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Leveling Up: Creating Everything From Nothing with Natalie Jill
Did you know that 50% of your hair disappears before you even notice it's thinning – AND – it might not just be because of hormones? Groundbreaking research reveals the real culprit: "zombie cells" accumulating in your scalp that literally sabotage your hair follicles from within. In this eye-opening conversation, Natalie sits down with Carolina, co-founder of OneSkin, to uncover the cellular science behind why traditional hair loss treatments often fall short—and why a revolutionary patented OS-01 peptide targets aging cells at the molecular level to rejuvenate both skin and scalp. You'll discover why your scalp ages just like your skin, what creates the perfect storm for hair loss, and the surprising truth about why natural solutions can actually outperform chemical treatments when they target the right mechanisms. Carolina shares the fascinating story behind their breakthrough discovery of the OS-01 peptide, which took years to develop after testing over 900 different compounds. Whether you're already noticing thinning or want to prevent it, this conversation will completely transform how you think about hair health and aging. Plus, Natalie shares her own 3-month experiment results that surprised even her—including why she almost gave up at 8 weeks and what changed her mind. Interested in trying OS-01 HAIR? Visit https://oneskin.co/NATALIEJILL and use code NATALIEJILL for 15% off. Note: The bottle shown in this episode is OneSkin's OS-01 HAIR refill bottle, which is meant to refill the primary bottle that customers receive when purchasing the product. For instructions on how to properly apply OS-01 HAIR, please visit oneskin.co/nataliejill Catch the full episode on YOUTUBE HERE: https://bit.ly/MidlifeConversationsYouTube Learn More About OneSkin: https://www.instagram.com/oneskin.co http://oneskin.co/NATALIEJILL Free Gifts for being a listener of Midlife Conversations! Mastering the Midlife Midsection Guide: https://theflatbellyguide.com/ Age Optimizing and Supplement Guide: https://ageoptimizer.com Thank you to our show sponsors! BIOPTIMIZERS: Get the digestive enzymes I take with every meal here https://www.bioptimizers.com/nataliejill Connect with me on social media! Instagram: www.Instagram.com/Nataliejllfit Facebook: www.Facebook.com/Nataliejillfit For advertising inquiries: https://www.category3.ca/ Disclaimer: Information provided in the Midlife Conversations podcast is for informational purposes only. This information is NOT intended as a substitute for the advice provided by your physician or other healthcare professional. Do not use the information provided in this podcast for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before making any changes to your current regimen. Information provided in this podcast and the use of any products or services related to this podcast does not create a client-patient relationship between you and the host of Midlife Conversations or you and any doctor or provider interviewed and featured on this show. Information and statements may have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent ANY disease. Advertising Disclosure: Some episodes of Midlife Conversations may be sponsored by products or services discussed during the show. The host may receive compensation for such advertisements or if you purchase products through affiliate links. Opinions expressed about products or services are those of the host and/or guests and do not necessarily reflect the views of any sponsor. Sponsorship does not imply endorsement of any product or service by healthcare professionals featured on this podcast.
Welkom bij de nieuwe mini-serie 'Yoga Nidra: Wat je niet leert in de les'. In deze serie neem ik je mee in de wereld van Yoga Nidra en gaan we de diepte in over thema's zoals het doceren van Yoga Nidra, de Yoga Nidra traditie en het trauma bewust doceren van Yoga Nidra. In deze eerste aflevering vertel ik je meer over mijn achtergrond in Yoga Nidra en de reis die ik als student en docent aflegde, en nog steeds maak, als het gaat over mijn kennis en ervaring met deze magische practice. Ik vertel je meer over de verschillende vormen en stromingen van Yoga Nidra en hoe ik deze benader en mijn eigen heb gemaakt. Ook ga ik dieper in op hoe ik Yoga Nidra door de jaren heen in mijn Yogalessen heb ingezet, en hoe ik daar nu naar kijk. Op vrijdag 3 oktober begint de Yoga Nidra Teacher Training 'Een Stevige Basis', waarin je in vier live dagen leert hoe je Yoga Nidra op een professionele en integere manier over brengt. Met veel liefde gedeeld door mij, Sanne Bogers, vanuit mijn fijne Yogaschool in Breda. Meer weten? Je vindt hier alle informatie over de Yoga Nidra Teacher Training. Geïnspireerd? Laat het ons weten! Schrijf een review, tag ons in jouw Pure Yoga moment op Instagram en wordt deel van onze online magazine community. Je kunt nu ook een reactie achterlaten op de podcast via Youtube en Spotify. Namasté! > Vind Sanne & Yoga Puur Breda op: - Instagram (@yoga_puur_breda) - Youtube (@yogapuurbreda) - Nieuwsbrief (abonneer je hier) - Website (yogapuurbreda.nl)
No episódio desta sexta-feira, o destaque é total para a vitória do Pacers contra os OKC e para o iminente jogo 7. Depois, falamos da venda dos Lakers e do que isso pode significar para a franquia e para a NBA
The wine industry contributes R56.5 billion to our economy annually, and for every one job produced on a wine farm, another 10 are created further down the value chain. In this episode CEO of SA Wine, Rico Basson and Victor dos Reis, a senior transactor in the Leverage Finance team at Investec discuss the industry's growth prospects, how exporters can mitigate US trade tariffs and how the future of the industry relies on it moving from a bulk to a value business. 00:00: Introduction – Industry insights and global opportunities 01:10: SA Wine's economic footprint – Beyond the glass 04:10: The multiplier effect – Careers across the wine economy 07:10: Wine tourism – Driving local growth 09:05: Expanding the experience – Attracting more tourists 10:43: The tariff threat – Challenges in the US market 14:40: Diversifying markets – Where to next? 15:43: Infrastructure matters and collaboration counts 19:27: Foreign investment – A global vote of confidence 21:40: What drives global investment in SA Wine? 23:32: Regional growth and new opportunities 24:58: Looking ahead – A 10-year vision for SA wine 26:58: A toast to progress and looking ahead Buy trophy winning wines · Investec Focus Radio SA
Transfermarkt hat die Marktwerte der 2. Bundesliga einem umfangreichen Update unterzogen und im Zuge dessen rund 500 Spieler angepasst. Erstmals wird beim Gesamtwert aller Klubs die Schallmauer von 600 Millionen Euro durchbrochen. Die größten Gewinner im deutschen Unterhaus sind der zum Club Brügge wechselnde Angreifer Nicolò Tresoldi, Fisnik Asllani und Ludovit Reis. Hier geht es zu allen neuen Marktwerten in der 2. Liga: https://tm.de/s/wu9 Hier geht es zur Marktwert-Definition: https://tm.de/s/oxm
O IBGE (Instituto Brasileiro de Geografia e Estatística) divulgou na sexta (6) os dados de religião do último Censo, feito em 2022. A expectativa era que o número de evangélicos disparasse, mas o crescimento da religião parece ter desacelerado. Já o catolicismo, mesmo recuando, segue predominante no Brasil. O levantamento também mostra a pluralidade religiosa no país, com aumento de adeptos das religiões de matriz africana e daqueles que se consideram sem religião. O Durma com Essa conversou com Lívia Reis, coordenadora do Instituto de Estudos da Religião e doutora em ciências sociais pela Universidade do Estado do Rio de Janeiro, para explicar o que move as escolhas religiosas dos brasileiros. Learn more about your ad choices. Visit megaphone.fm/adchoices
Die deutsche U21 gewinnt mit der zweiten Garde gegen England 2:1 und sichert sich den Gruppensieg. Leipzig-Stürmer Benjamin Sesko ist sich mit Arsenal über einen Wechsel einig, der Poker um die Ablöse hat begonnen. Außerdem sprechen wir über die Klub-WM und Ludovit Reis, der den HSV für eine Millionen-Ablöse Richtung Belgien verlässt.
Cuatro personas privadas de libertad murieron calcinados ayer debido a un incendio provocado por otros reclusos en la celda en la que convivían en el módulo 11 de la Unidad 4 B de la cárcel de Santiago Vázquez, el ex Comcar. Conversamos En Perspectiva con el doctor Juan Raúl Williman, abogado del sindicato de funcionarios carcelarios. El Ministerio del Interior informó que las víctimas fueron identificados como Luciano Flores dos Reis, de 23 años, Emanuel Alexander Porcincula Martínez, de 27 años, Yony Francisco Sosa Caballero, de 34 años, y Walter Javier Ocampo Ifraín, de 47. Además, hubo tres operadores penitenciarios que resultaron afectados por inhalación de monóxido de carbono. Desde la cartera se señaló que la tragedia fatal se produjo a raíz de un enfrentamiento que se dio previamente entre los reclusos que estaban alojados en celdas contiguas a la que terminó tomando fuego. Tras romper los candados, los dos grupos de hombrespelearon esgrimiendo cortes carcelarios. Al acudir la Policía a reprimir con “munición no letal y agentes químicos”, los presos enfrentados utilizaron colchones para frenar el avance de los operarios carcelarios. Uno de los grupos se replegó y se encerró en una de las celdas. Posteriormente, según relataron las autoridades policiales, el otro grupo tiró un pedazo de colchón quemado hacia adentro del espacio cerrado, lo que provocó que los otros colchones —producto altamente inflamables— también tomaran fuego y el foco se expandiera rápidamente. En total, además de las cuatro víctimas fatales, participaron del incidente otros nueve privados de libertad. El sindicato de operadores penitenciarios, que agrupa a los funcionarios civiles que trabajan en las cárceles, sostuvo que hay “falta de control del Estado” en el sector donde ocurrieron las muertes y señaló que, al momento de los hechos, había en el Módulo 11 cinco funcionarios para controlar a 700 reclusos.
No episódio desta terça-feira, o destaque vai para as duas vitórias de OKC nas finais, que deixa a equipa do Oeste a um triunfo do título. Olhamos ainda para a troca de Desmond Bane para os Magic e o que isso significa para o jogador e para as duas equipas. No final, abordamos a conquista da Liga Betclic por parte do Benfica e a seleção feminina.
From www.expatsportugal.comSign up at https://expatsportugal.com/join-us/ and quote 'GMP' for a 10% discountThis webinar is focused on *wills and estates* for expats in Portugal, covering important topics like *inheritance* rules and *asset protection**.The presenter explains key legal steps to help expats protect their assets and make informed decisions, including **healthcare directives* and understanding **power of attorney**. Whether you're considering a move to Portugal, already in the process, or living here now, estate planning and wills in Portugal are crucial but often overlooked. It's not always easy to think about, especially because it involves sensitive topics around the end of life and what happens afterwards. But delaying these decisions can create difficult and stressful situations for those you care about most, especially when foreign laws and procedures come into play. In this webinar, international lawyerAndreia Goncalves from Reis & Pellicano will cover key topics essential to understanding estate planning in Portugal.Become a supporter of this podcast: https://www.spreaker.com/podcast/the-good-morning-portugal-podcast-with-carl-munson--2903992/support.
Um Bom Dia Para Você! Todos os dias, às 06h30. Lindas mensagens de vida para o seu dia-a-dia, com Padre Dirceu Junior dos Reis.
Um Bom Dia Para Você! Todos os dias, às 06h30. Lindas mensagens de vida para o seu dia-a-dia, com Padre Dirceu Junior dos Reis.
Um Bom Dia Para Você! Todos os dias, às 06h30. Lindas mensagens de vida para o seu dia-a-dia, com Padre Dirceu Junior dos Reis.
Um Bom Dia Para Você! Todos os dias, às 06h30. Lindas mensagens de vida para o seu dia-a-dia, com Padre Dirceu Junior dos Reis.
Diviértete, aprende y conoce nuevos e interesantes temas en nuestro programa El ritual del viernes, Transmitido todos los viernes en punto de las 21:00 hrs. Con tu locutores favoritos Daniel dos Reis y Javier Hernández hoy platicamos sobre: Toc Toc, Club el juego de la sospecha my invitado Dr. Pedro Gomez
E no Performance S.A. deste mês vamos falar de corrida mas do ponto de vista de negócios. E ninguém melhor do que Marcos Paulo Reis, fundador e diretor técnico da MPR, para falar sobre este mercado. "Marcão" falou sobre o passado, presente e qual o futuro do negócio de assessoria esportiva no Brasil. A RN Investimentos é a patrocinadora do Performance S.A. Mais que especialistas em investimentos o objetivo maior da RN Investimentos é ressignificar a maneira como você interage com odinheiro, e apresentar um jeito muito mais leve e descomplicado de navegar pelo mercado financeiro. Conheça mais em https://rninvestimentos.com.br/
Juntem-se a este comboiinho da análise literária para conhecer melhor a obra sobre parir mães. Tudo começou dentro de um pequeno e aconhegante saco de carne e músculo e culminou num estúdio de danças latinas. E, sim, nunca mais vão olhar para um banana split da mesma forma.Poderão subscrever o nosso patreon para apoiar o projecto e conteúdo extra:https://www.patreon.com/jcdireitaReacts e vídeos exclusivos no youtube: https://youtube.com/@livrosdapicaInstagram: https://www.instagram.com/livrosdapica/twitter: https://twitter.com/livrosdapicaimagem: https://www.instagram.com/tiagom__/Genérico da autoria de Saint Mike: https://www.instagram.com/prod.saintmike/
https://youtu.be/QmLWBZ8QP-U11 DE JUNHO - QUARTARef.: 1 Reis 16.34
Um Bom Dia Para Você! Todos os dias, às 06h30. Lindas mensagens de vida para o seu dia-a-dia, com Padre Dirceu Junior dos Reis.
Whitney Tingle sits down with Carolina Reis Oliveira, PhD—co-founder and CEO of OneSkin—to explore the latest science on skin aging, the role of senescent "zombie" cells, and how what we put on our bodies can be just as important as what we put in them. With a PhD in stem cell biology and a mission to help people live healthier, longer lives, Carolina shares her groundbreaking work on peptides, how the skin functions as part of the immune system, and which lifestyle and nutrition habits truly move the needle for vibrant, resilient skin at every age. This conversation is a must-listen for anyone who wants to understand the connection between longevity and beauty from the inside out. Check out the video version on the Sakara Life YouTube channel here: https://youtu.be/k_bJgAKt7k4 Dr. Carolina shares: What skin aging really is and how it happens at the cellular level Why 90% of visible skin aging is not genetic The science of senescent cells (aka “zombie cells”) and how they accelerate aging Why your skin is a critical part of your immune system The role of antioxidants, both topically and through food, in protecting skin About Dr. Carolina: Carolina Reis Oliveira, PhD is the CEO and co-founder of OneSkin and an advocate for healthy aging. After earning her doctorate in immunology, she relocated from Brazil to Silicon Valley to pursue her goal of using science to help prevent age-related diseases. Under her leadership, OneSkin has made significant strides toward this mission, starting with their proprietary OS-01 peptide, the first peptide scientifically proven to reverse skin's biological age.
Living a Nutritious Life PodcastIn this episode of Living a Nutritious Life, we are thrilled to welcome Dr. Carolina Reis Oliveira, a bioscientist, stem cell researcher, and skincare innovator.About Our Guest: Dr. Carolina Reis Oliveira is the co-founder and CEO of OneSkin, a leading science-backed skincare brand. After earning her doctorate in immunology, she relocated from Brazil to Silicon Valley to pursue her goal of using science to help prevent age-related diseases. Full bio here. What You'll Learn in This Episode:- The groundbreaking science of how aging starts at the cellular level and why traditional skincare often misses the mark.- The real difference between quick-fix topical products and skincare that supports long-term skin health.- The powerful impact of lifestyle habits on your skin's biological age.- How midlife hormonal changes affect skin (and what you can do about it utilizing nutrition, hydration, and targeted products).Episode Highlights:- Discover Dr. Oliveira's fascinating journey from the stem cell lab to creating products that support healthy aging and longevity.- Learn how OneSkin's proprietary OS-01 peptide targets “zombie” senescent cells to improve skin health from the inside out.- Get practical advice on what exactly to eat, how to supplement using collagen, how to hydrate properly and what to put on your skin to support glowing, healthy skin.- Hear how a well-formulated skincare routine can translate to whole-body benefitsAbout Living a Nutritious Life Podcast: Welcome to the Living a Nutritious Life podcast with Keri Glassman, MS, RDN, CDN, where we break down the latest nutrition science into smart, actionable tips to help you live your most nutritious life.On the Living a Nutritious Life podcast, Keri and her world-renowned guests cut through the noise, sharing unparalleled, forward-thinking tips, tricks, and the latest in health, wellness, and nutrition science.Based on Keri's whole-person approach to healthy living, each impactful episode extends far beyond the simplistic “get more sleep” and “eat your greens” advice. She connects the dots like no one else – like how morning yoga can make it easier to choose a healthy lunch, leading to better sleep at night.Listen as Keri and her expert guests explore the physiological and behavioral connections that explain, for example, why the common wisdom around dieting and exercising alone doesn't work, so you can finally make the meaningful changes you've been looking for.If you found value in this episode, please RATE, REVIEW and SHARE.Join our amazing global community of like-minded students and alumni. Get in on the action—enroll in our Become a Nutrition Coach program at nutritiouslife.com/bnc. Keri has a lot to teach, and we're here to help you get started on your journey!Connect with Dr. Carolina Reis Oliveira: Instagram: https://www.instagram.com/carolreisoliveira/ OneSkin: https://www.oneskin.co/ OneSkin Clinical Research: https://www.oneskin.co/pages/scienceInterested in trying OneSkin for yourself? They've provided the Living a Nutritious Life audience with a 15% off discount! Visit oneskin.co/KERI and use code KERI for 15% off your first purchase.Connect with Keri on social: Instagram: https://www.instagram.com/nutritiouslifeofficial/ Website: https://nutritiouslife.com/ Become a Nutrition Coach: https://nutritiouslife.com/bnc/Copyright © 2023-2025 Nutritious Life.#LivingaNutritiousLife #NutritiousLife Hosted on Acast. See acast.com/privacy for more information.
Securitização dos produtores e demandas do setor.
Securitização dos produtores e demandas do setor.
Bom dia, graça e paz! Neste dia 10 de Junho de 2025, meditaremos em 1 Reis 8:38 Tenha um ótimo dia, Deus te abençoe. •E Acompanhe-nos pelas redes sociais:"Facebook & https://abrir.link/e8kDWInstagram € https://abrir.link/in4hmSala da Alma € https://abrir.link/5gjHkYouTube:Igreja Caminho da VerdadE
Um Bom Dia Para Você! Todos os dias, às 06h30. Lindas mensagens de vida para o seu dia-a-dia, com Padre Dirceu Junior dos Reis.
Join us on this episode of the Stang Stories podcast as Gustavo dos Reis sits down with Mr. Lamont Gordon '87, a proud Milton Academy alumnus and the executive director of College Visions. Reflecting on his years at Milton and beyond, Mr. Gordon shares the transformative experiences and leadership roles that shaped his path in education. From advocating for minority students to founding impactful programs at Brown University, his journey is a testament to the power of education and community. Discover how the values of confidence, diversity, and authenticity learned at Milton Academy guided him through his career and informed his work with organizations like the Posse Foundation. Mr. Gordon's story is a compelling narrative of dedication to making education accessible and equitable for all students. Gain insights into how Milton prepared him for success and the crucial mission he continues to pursue in the nonprofit sector.
Führung beginnt bei einem selbst – auch auf dem Teller! In dieser Folge spricht Corinna Pommerening mit Gesundheitscoach und Ernährungsexpertin Wiebke Satz über das, was uns im hektischen (Business-)Alltag oft fehlt: Energie, Fokus und Balance. Wiebke zeigt, warum gesunde Ernährung viel mehr ist als Kalorienzählen oder Diättrends. Sie spricht über das Essen unserer Großeltern, die Erkenntnisse aus den Blue Zones, das gesunde-Teller-Prinzip und das 80/20-Prinzip, das Genuss und Gesundheit auf entspannte Weise vereint. Wir gehen der Frage nach, warum Ernährung gerade heute – in Zeiten von Stress, Hybridarbeit und Reizüberflutung – ein echter Schlüssel zu nachhaltiger Leistungsfähigkeit und mentaler Stärke ist. Dazu gibt es viele praktische Tipps für alle, die viel leisten und trotzdem achtsam mit sich umgehen wollen. Freuen Sie sich auf eine Episode, die motiviert, die eigene Ernährung mit mehr Leichtigkeit und Klarheit neu zu denken – ohne Dogma, dafür mit Genuss und einem ganzheitlichen Blick auf Körper, Geist und Leadership.
Chris Zegers is acteur, presentator en zanger. Hij werd bekend door zijn rollen in series als ‘All Stars', ‘Van God Los' en ‘Onderweg naar Morgen'. Sinds 2001 presenteert hij reisprogramma's, waaronder ‘3 op Reis', waarmee hij zijn liefde voor reizen deelt met het publiek. Ook was hij te zien in films als ‘Alles is Familie', ‘De Hel van '63' en ‘Liever Verliefd', en speelde hij in de Amerikaanse film ‘Shaka Zulu'. Daarnaast maakte hij met het Noord Nederlands Orkest theatertours met muziek van Pink Floyd en The Beatles. Nu komt Zegers met het boek 'Geluksvogel', over zijn leven tot nu toe, waarin hij elke kans greep. Sommige kansen waren succesvol, andere niet. Het belangrijkste, vindt hij, was het avontuur dat hij eruit haalde. Femke van der Laan gaat met Chris Zegers in gesprek.
In this episode of the Longevity Optimization Podcast, Dr. Carolina Reis Oliveira, co-founder and CEO of OneSkin, shares her journey in stem cell biology and the development of innovative products focused on skin and hair health. With a PhD in immunology and a background in stem cell and tissue engineering, Dr. Carolina leads OneSkin's research and development efforts to create molecules that target cellular aging, including the groundbreaking OS-01 peptide.OneSkin is a biotechnology company founded in 2016 and based in Silicon Valley, focused on developing anti-aging skin and hair products. Under Dr. Carolina Reis Oliveira's leadership, OneSkin aims to delay the onset of age-related diseases by targeting cellular aging mechanisms. Their flagship innovation, the OS-01 peptide, is scientifically designed to reduce senescent cells, promoting skin and hair health at a molecular level. The company combines cutting-edge research with practical applications to create products that support longevity and wellness.Save On OneSkin Hair Here: oneskin.co/KAYLALet's be friends!Instagram: https://www.instagram.com/kaylabarnes/?hl=enTikTok: https://www.tiktok.com/@femalelongevityX: https://x.com/femalelongevityWebsite: https://kaylabarnes.comJoin Female Longevity Community: https://kayla-barnes-lentz.circle.so/checkout/become-a-memberFollow One Skin:Instagram: https://www.instagram.com/oneskin.co/?hl=enTikTok: https://www.tiktok.com/@oneskin.coTimestamps00:00 Introduction to Longevity and Skin Health02:50 Understanding Hair Biology and Growth Phases07:00 Root Causes of Hair Loss10:10 Addressing Hair Loss: Diagnosis and Treatments12:03 Current Hair Loss Products and Their Limitations17:12 Innovative Solutions: OS1 Hair Product Development20:51 Clinical Study Results and Efficacy of Hair Treatments24:22 Combining Therapies for Optimal Hair Health25:03 Scalp Care and Hair Washing Practices28:24 Understanding Scalp Health and Microbiome33:55 Preventative Measures for Hair Loss39:57 Innovative Approaches to Hair Thinning46:18 The Science Behind Peptides and Hair Care
Marco do Big Brother defende Matheus Reis
Leitura Bíblica Do Dia: Habacuque 3:11-19 Plano De Leitura Anual: 2 Crônicas 7–9; João 11:1-29 Já fez seu devocional hoje? Aproveite e marque um amigo para fazer junto com você! Confira: “Sei que o papai vai voltar pra casa; ele me mandou flores!”, disse minha irmã no seu aniversário de sete anos, quando nosso pai estava desaparecido por causa da guerra. Ele encomendara aquele buquê antes de viajar. Mas ela estava certa: o pai realmente voltou, após um combate perturbador. Décadas depois, minha irmã ainda guarda o vaso que recebeu com aquelas flores como um lembrete para manter a esperança. Nem sempre é fácil manter-se esperançoso num mundo falido e pecaminoso. Nem sempre acontece como queremos. Mas Deus traz esperança até nas circunstâncias mais difíceis. Em outros tempos de guerra, o profeta Habacuque predisse a invasão babilônica (1:6; 2 REIS 24); ainda assim, ele afirmou que Deus continuava sendo sempre bom (HABACUQUE 1:12-13). Lembrando da bondade divina para Seu povo no passado, ele proclamou: “Ainda que a figueira não floresça e não haja frutos nas videiras, ainda que a colheita de azeitonas não dê em nada e os campos fiquem vazios e improdutivos, ainda que os rebanhos morram nos campos e os currais fiquem vazios, mesmo assim me alegrarei no Senhor; exultarei no Deus de minha salvação!” (3:17-18). Alguns comentaristas afirmam que Habacuque significa apegar- -se. Apeguemo-nos a Deus como nossa sublime esperança e alegria, mesmo nas provações, porque Ele nos ampara e jamais nos abandonará. Por: JAMES BANKS
Hoje o Futeboteco recebe a atriz e apresentadora Sophia Reis para o episódio 228 do podcast Tomando Uma.REDES SOCIAIS:Instagram:https://www.instagram.com/futebotecotv/Twitter:https://twitter.com/FutebotecoTVFacebook:https://www.facebook.com/futebotecotvTikTok:https://www.tiktok.com/@futebotecotv?Kwai:https://www.kwai.com/@futebotecoTV------------------------------------------------------------APRESENTADORES:Rodolfo Gomeshttps://www.instagram.com/rodox_gomesFelipe Oliveirahttps://www.instagram.com/felipe_futebotecoPRODUÇÃO:João Rodrigueshttps://www.instagram.com/joaor_r
On this episode of The Wholesome Fertility Podcast, I am joined by Dr. Nirali Jain (eggspert_md), a board-certified OB/GYN and reproductive endocrinologist at Reproductive Medical Associates (RMA). Dr. Jain shares her expert insights on fertility preservation for individuals undergoing cancer treatment, a crucial yet often overlooked aspect of reproductive care. We explore what options are available for fertility preservation, including egg and sperm freezing, and why it's so important to initiate these discussions before starting chemotherapy or radiation. Dr. Jain also explains the difference between Letrozole and Clomid, the impact of estrogen-sensitive cancers on IVF treatments, and innovative approaches like random-start cycles and DuoStim protocols. Whether you're facing a cancer diagnosis or simply thinking proactively about your reproductive future, this conversation is filled with knowledge and reassurance. Key Takeaways: Why it's essential to discuss fertility before starting cancer treatment. The role of Letrozole in estrogen-sensitive cancers and fertility preservation. Differences between Letrozole and Clomid, and why Letrozole is often preferred. How new protocols like DuoStim and random-start cycles are improving outcomes. Why fertility preservation is important even for those without a cancer diagnosis. Guest Bio: Dr. Nirali Jain (@eggspert_md) is a board-certified OB/GYN and fertility specialist at Reproductive Medicine Associates (RMA) in Basking Ridge, New Jersey. She earned both her undergraduate degree in neurobiology (with a minor in dance!) and her medical degree from Northwestern University, before completing her residency at Weill Cornell/NYP, where she served as co-Chief Resident, and her fellowship in reproductive endocrinology and infertility at NYU Langone. Deeply passionate about women's health and fertility preservation, Dr. Jain blends the latest research and cutting-edge treatments with compassionate, patient-centered care. Her interests include third-party reproduction and oncofertility, and she is especially passionate about supporting patients navigating fertility preservation through a cancer diagnosis. Outside of the clinic, Dr. Jain is a trained dancer, a dedicated global traveler, and an adventurer working toward hiking all seven continents with her husband. Her diverse experiences, from international medical rotations to personal connections with friends and family navigating infertility, have shaped her into a warm, resourceful, and determined advocate for her patients. Links and Resources: Visit RMA websiteFollow Dr. Nirali Jain on Instagram For more information about Michelle, visit www.michelleoravitz.com To learn more about ancient wisdom and fertility, you can get Michelle's book at: https://www.michelleoravitz.com/thewayoffertility The Wholesome Fertility facebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/ Instagram: @thewholesomelotusfertility Facebook: https://www.facebook.com/thewholesomelotus/ Disclaimer: The information shared on this podcast is for educational and informational purposes only and is not intended as medical advice. Please consult with your healthcare provider before making any changes to your health or fertility care. -- Transcript: # TWF-Jain-Nirali (Video) [00:00:00] **Michelle Oravitz:** Welcome to the podcast Jain. **Dr. Nirali Jain:** Thanks so much for having me **Michelle Oravitz:** Yeah, so. **Michelle Oravitz:** I'm very excited to talk about this topic, which, um, actually you don't really hear a lot of people talking about, which is how to preserve your fertility if you're going through a cancer diagnosis and if you have to go through treatments. 'cause obviously that can impact a lot on fertility. **Michelle Oravitz:** I have, um, seen actually like a colleague of mine go through. And she also preserved her fertility and, and now she has a baby boy. so it's really nice. **Michelle Oravitz:** to **riverside_nirali_jain_raw-video-cfr_michelle_oravitz's _0181:** so nice. **Michelle Oravitz:** So I'd love for you first to introduce yourself and kind Of give us a background on how you got into this work. **Dr. Nirali Jain:** Of course. Um, so I am Dr. Narly Jane. I am, um, an OB GYN by training, and then I did an additional, after completing four years of residency in OB GYN and getting board certified in that, I did an additional training in reproductive endocrinology and [00:01:00] infertility or otherwise known as REI. So now I'm a fertility specialist. **Dr. Nirali Jain:** Um, I trained at Northwestern in Chicago, so I went to undergrad and medical school there. And then, um, home has always been New Jersey for me, so I moved back out east to New Jersey. Um, I did all my training actually in New York City at Cornell for residency and NYU for fellowship. Um, and then moved to the suburbs. **Dr. Nirali Jain:** Um, and now I'm a fertility specialist in, in Basking Ridge at Reproductive Medical Associates. **Michelle Oravitz:** Very impressive background. That's awesome. **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** I'd love to hear just really. About what your process is. If a person has been diagnosed with cancer, like what is the process? What are some of the things that you address if they are trying to preserve fertility, and what are some of the concerns going **Dr. Nirali Jain:** yeah, yeah. All great questions. So, you know, there's a lot of us, uh, the Reis. Are a very small, [00:02:00] there's a very small number of us. So in terms of specializing in fertility preservation, technically we all are certified to treat patients with cancer and kind of move them through fertility preservation before starting chemotherapy. **Michelle Oravitz:** Mm-hmm. **Dr. Nirali Jain:** Um, luckily we've been working closely with oncologists in the past several years just to establish some type of streamlined system because having a diagnosis of cancer and hearing all that information. Especially when you're young is so hard. So I think that's, that's where my interest started in terms of being able to speak to and counsel cancer patients. **Dr. Nirali Jain:** I think it is a very specific niche that you really have to be comfortable with in our field. Um, I. So I'll kind of walk you through, you know, what it, what does it look like, right? Um, you go into your oncologist's office suspecting that you have this, this lump. I'll take breast cancer, for example. It could really be any kind of cancer. **Dr. Nirali Jain:** Um, but breast cancer in a reproductive age patient or someone that's in those years where you're starting [00:03:00] to think about building a family, planning a family, um, or if you have kids at home, that's usually the type of patient that we see come in with a breast cancer diagnosis. So. Kinda just taking that, for example, um, the minute that you're diagnosed, it's really your oncologist's responsibility to counsel you on what treatment options are going to be offered to you. **Dr. Nirali Jain:** And then based off of the treatment options, it's important to know how that affects your reproduction. So how does it affect your ovaries in the short term, in the long term, um, in any way possible. So. Once a patient is initially referred from their oncologist to myself or any other fertility specialist, they come into my office and we just have a 30 minute conversation really talking about family planning goals. **Dr. Nirali Jain:** Any kids that they've had in the past either naturally conceived or through um, IVF, and then we talk about where they're at in their relationship. Are they married, are they not? Are they with a partner, [00:04:00] a male partner, a female partner, whatever it might be. It's important to know the social standpoint, um, especially in this sensitive phase of life. **Dr. Nirali Jain:** So patient patients usually spend anywhere from 30 minutes to an hour. Um, just kind of talking through where they're at, how they're feeling, what their ultimate childbearing goals are. And then from there we do an ultrasound and that's when I'm really able to see, you know, the, the reproductive status. **Dr. Nirali Jain:** So what do the ovaries look like? What does the uterus look like? Is there something that I need to be concerned about from a baseline GYN standpoint? Um, and all of those conversations are happening in real time. So. I think one of the things is patients come in and they're like, I'm already so overwhelmed with all this information from my oncologist, and now my fertility specialist is throwing all this information at me. **Dr. Nirali Jain:** Luckily, the way I like to frame it is you come in and you just let go. Like you let us do the work because in the background we're the ones talking to your oncologist. We're the [00:05:00] ones giving that feedback and creating a timeline with your oncologist. Um, and really I think just getting in the door is the hardest part. **Dr. Nirali Jain:** So once patients are here to see us, we go through the whole workup. We do anything that we would do for a normal patient that came in for fertility preservation. And then based off of where they're at in their journey, we talk about what makes sense for them, whether that means freezing embryos, freezing eggs, they're very similar in terms of the, the few weeks leading up to the egg retrievals. **Dr. Nirali Jain:** So I have that whole conversation just at the initial visit. And then from there we talk about the timeline behind the scenes and make sure that it works with their lives before moving forward. **Michelle Oravitz:** So for people listening to this, why, and this might be an obvious question, but to some it might not be, **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** why would somebody want to preserve. eggs or sperm. 'cause I've had actually some couples **Dr. Nirali Jain:** Yep. **Michelle Oravitz:** come to me where the husband preserved the sperm and they had to go through IVF just because he was going [00:06:00] through cancer treatments. So he had to preserve the sperm ahead of time. **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** people need to consider doing that before doing cancer treatments? **Dr. Nirali Jain:** So there are certain cancer treatments that do affect the ovaries and the sperm health, and you know, for men and women, it affects your reproductive organs. In a similar way, um, depending on the type of chemotherapeutic agent, there are some that are more dangerous in terms of, um, being toxic to your ovaries or toxic to your sperm. **Dr. Nirali Jain:** And those are the instances where we are really thinking about what's the long-term impact because there's medications that oncologists do give patients, and our oncologists are amazing, the ones that we work with, Memorial Sloan Kettering from Reproductive Medical Associates through RMA, um, and. **Dr. Nirali Jain:** They're just so good at what they do and are so well-trained, so they know in the back of their mind, is this going to impact your ovaries or your sperm health or not? Um, and I [00:07:00] think that any chemotherapy, you know, your ovaries are these, these small organs that are constantly turning over follicles every month. **Dr. Nirali Jain:** So every month we're losing those eggs, and if they don't become. If an egg isn't ovulated, it doesn't become a baby, it's just gonna die off. So I counsel even patients that don't have cancer, I counsel them on fertility preservation as young as possible. You know, between the ages of 28 and 35, that's like the best time to preserve your fertility. **Dr. Nirali Jain:** So in cancer patients, there's an extra level added to that where even if they are a little bit younger, a little bit older. Your eggs are not gonna be the same quality. There's gonna be higher level of chromosomal errors, more DNA breakage, um, and, and bigger issues that lead to issues with conceiving naturally afterwards. **Dr. Nirali Jain:** So I think that it's important to consider how that chemotherapy is going to affect them or how surgery would affect them if it was, for example, a GYN cancer where [00:08:00] we're removing a whole ovary, you know, what, what do we have to do to preserve your fertility in that case? And those are important conversations to have. **Michelle Oravitz:** Yeah. for sure. I know that a lot of people are also concerned, you know, with going through the IVF process, you're taking in a lot of estrogen, a lot of hormones, and many cancers are actually estrogen sensitive. So I wanted to talk to you about that. 'cause I know that the data shows that it's. It's been fine, which some people might find surprising, but I wanted you to address that and just kind of **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** from your perspective. **Dr. Nirali Jain:** That's so interesting that you asked that question because I actually, my whole I I graduated fellowship last year and my entire, like passion project in fellowship was looking at one of the drugs that we use to suppress the estrogen levels specifically in cancer patients. Um, and I had presented this at a few of our reproductive meetings. **Dr. Nirali Jain:** Um, A SRM is one of our annual meetings where all of the reiss get together. A lot of male fertility [00:09:00] specialists come and we kinda just talk about. Specific things and fertility preservation for cancer patients is, has been an ongoing topic of interest for all of us. Um, and it's important to know that there are different medications that we can offer. **Dr. Nirali Jain:** Letrozole is the one that I, um, have a particular love for and I, uh, you know, I use all the time for my patients, um, for different reasons, but it suppresses the exposure that your body has to estrogen. And there's mixed data, um, out there in terms of, you know, does Letrozole suppression actually impact, you know, does it help or. **Dr. Nirali Jain:** Or does it have no impact on your future risk of cancer after treatment? Um, and that honestly is still up for debate. But what we do know is that there's no increased risk of cancer recurrence in patients that have undergone fertility preservation with or without Letrozole. Um, Letrozole is one of those things that we can give, and the way it works is basically. **Dr. Nirali Jain:** It masks that [00:10:00] conversion. It, it doesn't allow for conversion from those androgens in the male hormones over to estrogen. Um, and so your body doesn't really see that estrogen exposure. It stays nice and low throughout your cycle, and it does help with actually ovarian maturation and getting mature eggs harvested and, um, helps a little bit with, with quality too. **Dr. Nirali Jain:** So I think that it's really nice in terms of having that available to us, but know that. It's not, it's not essential that you have it, really, the data showing plus minus. Um, but there are certain things that we can do to protect the ovaries, protect your exposure to estrogen. Um, and so that shouldn't be top of mind of concern when we're going through fertility preservation, even with an estrogen sensitive cancer. **Michelle Oravitz:** Actually, so, uh, on a different topic, kind of going back to that, so Letrozole versus Clomid, I, it's like a, the questions I personally feel just based on what I've heard and like my own research that Letrozole would be kind of like the more. [00:11:00] Um, the, it's, it's a little better, but I know that it really depends on the person as well. **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** they might do better with Clom, but I'd love to hear your perspective and kind of pick your brain on this. **Dr. Nirali Jain:** totally. You're choosing all the, all the right questions because these are all of my, my specific interests and niches. So **Michelle Oravitz:** Oh, **Dr. Nirali Jain:** Letrozole is basically, you know, we use Letrozole and Clomid in. Patients that don't have cancer and patients that come in for an intrauterine insemination, that's kind of the most common scenario where we're thinking about, you know, which medication is better? **Dr. Nirali Jain:** Letrozole or Clomid and Clomid used to be the, the most common medication that we use, we dose patients, you know, have 50 milligrams of Clomid, give them five days of the medication. It's an oral pill. Feels really easy and. The way it works is really, it recruits more than one follicle, so it really helps with the release of, um, more than one follicle growing more than one follicle in the ovary. **Dr. Nirali Jain:** Um, but it has a little bit [00:12:00] higher of a risk of twins because that's exactly what it's good at. Um, Clomid, not so much in the cancer. In the cancer front, it's not really used there because it's considered, from a scientific perspective, it's considered like a selective estrogen receptor modulator. So it doesn't necessarily suppress your estrogen levels in the same way that Letrozole does versus. **Dr. Nirali Jain:** Letrozole is an aromatase inhibitor, so it really blocks the chemical conversion of one drug or one hormone to the other hormone. Um, the reason we love Letrozole so much, and I don't mean to like gush over Letrozole, but um, it's a mono follicular agent, so it works really well at recruiting one follicle **Michelle Oravitz:** Mm-hmm. **Dr. Nirali Jain:** you know, every OB-GYN's nightmare in a way is having multiples when you didn't intend on having multiples at all. **Michelle Oravitz:** so **Dr. Nirali Jain:** Um. **Michelle Oravitz:** were saying that, um, there's more of a chance of twins, it's Clomid, not letrozole. **Dr. Nirali Jain:** Yes, there's a higher chance with Clomid versus Letrozole. And I mean, don't get me wrong, there's a chance of twins with [00:13:00] any type of assisted reproductive technology. Even when we're doing single embryo transfers, there's a chance that it's gonna split. So, um, the chance is always there just like it is in the natural world. **Dr. Nirali Jain:** But we know for a fact that. CLO is really good at recruiting many follicles. It's good for certain patients that don't respond well to Letrozole. Um, but Letrozole is kind of our, our go-to drug these days just because of all the benefits that we've seen. **Michelle Oravitz:** Awesome. **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** These are all fun things to ask because I, I love talking to our eis 'cause there's so much information that I'm always **Dr. Nirali Jain:** totally. **Michelle Oravitz:** learn a lot from my patients in my own research, but it's really cool. Picking your guys' brains. So another question I have, and I have actually talked to Dr. Andrea Elli, he's been on, **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** and he does a lot of endometriosis and, and immune related work as well, **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** so. I'd love to know just from your perspective. One thing that I do know from, based on what I've heard is that the, [00:14:00] guess like you were just saying, that breast cancer or estrogen sensitive breast cancer doesn't seem to be affected by IVF cycles, however, and endometriosis lesions do get affected. **Dr. Nirali Jain:** Yeah. **Dr. Nirali Jain:** that's a great question. So, you know, every, there are so many complex G mind diagnoses that the, that our patients come in with. Um, and endometriosis is a big one because there is clear data that endometriosis is linked to infertility. So we think about, you know, when a patient comes in with endometriosis, we really do think about the different treatment options and what are the short-term and long-term impacts of the hormones that we're giving 'em. **Dr. Nirali Jain:** Um, these days, again, kind of going back to Letrozole, we, letrozole is something that I give all of my endometriosis patients because it helps suppress their estrogen because we know. **Michelle Oravitz:** interesting. **Dr. Nirali Jain:** is very responsive to estrogen and leads to this dysfunctional regulation of all the endometrial tissue that can really flare in a, [00:15:00] in a cycle, or shortly after a cycle. **Dr. Nirali Jain:** I. So we really, for endometriosis patients, the, the best treatment is being on birth control because we don't see that hormonal fluctuation. The up and down of the estrogen and the progesterone, that's what leads to those flares. Um, so I really, I watch patients closely after their cycles too, because you definitely can have an endometriosis flare and we say the best treatment for endometriosis is pregnancy, right? **Dr. Nirali Jain:** That's when you're suppressed, that's when you're at your lowest. Um, and patients, my endo patients feel so good in pregnancy because they have. Hormones that are nice in that baseline, they're not getting periods of course. Um, and that's truly, truly the best treatment. **Michelle Oravitz:** That's interesting. **Dr. Nirali Jain:** But it is important to consider when you're going through infertility treatments. **Dr. Nirali Jain:** How does my endometriosis affect the short and long-term effects of the fertility medications? And really not to, not to say that they're bad in any way. I think a lot of endometriosis patients go through IVF and have success and do really, really well, and that's kind of the push that they need. [00:16:00] Um, but it's important to be mindful of the bigger picture here. **Dr. Nirali Jain:** It's not just, you're not just a number of. A patient with endo coming in, getting the same protocol. It's really individualized to the extent of your lesions, what symptoms you're having, what grade of endometriosis, where your lesions are. So we're the RAs are thinking about everything before we actually start your protocol. **Michelle Oravitz:** It's crazy how in depth it is, and it's, it, there's just so, it's so multifaceted, **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** when it's females **Dr. Nirali Jain:** totally. **Michelle Oravitz:** are a little, I mean, they can, you know, there, there's definitely a number of things, but it's not as complicated and interconnected **Dr. Nirali Jain:** Exactly. Exactly. That's so true. **Michelle Oravitz:** And so one question I actually have, this is kind of really off topic, but something that I was curious about. **Michelle Oravitz:** 'cause I heard about a while **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** a, a type of cancer treatment that was used. I'm not sure exactly what it was, but for some reason it actually caused follicles to grow, [00:17:00] or to multiply. And they were **Dr. Nirali Jain:** Interesting. **Michelle Oravitz:** this definitely. Puts, um, the whole idea of like a woman being born with all the follicles she'll ever have on its head, I thought that was really Interesting. **Michelle Oravitz:** Now I learned a little bit about it. I don't think it really went further than that, **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** one of those things that they're like, Hmm, this is interesting. I don't know, it was kind of a random side effect of this chemo drug. I dunno if it was a chemo drug or a cancer drug. **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** ever heard of that. **Michelle Oravitz:** So I was just **Dr. Nirali Jain:** I haven't, I mean, that's interesting. I feel like I'd have to look into that because that would be definitely a point of interest for a lot of Reis. But it kind of does go back to the point of, you know, women are really born with all the eggs we're ever gonna have. So it's about a million, and then it just goes down from there. **Dr. Nirali Jain:** And the, by the time you start having periods, I like to kind of show my patients a chart, but you have a couple hundred thousand eggs and you ovulate one egg a month. That's, you know. Able to [00:18:00] progress into a fertilized egg and then into a, an embryo into a baby, um, if that's your goal. But otherwise, patients that are having periods and not trying to actually get pregnant, we're losing hundreds of eggs a month. **Dr. Nirali Jain:** So. **Michelle Oravitz:** Mm. **Dr. Nirali Jain:** It's important to kind of think about that decline, and it's important to know that that rate can be faster in patients with cancer, patients with low ovarian reserve. And sometimes when you have the two compounded, that's when a fertility specialist is definitely, you know, in the queue to, to have a discussion with you in terms of what that means and how you can reach your family building goals despite being faced with that, with that challenge. **Michelle Oravitz:** Yeah. **Michelle Oravitz:** I mean, 'cause we know oxidative stress is one of the things that can cause, uh, **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** quality eggs, but it's also can cause cancer. **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** um, similar, you know, like things that really deplete the body could definitely impact. Um, and then what are your thoughts? I know I'm asking you all kinds of random questions, **Dr. Nirali Jain:** I love it. **Michelle Oravitz:** are your thoughts about doing low simulation in certain [00:19:00] circumstances versus high stem? **Michelle Oravitz:** Sometimes people don't respond as well to higher stems. **Dr. Nirali Jain:** Yeah, that's a great point. I think that it kind of all goes back to creating an individualized protocol. If. A patient's going to a practice and basically just getting a protocol saying, this is our standard. We start with our standard of, you know, I, I think about the standard, which is 300 of the FSH or that pen that you dial up, and then 150 units of that powder vial. **Dr. Nirali Jain:** And we have patients mixing powders all the time, and that's kind of our blanket protocol that we give patients. But that's not really what's happening behind the scenes. And if you're given a protocol that's, and being told, you know, this is kind of what we give to everyone, it's probably not the right fit for you. **Michelle Oravitz:** Yeah, I **Dr. Nirali Jain:** Um, there are certain patients that respond to a much lower dose and do really, really well, and then some patients that need a much higher dose. Um, and I think it's, that's kind of like the fun part of being an REI of being able to individualize the [00:20:00] protocol to the patient. Um, and I know for a fact there are so many, luckily, you know, we have so many leaders in REI that have been. **Dr. Nirali Jain:** Have dedicated their entire careers to researching these different protocols and how they can help different patients. Um, patients with lower a MH, you know, might benefit from a duo stim protocol, for example. That's kind of the first one that comes to mind, but a protocol where we're using those follicles from the second half of a cycle. **Dr. Nirali Jain:** I would've never thought that those were the follicles that **Michelle Oravitz:** Oh, **Dr. Nirali Jain:** would be better than the first half of the cycle, **Michelle Oravitz:** Wait, **Dr. Nirali Jain:** but, **Michelle Oravitz:** that. Explain that. Um, because I think that that's kind of a unique **Dr. Nirali Jain:** mm-hmm. **Michelle Oravitz:** that I haven't heard of. **Dr. Nirali Jain:** Yeah, so there's this new day. It's still kind of developing, but um, kind of going back to, you know, what's an individualized protocol? Duo STEM is one of the newer protocols that we've started using. I, I've used it once or twice in patients. Um, but it goes back to the research that shows that you might actually have two different periods of time in a menstrual cycle where you could potentially recruit [00:21:00] follicles. **Dr. Nirali Jain:** You could have a follicular phase where there's a certain cohort of follicles recruited, and then you have a follicle that forms creates a corpus glut. **Michelle Oravitz:** um, protocols **Dr. Nirali Jain:** Yep. And then you basically go through the follicular protocol and then a few days after a retrieval, instead of waiting for a new follicular cohort or follicular recruitment from the first half of your menstrual cycle, you actually use the luteal phase and you recruit those follicles that would've actually died off or have been prematurely recruited in a prior cycle. **Dr. Nirali Jain:** So **Michelle Oravitz:** that's So **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** you just do a similar, I guess, um, medicine, **Dr. Nirali Jain:** go right back into it. **Michelle Oravitz:** do the same exact thing, but right after ovulation. **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** Fascinating. That's really interesting. **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** has been your experience with that? **Dr. Nirali Jain:** I think it's, honestly, it's mixed. Um, so far, you know, our data from fertility and sterility and A SRM, it, it shows support for these DUO STEM [00:22:00] protocols, saying that if patients don't have that great quality of eggs or if they have a very low number, maybe they'd benefit from starting the meds earlier and recruiting follicles. **Dr. Nirali Jain:** A little bit earlier. Um, so we've seen positive results so far. A lot of work to be done in terms of really understanding it. Um, and of course, as a new attending, I have a lot more experience to kind of build on. Um, but I, I have seen success from it. **Michelle Oravitz:** That's fascinating. Are there any other new technologies, like new add-ons, um, that you've seen, that you've found to be really cool or interesting? **Dr. Nirali Jain:** I think the biggest thing, actually, kind of going back to our whole topic for today is fertility preservation cancer patients. One of the biggest things that I've learned recently is that we used to start fertility, um, patients. You know, only in the beginning of the cycle days, two or three is technically like when most. **Dr. Nirali Jain:** Most clinics, um, start patients, but for our cancer patients, sometimes you don't have that time. You don't wanna wait a full month to [00:23:00] restart, um, your, you know, your menstrual cycle and then do the fertility preservation and then delay chemotherapy a full month. So we started doing what we call random starts. **Dr. Nirali Jain:** So you basically start a patient whenever they come in. You know, it could be the day after your consultation, the day of your consultation. I've kind of seen all of the above. Um, and we've seen really good success with random starts, per se. Um, and we've been doing a lot more of that, where it's not as dependent on where you're at in your cycle. **Michelle Oravitz:** Mm-hmm. **Dr. Nirali Jain:** Um, obviously there's a difference in outcomes. You might not be a great candidate for it, so definitely it's worth talking to your doctor about it. But it kind of gives relief to our cancer patients where if you have a new cancer diagnosis and you're like, oh, I just finished my period, like, I can't even start a cycle until next month. **Dr. Nirali Jain:** That's not always true. Um, so it's always worth it to go into see a fertility specialist and just get, you know, get the data that you need right away, and then you can make a decision later on. **Michelle Oravitz:** For sure. Um, Yeah. **Michelle Oravitz:** and I wanted to kind of cover a lot of different topics 'cause I know that [00:24:00] some people are gonna wanna hear what you have to say that don't necessarily, or, uh, have cancer. But it is important. I, I think that, you know, if you get to thirties and you haven't gotten married or you don't have a partner, I think it's really important to preserve your fertility in general. **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** important thing. And then if you were going through a cancer diagnosis and you decided to preserve your fertility, um, guess more for women because they're eventually going to be thinking about transfers after they go through treatment. So what are some of the things that they would need to consider as far as that goes? **Michelle Oravitz:** Like after the **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** then they go through the cancer treatments. Um, and then what, how long should they **Dr. Nirali Jain:** yeah. Like what does it look like? So I've had patients that come back, you know, in my fellowship training I did a, a couple research projects on patients that came back to pursue an embryo transfer, um, after chemotherapy agent. And basically compared them to how they did, um, [00:25:00] compared to patients that didn't have cancer and just froze their embryos or froze their eggs and then came back to pursue a transfer and. **Dr. Nirali Jain:** I think the, the most reassuring thing from the preliminary data that we have is saying that there's no difference in pregnancy rates and no difference in life birth, **Michelle Oravitz:** Awesome. **Dr. Nirali Jain:** of whether they had chemotherapy or not. After freezing those eggs and going through fertility preservation. **Michelle Oravitz:** Amazing. **Dr. Nirali Jain:** Um, in terms of where your body needs to be, I think the oncologist, we, we wait for their green light. **Dr. Nirali Jain:** We wait for their signal to say, you know, she's safe to carry a pregnancy. **Michelle Oravitz:** Mm-hmm. **Dr. Nirali Jain:** And then once we do that, we basically treat you like any other patient. So if you're coming in for a cycle, if you're having periods, then it's reasonable to try a natural cycle protocol, wait for your body to naturally ovulate an egg. **Dr. Nirali Jain:** And instead of obviously hoping that egg will fertilize, we, um, use a corpus luteum. We use the progesterone from the corpus luteum to really support this embryo being implanted into the uterus. Um. Yeah. [00:26:00] And then there's also another side. I mean, some patients don't get their periods back and they always ask like, what if I never get my period back? **Dr. Nirali Jain:** What if I'm just like in menopause because of the chemotherapy agents? And for that, we can start you on a synthetic protocol or basically an estrogen dependent protocol where you take an estrogen pill for a certain number of days. We monitor your lining, then we start progesterone, um, to support your hormones from that perspective instead of relying on your ovaries to release the progesterone that they need, um, and then doing the embryo transfer a few, few days after progesterone starts. **Dr. Nirali Jain:** So there's definitely different protocols depending on where your menstrual health is at after the chemotherapy or after the cancer treatment. Um, but it's important to kind of just know that. That there's options. It doesn't mean that it's the end of the road if you all of a sudden stop getting your period. **Michelle Oravitz:** Yeah, for sure. I mean, 'cause you, technically speaking, you can really control a lot of that. More so for transfers **Dr. Nirali Jain:** Yep. **Michelle Oravitz:** Retrievals really is kind of like what [00:27:00] eggs you have, what the quality is. But people can be in complete menopause and you guys can still control their cycles for transfer, which is kind of. A huge difference **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** in the **Dr. Nirali Jain:** exactly. That's exactly right. Yeah. **Michelle Oravitz:** interesting. Any other, um, new, new things that you're, you guys are excited about? I always like to hear about like the new and upcoming things **Dr. Nirali Jain:** Of course. **Michelle Oravitz:** actually before, which I thought was fascinating. Yeah. **Dr. Nirali Jain:** I feel like there's always like updates and, and new data and things like that coming out, but just know, I think it's important for patients to know, like we're constantly, we're, the reason I chose to even pursue this field was because it's new. Right. There's something that we are discovering every day, every year, and that's what makes our, our conferences so important to attend, um, to really just stay up to date. **Dr. Nirali Jain:** Um, but we are, uh, constantly updating our embryology standards, the way we thaw our eggs, and the success rate associated with a thaw and [00:28:00] how we treat our embryos and the media that we use, right? Like, so we're really thinking about the basic science perspective every single day, and that's what makes this field so unique. **Michelle Oravitz:** It is really awesome. And so do you guys specialize specifically on, um. Egg freezing and, and I mean specific fertility preservation in patients that do that have cancer that are going through treatments, do you guys specialize specifically in that? I mean, I know you do range **Dr. Nirali Jain:** Yeah. Yeah, because it's such a small community, we all have our own niches and we all kind of have our own interests and **Michelle Oravitz:** Yeah. **Dr. Nirali Jain:** no like specific training. There are a couple courses that you take that I took in in training as well, just to kind of understand what it sounds like to, I. Council of fertility preservation, patient with and without cancer. **Dr. Nirali Jain:** Um, and then, you know, you kind of just learn by experience and you form a niche for something that you're passionate about. 'cause that's what makes you, you know, really thorough in, in your treatment. [00:29:00] So that's one of my interests. Um, and, but I would say, **Michelle Oravitz:** training for that. It's just like **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** just know how to treat that in **Dr. Nirali Jain:** exactly. **Michelle Oravitz:** especially if you're interested in doing that. **Dr. Nirali Jain:** Exactly. That's exactly right. It's kind of, it just comes with the experience comes with your mentors and who you're surrounded by, and everyone kind of helps each other get to that point. But there are several specialists in our practice at RMA that specialize specifically in fertility preservation in cancer patients. **Dr. Nirali Jain:** So we have a close communication with our oncologist and they know who to refer to within the practice because everyone has their own little interests. **Michelle Oravitz:** Amazing. **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** Um, definitely. I, like I said, I really enjoy picking your brain because it's a lot of fun for me. I, I do **Dr. Nirali Jain:** Totally. **Michelle Oravitz:** acupuncture, so **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** and I, I think that it's just so crazy that our fields don't work together. I mean, we kind of do, but I think, I just feel like it would be so great **Dr. Nirali Jain:** exactly.[00:30:00] **Michelle Oravitz:** the expertise because you guys have immense. Benefits like in, in, uh, technology and incredible innovations and, and then the natural aspect of really understanding the, the body. And I, I just think that it would work so amazing together if it was more of like a thing. 'cause it, I know in China they actually combine the two **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** eastern. **Dr. Nirali Jain:** Yeah, I mean I think that that's so important and there is data that shows, you know, there's actually a recent study that came out just a few weeks ago on the benefits of acupuncture for fertility patients. And we know that, I mean, I recommend it to all of my patients, specifically the day of the embryo transfer. **Dr. Nirali Jain:** We, luckily, we offer it on site at RMA and we have acupuncturists that come in and, and do a session before and after the embryo transfer, and I think. A lot of that is targeted towards stress relief. But I also think that holistically it's important to feel at your best when we're doing something that's so crucial to your, to your health. **Dr. Nirali Jain:** So to really focus on the diet, focus on stress relief, [00:31:00] focus on meditation, yoga, whatever it takes to get to your best wellbeing when you're going through fertility treatments, um, is so important. So I appreciate **Michelle Oravitz:** Mm-hmm. **Dr. Nirali Jain:** like you that really specialize in the other side of. Of this, because I do consider it still part of the holistic medicine that we need to really maximize success for our patients. **Michelle Oravitz:** Awesome. Well, **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** Jane, this is such a pleasure Of talking to you. You've given us some, so much great information and we've definitely dived into a, do a topic that I don't typically, I haven't yet spoken about. But, um, that being said, it's such an important topic to talk about. And thank you so much for coming on today. **Michelle Oravitz:** Oh, **Dr. Nirali Jain:** course. **Michelle Oravitz:** I get off, how can people find you? **Dr. Nirali Jain:** That's a great question. So I have, um, a social media page. I, it's called Expert nc. So like EGG, **Michelle Oravitz:** I **Dr. Nirali Jain:** um, expert nc. Try, tried to make it a little bit humorous. Um, but I'm all over social [00:32:00] media and would love to hear from anyone that is listening. I, you know, every, every day I get different, um, dms and I'm happy to respond. **Dr. Nirali Jain:** I love hearing about everyone else's. Stories and things like that. Um, so that is kind of my main, main social media platform. Um, and then through like RMA and Reproductive Medical Associates, we also have a YouTube channel. We have an Instagram page, um, of our office available, um, as well that is public. **Dr. Nirali Jain:** So you can find us pretty easily if you just kind of hit Google. But um, yeah, I'm kind of developing my social media platform as the expert and I hope it grows. **Michelle Oravitz:** Love it. Great. **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** was such a pleasure talking to you. Thank you. so much **Dr. Nirali Jain:** Thank you. **Michelle Oravitz:** today. **Dr. Nirali Jain:** Of course. Thank you so much for having me. [00:33:00]
Thanks for listening to the River in The Hills Church podcast. We hope you are encouraged and edified by this message brought to you by Ashton Reis, an elder at RITH.
Anexos al abecé de la música popular de Brasil en forma de compilaciones. Intervienen: Joâo da Bahiana, Mário Reis, Aracy Cortes, Patrício Texeira, Almirante con Bando de Tangarás, Noel Rosa, Francisco Alves & Mário Reis, Ismael Silva, Lamartine Babo & Mário Reis, Os Cinco Crioulos, Lúcio Alves, Sílvio Caldas, Carmen Miranda, Carlos Cachaça y Maria Bethânia.Escuchar audio
In dieser Folge von HSV – Meine Frau nehmen wir euch mit auf eine Reise durch die Höhen und Tiefen der vergangenen Saison. Muchel berichtet von seinen Eindrücken beim DFB-Pokalfinale und erklärt, warum solche Erlebnisse jeden Spieler motivieren sollten. Wir analysieren die Leistungen der Spieler: Wer hat sich für die Bundesliga empfohlen? Wer könnte es schwer haben? Und wer war die Überraschung der Saison? Außerdem werfen wir einen Blick auf aktuelle Transfergerüchte und diskutieren die möglichen Veränderungen im Kader. Ein weiteres Thema ist die abgelehnte Kandidatur von Felix Magath für das Amt des HSV-Präsidenten. Wir beleuchten ein paar Hintergründe und die Reaktionen innerhalb des Vereins. Jetzt reinhören und mit uns die Saison Revue passieren lassen!
Se você tivesse a oportunidade de estar com uma pessoa que resolveria seu problema, você não iria atrás dela? A verdade é que quem serve a Deus também vive o dia mal. A mulher de 2 Reis 4:1-7 estava com uma dívida e buscou ao homem de Deus, e a resposta de Elizeu a isso foi: O que eu posso fazer por você? Talvez você se encontre na mesma situação de dívida. Hoje, Deus quer pagar sua dívida. Mas a chave para isso é a segunda pergunta que foi: O que você tem em casa? A verdade é que a resposta para sua questão talvez já esteja dentro de você, mas é preciso sair da zona de conforto para alcançar a vitória. Busque vasilhas! O azeite virá, mas você precisa estar pronto e disponível para que Deus realize o milagre.
IVIRMA is so big, they had 1,400 people just at their international congress. But what does it take to implement change, scale care, and keep the patient experience high inside an organization that large?This week's guest, Dr. Thomas Molinaro, Chief Medical Officer of IVIRMA North America, shares what's working, what's still being figured out, and what challenges fertility networks of every size should be preparing for.Tune in to hear about:The AI solution they're using to save REI time (and how it's going so far)What they've learned from piloting patient journey platformsTheir APP-to-REI ratio and how they approach shared workflowsThe evolving debate over who performs ultrasounds (REIs or sonographers?)The marketing on behalf of REIs before the patient walks in that is critical to careIf you're curious about the operational future of large fertility networks—or want a blueprint for scaling thoughtfully—don't miss this episode with Dr. Molinaro.
O tema deste podcast é “A Vila dos Trabalhadores do Vale dos Reis – Deir el-Medina ” com o Prof. Dr. Moacir Elias Santos. O Vale dos Reis é a região onde foram construídas as tumbas dos faraós que governaram o Egito durante o Reino Novo. Ao observar as tumbas faraônicas, nota-se que foram realizadas por uma mão de obra especializada. O Prof. Dr. Moacir Elias Santos conversou conosco sobre a vila de Deir el-Medina, organizada para abrigar os trabalhadores que construíram as tumbas do Vale dos Reis. Quem eram essas pessoas, como estavam organizadas e como era o seu cotidiano foram algumas das questões abordadas nesta entrevista.
Erschaffe die beste Version von dir: Ernährung, Fitness, Gesundheit, Entspannung, Abnehmen
Brot, Reis, Nudel? Oder doch Fleisch?
18.05.2025 - Mensagem do Culto Matutino ao vivo da Igreja Presbiteriana de Anápolis com Rev. Samuel Vieira. Texto Bíblico: 1 Reis 17.1-24 Tema: Os mistérios de Deus
OB/GYNs are entering the IVF space—but what role should they play?This debate is heating up in fertility medicine, and Dr. Stephanie Kuku, a former OB/GYN surgeon in the NHS and now Chief Knowledge Officer at Conceivable Life Sciences, offers her global, tech-forward perspectiveIn this episode, she talks through:What REIs and OB/GYNs really need from each otherWhere the line is on fertility care qualificationsWhat REI oversight could look like in different countriesHow new tech may expand REI roles (not replace them)How Conceivable is building collaborative care models (including their current 100-patient IRB study)The field is changing. How will REIs lead the way forward?
Por Pr. Miquéias Lima. | 2 Reis 5:1-19 | https://bbcst.net/R9269N
Musk by Alyssa Ashley (1969) + Miloš Forman's Hair (1979) + Jacques Levy's Oh! Calcutta! (1972) + Brian DePalma's Hi, Mom! (1970) with Samuel Reis 5/16/25 S7E32 To hear the complete continuing story of The Perfume Nationalist please subscribe on Patreon.
Quem são os maiores astros do cinema de ação? Hoje julgamos todos eles por sua fama e pelo impacto de seus filmes. Quem será uma lenda?Quem ficará como coadjuvante? Quem você acha que foi injustiçado? Veja também as dicas de lançamentos de séries, livros e filmes, tudo nessa edição de Café Antagonista #63Café Antagonista 2025 é o seu ponto de encontro semanal para ficar bem informado. Apresentado por José Inácio Pilar, o programa vai ao ar todos os sábados, às 10h e 16h, trazendo uma análise inteligente dos principais acontecimentos do Brasil e do mundo. Com um jornalismo independente e sem amarras, debate política, economia, notícias e bastidores exclusivos com um olhar crítico e direto. Inscreva-se no canal para não perder nenhuma edição do Café Antagonista 2025! #caféantagonista Não espere mais, assine agora e garanta 2 anos com 30% OFF - últimos dias. 2 anos de assinatura do combo O Antagonista e Crusoé com um super desconto de 30% adicional* utilizando o voucher 10A-PROMO30 Use o cupom 10A-PROMO30 e assine agora: café-antagonista (https://bit.ly/promo2anos-cafe) (*) desconto de 30% aplicado sobre os valores promocionais vigentes do Combo anual | Promoções não cumulativas com outras campanhas vigentes. | **Promoção válida só até o dia 31/05
Außerdem: Aufgewärmter Reis - Warum er gefährlich und gesund sein kann (06:25) // Habt Ihr Feedback, Anregungen oder Fragen, die wir wissenschaftlich einordnen sollen? Dann meldet Euch über Whatsapp oder Signal unter 0162 344 86 48 oder per Mail: quarksdaily@wdr.de. Von Sebastian Sonntag.
A medicina passou por inúmeras transformações ao longo dos anos – desde avanços tecnológicos até mudanças na relação entre médicos e pacientes. Mas, no centro da profissão, continua um pilar essencial: o cuidado.Neste episódio, Drauzio Varella recebe o dr. Rogério Reis, vice-presidente dos Hospitais Rede Américas, e o dr. Gustavo Fernandes, vice-presidente da Oncologia Américas, para uma conversa sobre os desafios da profissão médica.Vamos explorar a realidade da rotina médica: como é, de fato, o dia a dia de um médico? Quais são os principais desafios da profissão? Quais dilemas e pressões esses profissionais enfrentam? E como as novas tecnologias estão transformando a prática médica e a rotina hospitalar?Assista!Conteúdo produzido em parceria com Rede Américas.Veja também: Qual é o papel da enfermagem?
Send us a textEp 275 Wilson Reis BEFORE the UFC Wilson Reis came to us through a legendary team consisting of Macaco & Godoi; Reis witnessed the split between the two master coaches. We talk about the highs, the lows and the controversy between Godoi and MacacoSpecial Thank You to Matt Giancarlo for sitting in and lining this up Ep 275 Wilson Reis BEFORE the UFC 0:00 plugs/ promotions 0:42 Lytes out intro 1:14 guest introduction1:42 interview start 2:13 American jiu jitsu vs Brazilian Jiu Jitsu 2:59 making adjustments training in the US6:58 4 toughest American grapplers 9:19 beginnings in Jiu Jitsu 11:27 finding Acadamia de Macaco14:15 fallout between Macaco and Godoi 19:43 Macaco and Godoi black belt ceremony 21:16 choosing to stay with Godoi after split 25:24 experience with Charles Oliveira 27:26 plugs/ promotions 28:32 becoming a world champion at brown belt 29:50 rumor of switching to Gracie Barra 31:11 motivation for moving to the United States 32:53 relationship with Lloyd Irvin34:18 Wilson Reis vs Baba Shigeyasu36:26 Wilson Reis vs Justin Robbins37:58 Wilson Reis vs Bryan Caraway41:44 Elite XC financial issues 43:07 Wilson Reis vs Abel Cullum45:29 training with Eddie Alvarez 46:50 managed by Matt Stansell in Bellator 50:28 experience at Bellator 2 51:27 hanging out with Hector Lombard 53:13 thoughts on Alexis Vila 53:50 switching management to KO Reps 55:10 struggles fighting Brazilian opponents 55:52 training partner Matt Makowski56:45 training partner Jared Weiner57:08 problems with X guard in MMA58:32 Wilson Reis vs Deividas Taurosevicius59:21 Wilson Reis vs Zac George1:00:32 Wilson Reis rematch with Patricio Pitbul1:01:30 cancelled bout with Farkhad Sharipov1:03:15 released from Bellator 1:03:27 Wilson Reis vs Bruno Menzezes in Brazil 1:05:00 coaching on TUF 16 1:06:19 thoughts on Myles Jury 1:08:04 Billy Vaughan1:09:07 Wilson Reis vs Owen Roddy1:10:43 cancelled bout with Hugo Viana1:12:01 Wilson Reis vs Ivan Menjivar 1:16:39 advice to fighters 1:18:59 interview wrap up 1:19:46 outro/ closing thoughts Subscribe to the Lytes Out Podcast:https://www.youtube.com/@MMAHistoryPodcastDiscord:https://discord.gg/s3mV6wyNgvSocials: Facebook -https://www.facebook.com/groups/1027449255187255/?mibextid=oMANbwInstagram - https://www.instagram.com/lytesoutpodcast/iTunes - https://podcasts.apple.com/us/podcast/lytes-out-podcast/id1568575809 Spotify - https://open.spotify.com/show/3q8KsfqrSQSjkdPLkdtNWb Mike - The MMA Detective - @mikedavis632 Cash App - $mikedavis1231Venmo - Mike-Davis-63ZELLE: Cutthroatmma@gmail.com / ph#: 773-491-5052 Follow the #LOP team on Instagram: Chris Lytle - Founder/Owner - @chrislightsoutlytle Mike Davis - MMA Detective - @mikedavis632 Joey Venti - Assistant - @aj_ventitreTyson Green - Producer - @ty.green.weldingAndrew Mendoza - Timestamps - @ambidexstressAndy Campbell - Social Media Manager - @martial_mindset_Josh Campbell - ContributerJohn Perretti - Historical ContributerOutro song: Power - https://tunetank.com/t/2gji/1458-power#MMA #UFC #NHB #LytesOutPodcast #LytesOut #MixedMartialArts #ChrisLytle #MMADetective #MikeDavis #MMAHistory #OldSchoolMMA #FiftyFightClub #MMAPodcast #FightPodcastSupport the show
Zen is a practice to deeply explore and fully live our true Self. Might the Koan about the stone deep down in the sea of Ise be a helpful pointer
What if our skin—our most visible organ—is actually one of the best gateways to longevity and vibrant health?This week's guest is Dr. Carolina Reis Oliveira—a brilliant scientist, a bio-chemist with a focus in stem cells and tissue engineer who's redefining what it means to age well. As co-founder and CEO of OneSkin, Carolina's using cutting-edge biotechnology to not only improve how skin looks—but how it functions at the cellular level.This conversation isn't just about skin. It's about the mindset behind bold innovation. It's about resilience, purpose, self-doubt, and what it takes to move through uncertainty when the stakes are high.As you listen, I invite you to tune into the psychology beneath her success. Ask yourself: What's your relationship with aging? And where in your life might courage and conviction unlock something greater?I think you're going to love this conversation with Dr. Carolina Reis Oliveira.____________________________OneSkin is offering a great discount to the Finding Mastery community. Go to https://www.oneskin.co/findingmastery and use the code FINDINGMASTERY for 15% off your order.____________________________Get Dr. Mike's Morning Mindset Routine here: https://findingmastery.com/morningmindset/Get exclusive discounts from our sponsors here: https://findingmastery.com/sponsors/Watch this episode and many more on our YouTube Channel.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.