pregnancies. For those who have had an ectopic pregnancy, that number may go up to 10 percent, but it's still unlikely. That said, it's understandable that those seeking to be pregnant want to ensure the safest, healthiest, and most viable pregnancy. Guest Dr. Amy Criniti suggests taking a look via tubal imaging, called an HSG. This procedure can give the doctor an idea of the status of the fallopian tube. Listen to our previous episode on uterine/tubal evaluation for more details:  Snack 6: The Camera Goes Where? Assessing the Uterus and Tubes  Additionally, an ultrasound can tell you which side you're going to ovulate on, so you can aim for trying to get pregnant when the egg is traveling on the side with a functioning, healthy fallopian tube. Patients may also opt for IVF, which has a lower (but still not zero) chance of resulting in an ectopic pregnancy. Quick quiz: True or False: ovulation switches sides each month, so if it's the left fallopian tube in January, it'll be the right one in February.  True or False: smokers have a higher chance of ectopic pregnancy. True or False: if you've had an ectopic pregnancy, there's nothing doctors can do to decrease the risk next time. True or False: a fallopian tube can be repaired and returned to full function after an ectopic pregnancy. True or False: having your “tubes tied” for contraception is an easy surgery to reverse. Listen up to hear the answers! If you've had an ectopic pregnancy and would like to share your story, we'd love to hear it. Please send us a message at thewholepineapple@gmail.com.  As always, please be sure to share this episode with anyone who can benefit, and please subscribe, rate, and review. You can find more information about our medical team at seattlefertility.com, and you can hear more episodes at thewholepineapple.com.

Dr. Natalie Crawford answers the voicemails you called in. Questions answered: I had an ectopic requiring methotrexate. Is it okay to TTC 2 weeks before the recommended 3 month mark? What are the risks? What can be the reason for Ureaplasma? Could it be contributing to infertility? Can a prior chlamydia infection lead to tubal factor infertility? When do you recommend an HSG? What are treatments or supplements for PCOS that may need more research but looks promising based on research that currently exists? Is it possible to have a long (34 days) cycle and ovulate early around cycle day eleven? Is it okay to fly the day of or after an FET? 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: Apostrophe- Get your first visit for only five dollars at Apostrophe.com/AAW or use the code AAW at checkout. Nutrisense- Visit nutrisense.io and use code AAW to save $30 and get 1 month of free dietitian support. Athena Club-Go to athenaclub.com and use code AAW for 25% off your first order. Mosie Baby -Go to try.mosiebaby.com/AsAWoman and use code ASAWOMAN for 15% off your order at checkout LMNT-Go to DrinkLMNT.com/AAW to receive a free sample pack with any purchase AG1-Go to drinkAG1.com/asawoman and get a FREE 1-year supply of Vitamin D AND 5 Free AG1 Travel Packs with your first purchase. Quince-go to Quince.com/aaw to get free shipping and 365-day returns on your next order. 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

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

Dr. Natalie Crawford discusses IVF and religion and explains the IVF process, options for modifications, and some things to think about. Many people have preconceived ideas of what IVF is and what it is not. This technology exists for you to have a family and it's important for you to understand the process before making a decision.  We have decided to move 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! Finally, Natalie answers your social media questions during her segment FFS—For Fertility's Sake. Is spotting 4 days before your period normal? What could it mean? What Is the best way I can support a friends starting IVF? Is an HSG painful? What are your thoughts on metformin for insulin resistance? At what point should a PCOS patient see a fertility doctor? 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 sponsor! Check out this deal just for you: Green Chef- Go to GreenChef.com/aaw60 and use code aaw60 to get 60% off plus free shipping. 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