Podcasts about Reproductive medicine

Robotic revolution in reproductive surgery. In this episode, the host Saranya Ravindran speaks with Tommaso Falcone about transformative developments in reproductive health, including the evolution of endometriosis research, the promise of robotic surgery, and the global expansion of gynaecologic care. From debunking myths about fertility to reflecting on cross-continental medical practice, this episode explores the future of women's health through the eyes of a pioneering clinician and researcher. Timestamps: 00:20 – What's next in gynaecologic robotic surgery? 06:46 – Falcone's pioneering research 16:44 – Three wishes for healthcare

Innovations in the treatment of endometriosis and adenomyosis In this episode, the host Saranya Ravindran speaks with Tommaso Falcone about transformative developments in reproductive health, including the evolution of endometriosis research, the promise of robotic surgery, and the global expansion of gynaecologic care. From debunking myths about fertility to reflecting on cross-continental medical practice, this episode explores the future of women's health through the eyes of a pioneering clinician and researcher. Timestamps: 00:00 – Barriers to early endometriosis detection 09:16 – Treating adenomyosis and fertility impact 12:10 – Global health innovation in emerging markets 16:05 – The first uterus transplant

In this episode, the host Saranya Ravindran speaks with Tommaso Falcone about transformative developments in reproductive health, including the evolution of endometriosis research, the promise of robotic surgery, and the global expansion of gynaecologic care. From debunking myths about fertility to reflecting on cross-continental medical practice, this episode explores the future of women's health through the eyes of a pioneering clinician and researcher. Timestamps: 00:00 – Introduction 01:05 – Quickfire round 05:12 – ‘Yes or no' segment

Global Perspectives and Leadership in Gynaecology In this episode, the host Saranya Ravindran speaks with Tommaso Falcone about transformative developments in reproductive health, including the evolution of endometriosis research, the promise of robotic surgery, and the global expansion of gynaecologic care. From debunking myths about fertility to reflecting on cross-continental medical practice, this episode explores the future of women's health through the eyes of a pioneering clinician and researcher. Timestamps: 00:00 – Comparing gynaecology globally 03:20 – The evolution of endometriosis research 05:30 – Breakthroughs and hopes for a cure

When it comes to fertility in your 40s, the path to parenthood can feel overwhelming and, at times, isolating. That's why we're joined today by one of the UK's leading voices in fertility care: Dr. Jyoti Taneja, Consultant in Obstetrics and Gynaecology, and a specialist in Reproductive Medicine and Surgery at Avenues London. IVF Over 40: What's Really Possible? In this episode, we'll break down what women can realistically expect from IVF after 40. This will include success rates, treatment options, tests to consider, and what's available through the NHS versus private clinics. We'll also explore some of the biggest myths surrounding age and fertility, discuss donor egg options, and gain Dr. Jyoti's perspective on hope, timing, and making informed, empowered decisions on this deeply personal journey. Whether you're just starting to explore IVF or looking for clarity after setbacks, this episode, 'IVF Over 40', is here to inform, encourage and support you. Email us at info@mybaba.com Follow us on Instagram @mybabainsta and @mybabagram Show notes What is My Baba? My Baba provides the daily scoop on family, food and lifestyle - we're not just experts at all things parenting. Visit mybaba.com  The Content on this podcast is provided by My Baba and represents our sole opinions and views. For more information on our terms and conditions please refer to the website: https://www.mybaba.com/terms-conditions/

Dancing with the Stars co-host Julianne Hough has revealed that she recently had her eggs frozen for the third time. With more women than ever choosing to freeze their eggs, how much do we really understand about the process, the costs, and the emotional toll? Cassie Destino – Founder, IVF Support UAE and Dr Bohaira El Geyoushi, Consultant Gynecologist at American Hospital Dubai, specialising in Reproductive Medicine and IVF join Helen to discuss.See omnystudio.com/listener for privacy information.

Sean Tipton is Chief Advocacy and Policy Officer for the American Society for Reproductive Medicine. We'll discuss a new(ish) movement called "Ethical IVF" which is an intentionally nice-sounding misnomer of a move that aims to make IVF much more difficult and expensive.Executive Team | American Society for Reproductive Medicine | ASRMASRM Center for Policy & Leadership Releases Fact Sheet on Misleading Terminology, “Restorative Reproductive Medicine” and "Ethical IVF" | American Society for Reproductive Medicine | ASRM

Have you ever felt like your symptoms were dismissed or your fertility struggles minimized? In this episode, Dr. Monica Minjeur shares what Restorative Reproductive Medicine (RRM) really is—and why it's the missing piece for so many women facing cycle issues, hormone imbalances, and infertility. Through Patricia's story, you'll hear how RRM transformed her journey from frustration and confusion to empowerment and healing. You'll learn how RRM treats root causes instead of masking symptoms, how it compares to conventional options like IVF, and why it deserves to be a first-line approach—not a last resort.Book a Free Discovery Call Here: https://radiantclinic.com/discoverycall

On this episode of Talking Away The Taboo, Estie Rose, MS, CGC, Heather Hipp, MD, and Gail Heyman, join Aimee Baron, MD for the second episode of our 5-part IWSTHAB x JSCREEN Podcast series is all about Fragile X. When people think of genetic testing before pregnancy, they often think of Tay-Sachs or cystic fibrosis—but Fragile X is just as important and far less understood. In this episode, Estie Rose and Dr. Heather Hipp explain the difference between recessive and X-linked conditions, what it means to be a Fragile X carrier, and how it can affect fertility and family planning. We also hear from Gail Heyman, who shares her deeply personal journey navigating Fragile X in her own family—and how that led her to advocacy. Whether you're building your family or supporting someone who is, this episode is filled with insight, honesty, and heart. -Click here to watch Part 1: Introduction to Genetics and Infertility More about Estie:  Estie Rose is a certified genetic counselor at jscreen. She has a special interest in community education and serves as a resource for individuals who are facing genetic health issues. Connect with Estie:  -Follow her on Instagram More about Heather: Dr. Heather Hipp is a Reproductive Endocrinology and Infertility (REI) physician and an Associate Professor at Emory University School of Medicine. She earned her undergraduate degree at Duke University and then her MD degree at Emory University, where she continued her training in residency and fellowship. She is the Program Director for the REI fellowship at Emory and serves as chair for the American Society for Reproductive Medicine Education Committee. Her profession memberships include American College of Obstetrics and Gynecology, American Society for Reproductive Medicine, Alpha Omega Alpha Honor Society, and American Gynecological & Obstetrical Society. She is also on the National Fragile X Foundation Scientific and Clinical Advisory Committee. Her research focuses on women who are carriers for the fragile X mutation and their risk of premature ovarian insufficiency, as well as trends and outcomes of in-vitro fertilization (IVF) in the United States. More about Gail:   Gail Heyman is a passionate advocate and leader in the Fragile X community. After her son was diagnosed in 1989, she co-founded the Fragile X Association of Georgia and has served as its director ever since. Her family's experience—spanning three generations affected by Fragile X conditions—fuels her tireless work to raise awareness, promote research, and support others navigating similar challenges. Gail also serves on JScreen's advisory board and has received national recognition for her leadership in genetic advocacy and inclusion. -Click here to learn more about Gail's story -Check out Carly Heyman's book, My eXtra Special Brother -Learn more about Fragile X here Connect with JScreen:  -Visit their website -Coupon Code: IWSTHAB18 for $18 off initial testing (no expiration date on this offer) -Follow JScreen on Instagram Connect with us:  -Check out our Website - Follow us on Instagram and send us a message -Watch our TikToks -Follow us on Facebook -Watch us on YouTube

In this heartwarming episode of The Egg Whisperer Show, I'm honored to welcome Dr. Joseph Sanfilippo and Dr. Carey Andrew-Jaja, two distinguished experts in obstetrics and gynecology who have dedicated their careers to women's health. Over the years, they've developed a friendship and recently decided to write a book together: Everyday Medical Miracles, is a collection of powerful stories from the frontlines of women's healthcare. Read the full show notes on Dr. Aimee's website This conversation is uplifting and inspiring, and these two doctors represent something we all need more of today: love, hope, and unwavering dedication. In This Episode, We Discuss: The inspiration behind their book, Everyday Medical Miracles Heartwarming fertility stories and groundbreaking medical moments The biggest fertility breakthroughs that turned impossible dreams into reality The role of emotional support and empathy in patient care Lessons for doctors on improving reproductive healthcare A high-risk pregnancy case with an incredible outcome How hope and resilience help patients build their families The power of human connection and celebration in fertility medicine You can Purchase "Everyday Medical Miracles:" https://store.bookbaby.com/book/everyday-medical-miracles or on Amazon: https://www.amazon.com/Everyday-Medical-Miracles-Stories-Frontlines/dp/B0DSCRW85K Do you have questions about IVF?Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, May 19, 2025 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom. 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. Other ways to connect: Subscribe to my YouTube channel for more fertility tips Join Egg Whisperer School Subscribe to the newsletter to get updates  

Joelle Taylor, MD, FACOG is a board-certified Reproductive Endocrinologist and a Diplomate of the American Board of Obstetrics and Gynecology. She is an active member of several leading scientific societies, including the American Society for Reproductive Medicine (ASRM), the Society of Reproductive Endocrinology and Infertility (SREI), the Society of Assisted Reproductive Technology (SART), and the American Congress of Obstetricians and Gynecologists (ACOG).   Dr. Taylor earned her medical degree from the University at Buffalo School of Medicine and Biomedical Sciences in 2006. As a recipient of the Howard Hughes Medical Institute Scholar Award, she dedicated a year to research at the National Institutes of Health during her medical training. She went on to complete her residency in Obstetrics and Gynecology at Wake Forest University in 2010, followed by a fellowship in Reproductive Endocrinology and Infertility at the renowned Jones Institute for Reproductive Medicine in Norfolk, Virginia—home to the first IVF baby in the United States.   Throughout her career, Dr. Taylor has been recognized with multiple research grants, has published extensively, and has presented her work at national conferences.   Outside of her professional pursuits, Dr. Taylor lives in Jupiter with her family and their Australian Labradoodle. She enjoys weightlifting, yoga, playing pickleball, and cooking for family and friends.

Dr. Minjeur, an expert in the female menstrual cycle, shares her expertise on topics like hormonal health, PCOS, and perimenopause, including the psychological impacts of challenges with hormones. You can learn more about Dr. Monica Minjeur and her practice: RadiantClinic.comResources:To learn more about me and my reproductive & integrative psychiatry clinic helping patients across California, please visit - AnnaGlezerMD.comTo sign up for the Fellowship in Reproductive & Integrative Psychiatry, please visit:  PsychiatryFellowship.com. 

Order my new book: Finally F**kn Fertile Using Yoga Meditation & Breathwork to Conceive! https://www.lisapinedayoga.com/store/p1/FINALLY_F%2ACKING_FERTILE_Using_Yoga%2C_Meditation_%26_Breathwork_to_Conceive.htmlDID YOU KNOW PCOS can be managed by some medications and even improve egg quality? In the latest episode of The Dismantling You Podcast I interview Dr. Cary Dicken  Topics we discussed:*PCOS*Endometriosis*Egg Freezingand so much moreCary L. Dicken, MD, joined RMA of New York – Long Island in the fall of 2020. She comes to us from the Sher Institute for Reproductive Medicine in New York City, where she served as Associate Medical Director for over six years. Dr. Dicken is board certified in both Obstetrics & Gynecology and Reproductive Endocrinology & Infertility. She has been recognized by her peers and patients as an outstanding and compassionate physician. Dr. Dicken is a caring and warmhearted fertility specialist while still being honest and upfront with her patients. She is proud to be a reproductive endocrinologist and loves spending her days helping individuals/couples create the families they want.Contact Dr. Cary DickenWebsite: https://www.rmalongislandivf.com/physicians/cary-l-dicken-mdInstagram: @dr.cary.dicken

In this episode, we welcome Dr. Peta Wright, a distinguished gynecologist and fertility specialist, to discuss her holistic approach to addressing pelvic pain, endometriosis, and women's health. Drawing from her book Healing Pelvic Pain, Dr. Wright shares insights on the connection between the nervous system, inflammation, and trauma, offering integrative strategies for true healing. She emphasizes the importance of understanding pain as a messenger and adopting a whole-person approach to care. Tune in to explore how modern medicine and holistic practices can harmonize to empower women's well-being.Key takeaways:The link between pelvic pain, inflammation, and the nervous system.Why traditional approaches often fall short for endometriosis treatment.The role of attachment trauma and stress in chronic pain.Practical tools for creating safety in the body and mind.Integrative strategies for improving fertility outcomes.Dr. Peta Wright Bio: Dr. Peta Wright is a distinguished gynaecologist and fertility specialist, deeply committed to holistic women's health. She completed her medical degree with Honours at Monash University in 2004 and obtained her Fellowship with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists in 2013. Dr. Wright furthered her expertise with a Master's in Reproductive Medicine and a certificate in Women's Integrative Medicine. In 2020, she founded Vera Women's Wellness, aiming to provide comprehensive care that addresses the physical, emotional, and environmental aspects of women's health. Her clinical interests include paediatric and adolescent gynaecology, pelvic pain, endometriosis, polycystic ovarian syndrome, and menopause management. Dr. Wright is also an advocate for addressing the impact of nutrition, stress, and lifestyle on hormonal balance, empowering women to achieve optimal well-being. She is the author of Healing Pelvic Pain: Transforming the Trauma of period pain, endometriosis, and chronic pelvic distress published in 2023.Where To Find Dr. Peta Wright: Website: https://www.verawellness.com.au/Instagram Dr. Peta Wright: https://www.instagram.com/petavirginiaInstagramVera Wellness:https://www.instagram.com/verawellness.com.auFacebook Vera Wellness:https://www.facebook.com/verawellness.com.auBook: “Healing Pelvic Pain: Transforming the Trauma of Period Pain, Endometriosis, and Chronic Pelvic Distress” - https://www.amazon.com/Healing-Pelvic-Pain-Peta-Wright/dp/1761264400Acubalance Wellness Centre:Endometriosis Treatment Strategies : https://acubalance.ca/blog/endometriosis-awareness-month-10-tools-to-support-endometriosis/ Nervous System Reset - Enhance Mood & Sleep:

Who's adding the most value in IVF today—and who might not be here tomorrow?This week on Inside Reproductive Health, Dr. Cristina Hickman, founder of Avenue Center for Reproductive Medicine in London, breaks down the fertility field's evolving landscape. As a PhD embryologist and clinic owner, she shares her perspective on industry leaders, automation, and the shifting role of technology in fertility care.Tune in to learn:Why some clinic networks might be overextending by bringing too many verticals in-house.How automation could scale embryologist efficiency to 2,000+ cycles per year.The surprising relationship between robotics and AI in embryology.Which companies are providing the most value right now--in lab automation, EMR, financial management, and cryo storage and moreHow new intelligence could challenge the current standard of single embryo transfer.Listen now to hear Dr. Hickman's take on where the field is headed—and who's leading the way.

Is fertility doomed after age 35? In this episode, Dr. Monica Minjeur breaks down the science behind age and fertility, separating fact from fiction. Learn real statistics, key strategies to optimize fertility naturally, and why age isn't the only factor that matters. Dr. Minjeur shares an inspiring success story, explores the role of egg and sperm health, and discusses how restorative reproductive medicine has superior outcomes to IVF. If you're trying to conceive later in life and feeling uncertain about your fertility, this episode is a must-listen! Schedule a free discovery call to explore your options: https://radiantclinic.cocm

If you're in your 30s or 40s, you might not be thinking about menopause just yet, but now is the perfect time to start the conversation. Understanding what's ahead can help you feel more prepared, confident and in control of your health.In this episode, Dr. Renee White chats with Dr. Cheryl Phua, a highly respected fertility specialist at IVF Australia, to break down what every woman should know about perimenopause and menopause. Dr. Phua has extensive expertise in reproductive medicine, holding a Masters of Reproductive Medicine from the University of NSW, along with a BSE and Masters in Biotechnology from the University of Pennsylvania. She is passionate about helping women navigate all stages of reproductive health, from pre-pregnancy through to menopause and beyond.You'll hear about:✔️ What perimenopause actually is – and why it's not just “menopause lite”✔️ Common (and surprising) symptoms – beyond the classic hot flushes✔️ Treatment options – including the truth about hormone therapy✔️ How menopause affects long-term health – and why you need to advocate for yourself✔️ The biggest menopause myths debunked – so you don't fall for outdated adviceWhether you're starting to notice changes, supporting a loved one, or just want to be prepared for the future, this conversation is a must-listen. Menopause doesn't have to be a mystery—or something we just “put up with.” You deserve to feel informed, supported, and in control of your health every step of the way.Resources and Links:

One of the executive orders President Trump signed recently looks at expanding access to in vitro fertilization, also known as IVF. What will this mean for families across the US wanting to have children but struggling to do so, physically and financially? According to a 2024 survey, 1 in 10 women of reproductive age say they received fertility assistance, including IVF, but insurance coverage for the procedure is limited. Dr. Andrew Levi of Park Avenue Fertility and Reproductive Medicine weighs in on the impact of this order. Image Credit: Getty Images

'Sen-betweeners' is the term Lisa Lloyd, a mum of two autistic children, uses to describe her children. She says their neurodivergence is too severe to fit easily into mainstream school, but not severe enough for a special school, so they fall between the gaps. Lisa has written a guide for other parents on ‘Raising the Sen-betweeners,' in which she, whilst recognising that all children are different and there can be no rules, offers tips and advice for how to handle behaviours. Lisa joined Anita to share what she has learnt.The Children's Society are training staff at the fast food chain Chicken Cottage to spot signs of exploitation amongst their teenage customers. Nuala discussed the initiative and issues with the charity's Head of National Programmes, Lisa Witherden, and Chicken Cottage franchise manager Georgian Balog.Formula 1 has just turned 75, but how much headway are women racing drivers making? Nuala was joined by Jamie Chadwick, one of the leading British women in this sport, and BBC reporter Charlotte Simpson, who has spent months talking to a wide range of people trying to support more young women to become involved in the sport.Nussaibah Younis's debut novel Fundamentally is based on her own experiences working as a peacekeeping consultant in Baghdad. The book follows Nadia, a British Asian woman working for the UN, and her relationship with fellow Brit Sara, a nineteen-year-old three-times widowed member of the Islamic State Group. Nussaibah joined Anita to discuss finding the comedy in a desperate situation.Harvest, a new documentary, shows the realities of the egg freezing process. Director and writer Sophia Seymour decided to film her journey of elective egg freezing. With the number of women choosing this form of fertility planning rising, Nuala was joined by Sophia to discuss why she decided to do, and film it, and also by Dr Ippokratis Sarris, Consultant in Reproductive Medicine and Director of King's Fertility.Nao is a Grammy and Mercury nominated singer songwriter. She's described her unique brand of music as “wonky funk”. She joined Nuala McGovern to talk about fame, motherhood and her new album Jupiter. She performed live in the studio.Presenter: Anita Rani Producer: Annette Wells

Did you know there are ten types of miscarriage?! What are they? When it comes to a loss, does it really matter what kind of miscarriage you've experienced? (Hint: yes it does.) And how can proper diagnosis and evaluation help those facing recurrent miscarriages?  In this episode, Dr. Shahine breaks down the ten different types of miscarriage, including early and late, clinical and biochemical, threatened, missed, inevitable, complete, septic, and recurrent miscarriages.  She shares the information from the American Society of Reproductive Medicine on recurrent pregnancy loss and discusses the importance of proper evaluation for those who have experienced multiple losses. Listeners will come away with a deeper understanding of the causes of miscarriage, the importance of proper medical care, and the reassurance that pregnancy loss is never the fault of the person experiencing it. This episode provides knowledge, empathy, and practical guidance for those facing the heartbreak of pregnancy loss.    In this episode you'll hear: [1:51] Understanding miscarriage [2:33] Emotional impact and misconceptions of pregnancy loss [4:07 ] Detailed breakdown of miscarriage types Timing-Based Miscarriage Types Clinical vs. Biochemical Miscarriages Labels and Descriptions of Miscarriages Recurrent Miscarriage [17:42] Conclusion & final thoughts   Resources mentioned:  Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss Not Broken Illustrated: A Gift for Those Who Have Suffered Pregnancy Loss   Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

Why are members of the Afghan Cabinet speaking out against the de facto leader over his ban on girls' education and restrictions on women working? Nuala McGovern speaks to the BBC's Chief International Correspondent, Lyse Doucet, and Fawzia Koofi, member of the Afghan Parliament and the first woman to be elected as Second Deputy Speaker.Harvest, a new documentary, shows the realities of the egg freezing process. Director and writer Sophia Seymour decided to film her journey of elective egg freezing. With the number of women choosing this form of fertility planning rising, Sophia joins Nuala to discuss why she decided to do it, and film it. They are joined by Dr Ippokratis Sarris, Consultant in Reproductive Medicine and Director of King's Fertility.According to NHS figures more than 44,000 children in England and Wales were admitted to hospital with constipation last year - with a 60% rise overall in hospital diagnoses of constipation in primary schoolchildren in the past decade. Dr Ellie Cannon GP and author, and Sarah Timms from Education and Resources for Improving Childhood Continence (ERIC) a children's bowel and bladder charity join Nuala.22-year-old pistol shooter Manu Bhaker is this year's BBC Indian Sportswoman of the year. Our correspondent Divya Arya was at the event, and joins Nuala McGovern to tell us more. Presenter: Nuala McGovern Producer: Laura Northedge

On today's episode I have the pleasure of speaking with the founder of the Way of Yin, Kris González about the lunar new year and how we can learn from the wisdom of the snake to know when to use energy and when to conserve and reserve.I loved this conversations and I could honestly listen to Kris talk forever — her voice is so calming and so grounding.As she writes in the newsletter that inspired me to reach out to record this episode: “2026 will be the Year of the Full Fire Horse, bringing major transformation and change. As a result, 2025 is a year of transition. We must be careful not to burn out. It's important to nurture and take care of ourselves in 2025 to endure the fire ahead. I hope this season brings you deep rest, a touch of magic, and time to spend with the people and activities that keep your spirit alive.”Kris takes us on a journey through the elements starting with water with a special emphasis for women in their metal years (think Queen of Swords). She really helps connect the dots of how the energy of the elements comes alive in our lives at every phase.In this episode you'll learn about how the five elements give insight into the many ways life is sustained and maintained with extra special importance of the kidneys. At the end I weave it all back into the moon and how this all connects with the lunar cycle.For those of you who don't know her yet, Kris is a dedicated Chinese Medicine Practitioner and Herbalist, passionate about the Nourishing Life Tradition (養生 yǎng shēng). She founded The Way of Yin, a lifestyle education company focused on bridging the wellness gap in reproductive health through timeless wisdom.Her courses integrate insights from Chinese Medicine Gynecology, Reproductive Medicine, The Five Elements, Herbalism, and Longevity Practices. Kris aims to share the profound wisdom of East Asian Medicine, particularly in the realm of the Womb Continuum.The Way of Yin offers guidance to help you journey with more ease and grace, all while embracing nature's wisdom and helping you connect to your body, cycles, and rhythms.)) If you love this episode, please leave a review on Apple Podcasts or Spotify - thanks so much for listening! ((LINKS* Kris González, L.Ac ∘ Chinese Medicine Practitioner

Discover the truth behind common myths about IVF and artificial reproductive technologies (ART). In this episode, Dr. Monica Minjeur explores the risks, limitations, and alternatives to IVF, highlighting the benefits of restorative reproductive medicine. Learn how addressing root causes can improve fertility naturally and empower couples to achieve long-term reproductive health. Tune in to gain valuable insights and take control of your fertility journey.

If you are on a path for marketing your Canadian private practice, being mindful of your search engine optimization (SEO) may take some time to build momentum, but it is one of the direct routes to success.  In today's episode, Delia and I discuss our interests in SEO, why it is important for marketing our practices successfully, and other topics - including growing a business with interns!  MEET DELIA Delia Petrescu is a Registered Psychotherapist and founder of Get Reconnected Psychotherapy Services. She has over a decade of experience working in the mental health field, supporting clients facing mood disorders, anxiety, infertility, pregnancy loss, relationship difficulties, and stress management. Previously, she worked as a psychometrist in various clinical settings and at the Centre for Addiction and Mental Health (CAMH), conducting neuropsychological assessments in the Brain, Body, and Perception research department. Delia has specialized training from the American Society for Reproductive Medicine and is an active member of the Canadian Fertility and Andrology Society and Fertility Matters. Learn more about Delia on her practice website, LinkedIn, and Psychology Today profiles.  In this episode:  What motivated Delia to work in therapy? Starting a private practice Going from solo to group private practice with interns  Building a practice based on values SEO and marketing the practice  The dark side of AI in marketing and SEO Delia's direction for the future  What motivated Delia to work in therapy? Even though Delia always had an inkling of working in therapy, she started her professional career as a psychometrist.  Starting a private practice  In 2021, Delia opened up her practice. As her journey as a business owner developed, she slowly began taking on more of an interest in the back-end of building a successful practice, alongside providing great therapy on the front end.  Going from solo to group private practice with interns  In 2022, Delia's practice was steadily growing and she decided to help its development by purchasing paid ads. She also hired two interns.  To find her interns, Delia posted her job descriptions on Facebook groups and the Yorkville Practicum Portal that she is part of. In September 2022, Delia hired her first interns. She also hired an administrative assistant who was a previous colleague, and another psychologist as an independent contractor.  Now her 2022 interns have graduated and work at her practice as therapists, and she has taken on two new interns!  Building a practice based on values Curiosity is one of the guiding principles that Delia and her team use when working with clients. Beyond curiosity, dedication is another value that Delia uses as a guiding principle in her practice. SEO and marketing the practice Delia tends to avoid using ChatGPT in her marketing efforts because she prefers to use organic content as her personal preference and to help boost her SEO.  Delia has also made sure to section up her website with relevant content in the form of blog posts. The dark side of AI in marketing and SEO However helpful AI tools can be, be careful in how much you rely on them. They are tempting, but practice using them as assistants to your work instead of allowing them to do the whole job.  Delia's direction for the future  For her short-term goals, Delia wants to continue with her affordable therapy program by hiring interns into her practice. Over the next three to five years, Delia has her sights set on opening up more office space downtown.  Connect with me: Instagram Website  Resources mentioned and useful links: Ep 149: Alexia Wensing: Can You Make a Brand Out of a “Vibe”? | EP 149  Learn more about the tools and deals that I love and use for my Canadian private practice Sign up for my free e-course on How to Start an Online Canadian Private Practice Jane App (use code FEARLESS for one month free) Get some help and freebies on your website with WordPress!  Learn more about Delia on her practice website, LinkedIn, and Psychology Today profiles Rate, review, and subscribe to this podcast on Apple Podcasts, Spotify, Amazon, and TuneIn

In this episode, I sit down with Dr. Andrea Huddleston, an integrative chiropractor and globally recognised women’s health expert affectionately known as ‘The Period Whisperer.’ As the co-founder and co-host of the award-winning podcast Wellness Women Radio, Dr. Andrea has built a thriving practice by specialising in women’s health, hormonal balance, and natural fertility. Her unique personal brand has garnered international acclaim, attracting a dedicated patient base and a global audience. If you’re ready to elevate your practice by crafting a personal brand that builds trust and attracts your ideal clients, this episode is for you. You’ll learn: How to define your niche and position yourself as an expert in your field. Practical strategies to build trust and credibility with your audience. Proven branding techniques that attract your ideal clients and accelerate growth. Personal branding is more than a buzzword—it’s the key to creating meaningful connections and driving practice success. Tune in to discover actionable steps to craft a brand that truly works for you. Thanks for all you do. Keep saving lives. Angus Links: www.drandrea.com.au www.sagehealthwa.com.au @drandrea.xo Facebook.com/theperiodwhisperer www.thewellnesswomen.com.au https://podcasts.apple.com Bio: Dr. Andrea Huddleston is a holistic chiropractor and a globally recognised authority in women’s health and fertility who blends science with compassion to empower women at every stage of life. She holds two postgraduate Master’s degrees in Women's Health Medicine and Reproductive Medicine, along with qualifications in nutritional andfunctional medicine. Andrea is the owner of Sage Health, a multidisciplinary women’s health practice in Fremantle, a lecturer at the Australian Chiropractic College in Adelaide and is co-host of the award-winning Wellness Women Radio podcast, Andrea connects with millions of listeners worldwide who have affectionately titled her ‘the period whisperer’ for her unique approach to complex hormonal issues. Andrea has also created the first postgraduate training for chiropractors in women’s health called Women’s Health Mastery. However, most importantly, she’s an avid coffee addict and ‘crazy dog lady’!See omnystudio.com/listener for privacy information.

Send us a textIn this inspiring episode of Taco Bout Fertility Tuesday, Dr. Mark Amols shares his personal fertility journey, reflecting on the fears, challenges, and triumphs of building a family. Through heartfelt stories and compelling statistics, he highlights the significance of perseverance in fertility treatments. Whether it's overcoming financial obstacles, navigating setbacks, or exploring new advancements in reproductive medicine, this episode serves as a beacon of hope for anyone on their fertility journey. Discover why persistence, coupled with science, can lead to life-changing outcomes.Thanks for tuning in to another episode of 'Taco Bout Fertility Tuesday' with Dr. Mark Amols. If you found this episode insightful, please share it with friends and family who might benefit from our discussion. Remember, your feedback is invaluable to us – leave us a review on Apple Podcasts, Spotify, or your preferred listening platform. Stay connected with us for updates and fertility tips – follow us on Facebook. For more resources and information, visit our website at www.NewDirectionFertility.com. Have a question or a topic you'd like us to cover? We'd love to hear from you! Reach out to us at TBFT@NewDirectionFertility.com. Join us next Tuesday for more discussions on fertility, where we blend medical expertise with a touch of humor to make complex topics accessible and engaging. Until then, keep the conversation going and remember: understanding your fertility is a journey we're on together.

Creating life always starts from within; it is inner work. Meet Dr. Randine Lewis—fertility expert, Chinese medicine practitioner, and author. Today, she'll teach you how to transform your infertile mindset into a fertile mindset.Dr. Lewis shares how 80% of fertility starts with how people view the world and their life, and you'll learn how to become open and receptive to allow life to flow through you. By bringing spirituality into your fertility journey, you'll honor your longing for life and fully let go. And when this happens, you can expect miracles to occur. Key takeaways:-What is fertility? -The importance of mindset. -How spirituality can help you create life.-The difference between a mindset in your 20's vs your 40's. -Receptivity as a mindset. -Why you should move out of “trying mode.”-The reason fertility miracles happen.-The importance of self-compassion. Dr. Randine Lewis Bio: After her basic medical school curriculum, Dr. Randine Lewis received her Masters in Oriental Medicine at the American College of Acupuncture and Oriental Medicine, interned in China, and received her PhD in alternative medicine. Dr. Lewis has been a governing board member of the American Society for Reproductive Medicine, as well as a medical expert for numerous online resources. She is the author of The Infertility Cure and The Way of the Fertile Soul, conducts intensive retreats, and teaches workshops for practitioners internationally and online through HealthySeminars.comShe teaches for the integrative doctoral program at Daoist traditions College of medical arts. She has kept up a regular qi gong and meditative practice and uses elemental self-inquiry and body wisdom meditative and movement processes in her work.Where To Find Randine Lewis:TheFertileSoul.com@thefertilesoulFor acupuncturists who want to study online with Randine Lewis Healthyseminars.com How to connect to Lorne Brown online and in person (Vancouver, BC)Acubalance.ca book virtual or in person conscious work sessions with Dr. Lorne Brown Lornebrown.comConscious hacks and tools to optimize your fertility by Dr. Lorne Brown:https://acubalance.ca/conscious-work/Download a free copy of the Acubalance Fertility Diet & Recipes and a copy of the ebook 5 Ways to Maximize Your Chances of Getting Pregnant from Acubalance.caConnect with Lorne and the podcast on Instagram:@acubalancewellnesscentre@conscious_fertility_podcast@lorne_brown_officialDISCLAIMER: By listening to this podcast, you agree not to use it as medical advice to treat any medical condition in

Send us a textIn this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols revisits the critical topic of ovulation timing with a fresh, in-depth perspective. Understanding when ovulation occurs is essential for maximizing your chances of conception, and this episode is packed with science-backed insights and practical tools to help you track it accurately.Dr. Amols dives into the nuances of ovulation, explaining how the egg's 24-hour viability and sperm's 5-day survival make timing everything. He explores the pros and cons of various ovulation detection methods, including basal body temperature (BBT), cervical mucus monitoring, ovulation predictor kits (OPKs), and advanced tools like ultrasound and progesterone testing.This episode also sheds light on common misconceptions about ovulation, addresses the challenges faced by individuals with irregular cycles or conditions like PCOS, and provides actionable advice for those struggling to identify their fertile window. Whether you're new to ovulation tracking or looking for a more accurate approach, this episode will empower you with the knowledge to take control of your fertility journey.Tune in and discover the science, tools, and tips to optimize your chances of conception!Thanks for tuning in to another episode of 'Taco Bout Fertility Tuesday' with Dr. Mark Amols. If you found this episode insightful, please share it with friends and family who might benefit from our discussion. Remember, your feedback is invaluable to us – leave us a review on Apple Podcasts, Spotify, or your preferred listening platform. Stay connected with us for updates and fertility tips – follow us on Facebook. For more resources and information, visit our website at www.NewDirectionFertility.com. Have a question or a topic you'd like us to cover? We'd love to hear from you! Reach out to us at TBFT@NewDirectionFertility.com. Join us next Tuesday for more discussions on fertility, where we blend medical expertise with a touch of humor to make complex topics accessible and engaging. Until then, keep the conversation going and remember: understanding your fertility is a journey we're on together.

Powerhouse actors Keira Knightley and Sarah Lancashire are starring alongside Ben Wishaw in new Netflix spy drama Black Doves. It follows the story of a female spy seeking revenge for the murder of her lover – whilst outwardly being married to a high-ranking politician. Keira and Sarah spoke to Nuala McGovern about the drama, their careers and their experiences as women in the film industry.Sutara Gayle is an actor and reggae artist. She fuses music with memories of her eventful life in a new show: The Legends of Them. From hearing her radio debut whilst in Holloway Prison on remand, to the Brixton uprisings in 1985 that were sparked by the shooting of her sister, the show explores a hugely varied and at times deeply moving portrayal of her life, and the women who have shaped it. Sutara joined Anita Rani in the studio.Professor Nicola Rollock is best known for her academic research and writing on race and society. As a friend of the programme, she approached us to ask to talk about something more personal - her experience of uterine fibroids, something that affects around 70% of women, but this rises to 80% for black women. Nicola joined Nuala alongside Hilary Critchley, Professor of Reproductive Medicine at the University of Edinburgh, to discuss more.After the actor Anna Maxwell Martin spoke on the programme about the grief she experienced after her husband died suddenly in 2021, we were inundated with listeners sharing their stories. Two of them, Giselle De Hasse and Heather Ashley, joined Anita to talk about how they manage their grief day to day.Author Josie Lloyd joined Nuala to discuss her new novel featuring fictional Alice Beeton, the prim and organised owner of The Good Household Management Agency and distant relative of the real-life Victorian cookery and household writer Mrs Beeton. Alice and her ancestor share a love of recipes and an eye for detail, which comes in handy when Alice becomes involved in a cosy, Christmassy crime in Miss Beeton's Murder Agency.Presenter: Anita Rani Producer: Annette Wells Editor: Louise Corley

The TV presenter Gregg Wallace has denied behaviour of a sexually harassing nature, after 13 people came forward last week with allegations of inappropriate comments. In a video posted on Instagram, he said the accusations had been made by 'a handful of middle-class women of a certain age'. Nuala McGovern is joined by former head of Channel 4 News Dorothy Byrne and the Chair of the Fawcett Society, Baroness Harriet Harman, to discuss.When Daniel Wing was a year old, his mother Tina was murdered. 32 years on, the murder still remains unsolved – but a spotlight is thrown on the case in a new documentary: Who Murdered You, Mum? Nuala is joined by Daniel and barrister Harriet Johnson to talk about what the programme shows in terms of change in fighting violence against women and girls, and what needs to happen next to keep women safe.Professor Nicola Rollock is best known for her academic research and writing on race and society. As a friend of the programme, she approached us to ask to talk about something more personal - her experience of uterine fibroids, something that affects around 70% of women, but this rises to 80% for black women. Nicola joins Nuala alongside Hilary Critchley, Professor of Reproductive Medicine at the University of Edinburgh, to discuss more.Hindi-language film, Laapataa Ladies, also known as Lost Ladies, has just been submitted for Bafta consideration. Set in 2001 in rural India, it follows two separate newlywed brides, Phool and Jaya, whose lives take unexpected turns after a mix-up on a crowded train. It's director, filmmaker Kiran Rao joins Nuala live in the studio to discuss the film and its variety of female characters.Presenter: Nuala McGovern Producer: Lottie Garton

In this episode, the penultimate episode that Kate is hosting, Kate is joined by Professor Tim Child. Tim is Associate Professor of Reproductive Medicine at the University of Oxford. He has published more than 100 research papers, and has brought new treatments and techniques to the UK, increasing both the success and safety of fertility treatment.In 2021, he was appointed by the Secretary of State for Health to the board of the Human Fertilisation and Embryology Authority (HFEA), the UK's regulator of assisted conception treatment and research. Tim Chairs its Scientific and Clinical Advances Advisory Committee (SCAAC), responsible for the IVF Add-Ons traffic light system. And not only that but Kate and Tim worked together many moons ago in Oxford, and Tim was rather partial to Kate's homemade strawberry cheese cake!So, Tim is here to talk all things IVF Add-ons with us and I'm sure you'll agree he's absolutely best placed to do so!Kate and Tim discuss exactly what are IVF add ons, whether you should be using them, how they are graded and the importance of making the right decision for you with as much information from your doctor as possible.The pair also discuss the rise of misinformation on social media, how to filter through this fake information and where to find evidence based information. Go and take a look at Tim's excellent Instagram account where he shares so much top quality information to help you along your fertility journey.Thanks for joining OUR SPONSOR:We are delighted that the current series is being sponsored by Proceive who are kindly offering all listeners to The Fertility Podcast 15% off any Procieve purchase, when you use the discount code FP15.Socials:Follow @YourFertilityNurse on InstagramFollow @TheFertilityPodcast on InstagramFollow Natalie Silverman she / her (@fertilitypoddy) • Instagram photos and videos on InstagramFollow Fertility Doctor (@drtimchild) • Instagram photos and videos on InstagramFind HFEA: UK fertility regulator website

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 to discuss early disclosure of donor identity for donor-conceived people. Dylan Morgan, Chief Operations Officer of Cascade Cryobank, and Melanie Mikkelsen, a reproductive mental health counselor for Hold Hope join them to discuss the issues relating to early disclosure. For many years, donor identity was kept secret from parents and children. We know that children are not harmed by understanding their origin story. Josh is an advocate for donor disclosure and discusses why he believes all banks should adopt this practice. Parents either find out identifying information at the time of donation or when the child becomes an adult. Donors at Cascade Cryobank can opt in or out for early disclosure to children conceived with their sperm. If donors opt in for early disclosure, parents receive identifying information at conception. Melanie shares information about psychological outcomes for children. She also discusses the latest information from the American Society of Reproductive Medicine on donor disclosure. 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 Theralogix. 

Alice D. Domar, Ph.D. Hands down the most experienced and published mind in the field of reproductive psychology. This interview will introduce you to Dr Domar and her long standing dedication to influencing the reproductive health field and its need to integrate psychological care as standard practice in conventional fertility care and IVF.  So much valuable information tucked into this podcast, but she does boil it all down to 4 main recommendations… Do not suffer in silence, seek out mental health care Don't expect your partner to feel the same way you do Your relationship with your REI is important, switch doctors if necessary You do not have to go to that baby shower ABOUT DR. ‘ALI' DOMAR Dr. Domar is a health psychologist 1987 who focuses on the application of mind/body medicine to women's health issues. Her plethora of research focuses on the relationship between stress and infertility, with a focus on the impact of cognitive behavioral interventions as well as access to care and patient retention. Alice “Ali” Domar, Ph.D., joined Inception Fertility in 2022 as Chief Compassion Officer. She is also a senior staff psychologist in the department of obstetrics and gynecology at Beth Israel Deaconess Medical Center and an associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School.  Dr. Domar is on the board for Parents Magazine and served 10 years on the board of Resolve, the National Infertility Association. She is the author of eight books, including Conquering Infertility and Patient-Centered Assisted Reproduction: How to Integrate Exceptional Care with Cutting Edge Technology, and is the co-creator of the apps FertiCalm and FertiStrong. She is a former chair ASRM's mental health professionals group. RESOURCES / REFERENCES HARVARD CV  [https://connects.catalyst.harvard.edu/Profiles/display/Person/28392] - This includes a listing of all the research discussed & published by Dr. Domar.   INCEPTION [https://inceptionfertility.com/] - a network of brands that touches every stage of the fertility lifecycle (IVF centres, research, tech, financing, egg bank, cryo, Rx, supplements) PRELUDE NETWORK [https://www.preludefertility.com/dr-alice-domar] - Subsidiary of Inception, network of fertility centres in N America (offer compassionate care at every step of the patient journey) PACIFIC CENTRE for REPRODUCTIVE MEDICINE [https://www.pacificfertility.ca] - Dr. Jon Havelock and his team at PCRM (Vancouver, Victoria, Edmonton) are members of the Prelude Network.  CONQUERING INFERTILITY [https://a.co/d/dmzUCjP] - Dr Domar's landmark book, revised edition published January 2025.  OTO STRESS / FERTILITY RESEARCH [https://fertilitystudies.com/oto/] - OTO and Inception Fertility (Dr Domar) and its family of brands, including The Prelude Network®, are partnering in a research study investigating the impact (if any) stress has on IVF cycle outcomes. ----- #mentalhealth #ivf #infertility  Podcast Website page -  ----- For more Episodes & Videos visit The Conception Channel - https://www.youtube.com/@TheConceptionChannel YOU CAN ALSO LISTEN AND SUBSCRIBE TO THE CONCEPTION CHANNEL PODCAST ON ALL YOUR FAVOURITE PODCAST PLATFORMS. ----- CONNECT WITH DR PENTLAND Private practice: https://drspencepentland.com/ Fertility Clinics: https://yinstill.com/

What happens when life throws you a curveball? In today's episode of "Step Into the Pivot," we are joined by the inspiring Dr. Elizabeth Grill, a health psychologist and medical researcher who shares her journey through the tumultuous waters of divorce and family court battles. Dr. Grill opens up about the survival mode mindset that took over during these challenging times, and the crucial role a strong support system played in her resilience.Imagine suddenly finding yourself as a full-time parent without financial stability or childcare support. A life-altering court decision propelled Elizabeth into immediate problem-solving mode, eventually resulting in personal growth and the birth of new business ideas. It's a story of resilience and innovation, where channeling energy into positive pursuits not only restored confidence but also inspired others along the way. “By listening to empowering narratives during my daily commutes, I found purpose and motivation amid adversity, reinforcing the belief that every challenge can be an opportunity in disguise.”Guest Bio:Dr. Elizabeth Grill is the Director of psychological services at the Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine and is Associate Professor of Clinical Psychology in the Departments of Obstetrics and Gynecology, Reproductive Medicine, and Psychiatry at Weill Cornell Medicine. She is also an Assistant Attending Psychologist at New York-Presbyterian Hospital.Dr. Grill is established as a nationally recognized expert and innovator in reproductive and sexual mental health.  She is the current Chair of RESOLVE, the National Infertility Patient Organization, the Past Chair of the Mental Health Professional Group of the American Society for Reproductive Medicine and the Past President of the Society for Sex Therapy and Research. Dr. Grill is experienced as a health psychologist and medical researcher with a special focus on the emotional aspects of infertility, IVF treatment, third party reproduction, oncofertility, fertility preservation, sexual dysfunction, and stress and infertility.  She is also the co-owner of FertiCalm and FertiStrong, the first digital apps developed to reduce distress for those experiencing infertility, using research proven modalities. Dr. Grill is an editorial reviewer for the top peer reviewed journals in the field, the author of numerous articles and book chapters, has lectured worldwide to patient and medical audiences and has participated in media interviews related to the emotional aspects of reproductive medicine. Connect with Elizabeth:LinkedIn: https://www.linkedin.com/in/drlizgrill/ Connect with Theresa and Ivana: Websites: Theresa, True Strategy Consultants: https://tsc-consultants.com/ Ivana, Courageous Being: https://www.courageousbeing.com/ Instagram: Ivana: https://www.instagram.com/courbeing/ Theresa: https://www.instagram.com/tscconsultants/ LinkedIn: Step into the Pivot: https://www.linkedin.com/showcase/step-into-the-pivot/ Theresa: https://www.linkedin.com/in/tree-conti/ Ivana: https://www.linkedin.com/in/ivipol/

Welcome to Episode 147 of The “So Now What?” Podcast with Lana Manikowski. In this special episode, Lana dives deep into the often-overlooked journey that follows fertility treatments for women who leave without a child. Whether you're a fertility doctor, clinic staff, mental health provider, or a woman navigating life after infertility, this episode highlights the unmet needs and real stories from women who feel unseen after treatment ends. Highlights: Free Masterclass on Handling the Holidays    Join Lana's free MasterClass on November 20 at 6 p.m. CST to learn how to manage holiday gatherings and traditions when childless after infertility. In this live class, you'll gain strategies for building new traditions, handling family dynamics, and creating a plan for holiday celebrations. Register here to reserve your spot!   When Treatment Ends: What Childless Women Really Want    Lana addresses the gap in support often felt after IVF and fertility treatments conclude. Without a plan or follow-up, patients are left to navigate grief, mental health challenges, and marital and social dynamics alone. Lana shares her recent discussions at the American Society for Reproductive Medicine's Congress, where she raised awareness about the importance of continued support for patients who leave treatment without a child.   Real Voices from Infertiole, Childless, Women Who Needed More    Lana shares direct feedback from her community of listeners and followers. Hear heartfelt perspectives from women who longed for acknowledgment and empathy post-treatment, as well as a structured care plan including mental health resources, peer support networks, and follow-up care. These women are calling for a roadmap to help navigate the grief and redefine purpose after infertility.   Advocating for Better Resources when IVF Fails    Lana encourages women to advocate for their needs by requesting additional resources and post-treatment support from clinics and mental health professionals. To the fertility community, Lana calls for a more holistic approach, recognizing that when treatments end, the journey is far from over for many women. Support beyond the treatment room can bridge a painful void.   Why It Matters: This episode sheds light on the immense need for a compassionate continuum of care when ferrility treatment ends without children. From practical resources to sensitive emotional support, The "So Now What?" Podcast aims to uplift women who feel left behind and encourages providers to extend the care they give their patients. Links Mentioned: -Register for the Free Holiday MasterClass here - Free Resource: “The Top 27 Things People Say When You're Childless (…and how to respond)    Download this helpful guide to handle common questions and comments that can feel intrusive or hurtful: https://lanamanikowski.com/thingspeoplesay   For fertility doctors, fertility clinics, and anyone involved in patient care, this episode is a heartfelt reminder that the impact of fertility treatments extends far beyond conception. Understanding and addressing these needs can help more women feel seen and supported through their childless journeys.  

Join us for an insightful episode of the Oncology Brothers podcast as we dive deep into the world of gynecologic oncology, focusing specifically on endometrial cancer. Hosted by Drs. Rohit and Rahul Gosain, this episode features Dr. Shannon Westin, a Professor of Gynecology, Oncology, and Reproductive Medicine at the MD Anderson Cancer Center. In this episode, we explored: •⁠  ⁠The different histologies of endometrial cancer, including endometrioid, serous, clear cell, and undifferentiated types. •⁠  ⁠The evolving landscape of molecular classification and its impact on treatment decisions. •⁠  ⁠The current treatment paradigms for early-stage and advanced endometrial cancer, including the role of surgery, chemotherapy, and immunotherapy. •⁠  ⁠The significance of NGS (Next-Generation Sequencing) testing in identifying actionable mutations, such as MSI-high tumors and HER2-positive cancers. •⁠  ⁠The latest advancements in adjuvant therapies and the potential of combining chemotherapy with immunotherapy. Whether you're a healthcare professional or simply interested in the latest developments in cancer treatment, this episode is packed with valuable insights and expert opinions. Don't forget to like, subscribe, and check out our other discussions focusing on ovarian cancer and more! Website: http://www.oncbrothers.com/ X/Twitter: https://twitter.com/oncbrothers Contact us at info@oncbrothers.com

Hello, beautiful! I'm so glad you're here for this week's episode of The "So Now What?" Podcast.  If you're watching on YouTube, you'll notice I'm in a different setting than usual. I'm currently in Denver, attending the American Society of Reproductive Medicine  (ASRM) Annual Congress. This episode might sound a bit different, but it's coming straight from the heart, and I think it's one you'll connect with if you've been searching for recognition after leaving IVF or fertility treatments without the child you dreamed of. In this episode, I share a deeply personal story about reuniting with my reproductive endocrinologist after six years of wondering what I'd say if we ever crossed paths again. This was the doctor who, back in 2018, told me my only frozen embryo wasn't viable for implantation. It was a moment that shifted everything for me and my journey to motherhood. If you've ever felt like you were left to figure out life on your own after fertility treatments, this episode is for you. I talk about what it was like to finally speak with him face-to-face and express gratitude for his efforts, even though the outcome wasn't what I'd hoped for. It was also an opportunity to tell him how I've moved forward—leaving my corporate career, becoming a life coach, and now dedicating myself to helping women like you who are navigating life after IVF. As you listen, I want you to think about what you would say if you ever had the chance to speak to your own Reproductive Endocrinologist (RE) or fertility team again. What would you want them to know about where you are today? Whether or not you ever get that chance, it's important to acknowledge yourself for how far you've come and the life you're creating, even though it looks different than what you envisioned. After the episode, I encourage you to take a few minutes to write down what your conversation would look like. It's a powerful exercise in recognizing your strength, resilience, and everything you've achieved since your fertility journey ended. And if you're still feeling unsure about what's next, I'm here to help. Book a free Thrive Call with me, and together, we'll create a plan for how you can move forward feeling fulfilled, even without the children you hoped for. It's time to thrive again, and I'm here to walk that path with you. Key Takeaways: You're not alone in feeling left behind after fertility treatments. It's a common experience to feel lost without the support and guidance you once had. Think about what closure looks like for you. Even if you never speak to your RE again, you can still acknowledge what you've accomplished since that part of your life ended. Your story is yours to create. The narrative around living without children doesn't have to be one of loss or sadness. You have the power to rewrite your story into something beautiful and fulfilling. Resources: YouTube:  Watch this week's podcast on Youtube.  Find my YouTube channel here. Free Download: The Top 27 Things People Say When You're Childless and How to Respond. Grab your free copy at https://LanaManikowski.com/thingspeoplesay Thrive Call: Ready to create a plan for thriving without the children you dreamed of? Schedule a free Thrive Call with me at https://LanaManikowski.com/thrivecall Thank you for tuning in this week. Remember, it's never too late to discover your meaning and create a life that feels whole, even if motherhood wasn't part of your story. I'm so proud of you for showing up and doing the work to live life on your terms. Until next week, take care, and know that I see you, I celebrate you, and I love you.  

How do you revolutionise medicine, helping develop an entire new field of medical science in this country? Well, back when he was a young doctor Professor Gab Kovacs did just that. By starting small and taking 1 step at a time he helped change the practice of reproductive medicine, by pioneering IVF in this country – “test tube” babies they used to be called - as an option for infertile couples to have children in the late 1970's. Professor Kovacs worked with the greats, lead by Dr Carl Wood and Alan Trounson, those doctors and scientists who researched, tested, achieved breakthroughs and broke down barriers, to change the way infertility was treated and managed. This team was so successful, after years of hard work they built a thriving business that has enabled thousands of Australian women, and many more around the world, to have babies when their bodies' biological doors seemed closed forever.See omnystudio.com/listener for privacy information.

Imagine a world where parents have the power to protect their future children from inherited genetic disorders before they even take their first breath. In this episode, we dive into the groundbreaking science of single euploid embryo transfers and Preimplantation Genetic Testing (PGT) with returning guest, Dr. Rachel Danis, a reproductive endocrinologist, infertility specialist, and board-certified obstetrician and gynecologist at RMA of New York. Join us as we discuss Dr. Danis' research on this topic, how this technology is revolutionizing fertility treatments, and what it means for parents hoping to eliminate the risk of passing on genetic diseases. You'll also learn more about the ASRM 2024 Scientific Congress and Expo, where Dr. Danis will present her findings. Tune in as we uncover the science, the stories, and the ethical debates shaping the next generation of reproductive medicine! 

Host: Noah Parrish, Gender Justice Communications Director Guests: Erin Maye Quade, Gender Justice Special Projects Advisor, and Miraya Gran, Minnesota Building Families Coalition infertility advocate At Gender Justice, we advocate for gender equity under the law. We also subscribe to the philosophy of reproductive justice, a concept developed by Black women advocates in the 1990s defined as “the human right to maintain personal bodily autonomy, to have children, to not have children, and to parent the children we have in safe and sustainable communities.” Access to infertility treatment and services is a key component of this right.  Though specifics on state laws vary widely, 22 states and the District of Columbia require insurance to cover some kind of fertility treatment — but Minnesota isn't one of them. In this episode we talk with Miraya Gran, a leader of the Minnesota Building Families Coalition, and Gender Justice Special Projects Advisor Erin Maye Quade, who in her role as a Minnesota legislator is lead Senate author of the Minnesota Building Families Act, which would align Minnesota law with the position of the medical community as well as the reproductive rights, health, and justice communities. Links to resources mentioned in the show: Minnesota Building Families Coalition Sign up for action alerts Follow the Minnesota Building Families Coalition on Facebook and Instagram Infertility insurance coverage by state  Minnesota Building Families Act legislation  2024 letter to the Minnesota Senate Health and Human Services Committee from Gender Justice in support of the Minnesota Building Families Act  Disparities in access to effective treatment for infertility in the United States: an Ethics Committee opinion | American Society for Reproductive Medicine  ### Visit the "Gender Justice" Website ⁠here⁠ and "Unrestrict Minnesota" ⁠here⁠. The GJB is produced by Michael at ⁠www.501MediaGroup.com⁠

Recording of live IVIRMA Journal Club. Dr. Nola Herlihy presents a randomized controlled trial recently published in Human Reproduction on the use of platelet-rich plasma (PRP) in patients with poor ovarian response (POR). Drs. Manuel Muñoz and Emre Seli offer expert commentary on the use of PRP from the clinical and research perspectives, followed by Q&A from the audience. Podcast website: https://www.ivi-rmainnovation.com/fertilipod/

Dympna Lynch Weil, MD is a board-certified obstetrician-gynecologist with a long-standing interest in women's health and physician wellness. She received her undergraduate and medical degrees at NYU and completed her residency in OB/GYN and Reproductive Medicine at Stony Brook Medicine where she was Chief Resident, remained on Faculty for several years and was the Assistant medical student clerkship director. Dr. Weil was most recently in clinical practice as an OBGYN Hospitalist, with experience in academics and private practice. During more than twelve years of clinical practice, Dympna was committed to education and service: she was an educator of patients, medical students, and residents, while also serving in various leadership positions. Dr. Weil founded and Chaired the Clinician Wellness Committee at her organization. She also was a member of the CARE program – a peer-to-peer support group within the organization to help with second victim and difficult outcomes among her colleagues.Dympna is a Physician Wellness Advocate, author + speaker who empowers and educates healthcare practitioners, residents, and students who are struggling in their lives to advocate and take of themselves from the inside out. Work-life harmony, self-care, medical litigation, infertility, and self-compassion are among the coaching topics which are near to her heart. She trained with Martha Beck and is a Certified Wayfinder Master Coach; she also holds her ICF certification as an Associate Certified Coach and she is featured in the American Medical Women's Association's Physician Coaching Directory.Some of the topics we discussed were:The importance of self care and self compassion in protecting your wellbeingPractical strategies for practicing self compassion and preventing burnoutHow to allow yourself to feel and recognize your emotions without getting overwhelmed by them Dr. Weil's dialing up and dialing down methods for dealing with intense emotionsHow the push to be resilient can overshadow the need to take care of ourselves, especially as physicians who deal with the emotional toll of working in medicineWhy perfectionism can hold us back How doing an activity you really enjoy that captures your attention and gets you out of your head is a form of meditationThe benefits of prioritizing physical wellness on patient care and outcomesAnd more!Learn more about me or schedule a FREE coaching call:https://www.joyfulsuccessliving.com/Join the Voices of Women Physicians Facebook Group:https://www.facebook.com/groups/190596326343825/Connect with Dr. Weil:Website:https://www.dympnaweil.com/LinkedIn:https://www.linkedin.com/in/dympnaweil/Facebook:https://www.facebook.com/dympna.weilInstagram:https://www.instagram.com/dympnaweil/

AshLeigh Meyer Dunham is one of five reproductive law lawyers in Alabama and the only one who has done IVF. She was front and center when IVF stopped for 3 weeks in early 2024 due to a lawsuit brought by IVF patients in front of the State Supreme Court. On this episode of Baby or Bust, Dr. Shahine asks AshLeigh to explain what happened in Alabama, how treatments restarted, and what the process means for access to IVF in the future. AshLeigh explains why the way IVF restarted in Alabama is not a permanent solution and what this means for the future of IVF in Alabama and all of the United States.  Threats, political and legal, against IVF have been all over the news lately. All the controversy and proposed legislation is downright terrifying because for some, as IVF may be the best or only option they have to build their families.  One thing is very clear: people's right to build their families how and when they choose — and sometimes to build them at all — is under attack. Please share this episode to educate and spread knowledge and awareness.  In this episode you'll hear: [2:35] AshLeigh's IVF journey [5:40] Legal context around Alabama's IVF ban [15:15] Legal and clinical implications of an IVF ban [36:55] Ongoing legal challenges [42:00] Advocacy and legislative efforts [47:20] Future prospects with reproductive rights Resources mentioned:   Find AshLeigh Meyer Dunham on IG - @magiccityfertilitylaw and her firm www.magiccityfamilylaw.com  The Case Discussed: LePage v. Center for Reproductive Medicine, P.C.: hlaw.justia.com/cases/alabama/supreme-court/2024/sc-2022-0579.html  doctorsforfertility.com: nonprofit co-founded by Dr. Shahine   www.fightforalabamafamilies.org Dr. Shahine's Weekly Newsletter on Fertility News and Recommendations Follow @drlorashahine Instagram | YouTube | Tiktok | Her Books

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.    

Join HeHe as she sits down with Dr. Jessica Ryniec from CCRM Fertility of Boston to delve into the crucial topic of sperm quality and male fertility. In this episode, they discuss what sperm quality means, how sperm analysis is conducted, and the impact of lifestyle, supplements, and medications on sperm health. Dr. Ryniec also provides insights into the factors affecting sperm morphology, the importance of a healthy lifestyle, and the potential effects of lifestyle choices like bicycling and using hot tubs. Learn about the role of antioxidants in sperm health, the importance of using fertility-friendly lubricants, and the process and benefits of freezing sperm for future fertility planning. Whether you're trying to conceive or just curious about reproductive health, this episode offers invaluable information and expert advice.   Understanding Sperm Quality Sperm Morphology and Variations Key Terms in Semen Analysis Who Should Get a Semen Analysis? Impact of Lifestyle on Sperm Quality Supplements and Medications for Sperm Quality Lubricants and Sperm Health Steps for Getting a Semen Analysis Freezing Sperm: When and Why     Guest Bio: Dr. Jessica Ryniec is double board certified in Obstetrics and Gynecology, as well as Reproductive Endocrinology and Infertility. She joined CCRM Boston in 2020 after completing her fellowship at the University of Vermont Medical Center in Burlington, VT.   She received her undergraduate degree from Wake Forest University and her MD from Georgetown University School of Medicine in Washington, D.C. During her residency for obstetrics and gynecology at Rutgers Robert Wood Johnson Medical School, Dr. Ryniec received the Excellence in Female Pelvic Medicine Award and recognition for Outstanding Accomplishment in Women's Health.   In addition to presenting her research at prestigious medical conferences, such as the American Society for Reproductive Medicine and the Society for Reproductive Investigation Annual Meeting, Dr. Ryniec has authored several publications for notable peer-reviewed journals, including the American Journey of Obstetrics and Gynecology.   Dr. Ryniec practices medicine embracing the motto of Cura Personalis, or care of the entire person. She believes in education and in the value of shared decision making and patient empowerment, and spends time on social media educating, empowering, and supporting people while trying to conceive, going through fertility treatments or fertility preservation. She believes in family, and understands that family comes in many forms, and is committed to helping her patients achieve the family they desire. Social Media: Connect with HeHe on IG  Connect with Dr. Ryniec on IG  Connect with HeHe on YouTube   BIRTH EDUCATION: Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience!   Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone!

Send us a Text Message.In this episode of "Taco Bout Fertility Tuesday," Dr. Mark Amols delves into the groundbreaking world of vitrification—a transformative technique that has revolutionized the field of fertility preservation. Vitrification, or flash freezing, is a process that prevents the formation of ice crystals in cells, ensuring their viability and integrity. This episode unpacks the science behind vitrification, explaining how it differs from traditional slow freezing methods and why it represents a significant advancement in reproductive medicine.Join Dr. Amols as he explores the origins of vitrification, initially developed for preserving tissues, and its subsequent adaptation for freezing eggs, embryos, and stem cells. Learn about the challenges of slow freezing, where the formation of ice crystals could damage cells, and how vitrification overcomes these obstacles with remarkable efficiency.Dr. Amols discusses the profound impact of vitrification on IVF success rates, highlighting how survival rates have soared from 55-65% with slow freezing to over 90% with vitrification. He shares compelling stories from his own practice, demonstrating how this technology has improved outcomes for patients, allowing for more flexible and safer fertility treatments.This episode also covers the broader implications of vitrification beyond human fertility, including its applications in the food industry, animal breeding programs, and the preservation of sensitive drugs and vaccines. Dr. Amols explains how future advancements, such as nanotechnology and magnetic freezing, promise to further enhance cryopreservation techniques.Whether you're a scientist, a student, or someone navigating the complexities of fertility treatment, this episode provides a thorough and engaging look at one of the most significant advancements in reproductive science. Tune in to understand how vitrification is not just preserving cells, but also hopes and dreams for countless individuals and families.If you enjoy this episode, please leave a five-star review and share it with friends who might find the science of fertility fascinating. As always, Dr. Amols looks forward to bringing you more insights on "Taco Bout Fertility Tuesday."Thanks for tuning in to another episode of 'Taco Bout Fertility Tuesday' with Dr. Mark Amols. If you found this episode insightful, please share it with friends and family who might benefit from our discussion. Remember, your feedback is invaluable to us – leave us a review on Apple Podcasts, Spotify, or your preferred listening platform. Stay connected with us for updates and fertility tips – follow us on Facebook. For more resources and information, visit our website at www.NewDirectionFertility.com. Have a question or a topic you'd like us to cover? We'd love to hear from you! Reach out to us at TBFT@NewDirectionFertility.com. Join us next Tuesday for more discussions on fertility, where we blend medical expertise with a touch of humor to make complex topics accessible and engaging. Until then, keep the conversation going and remember: understanding your fertility is a journey we're on together.

How many old wives' tales have you heard about nutrition and fertility? More importantly, how often have doctors told you that intentional weight loss will miraculously improve your IVF outcomes? If you're even slightly “overweight” and experiencing fertility issues, it's common for doctors to subtly (or not so subtly) suggest you “lose a little weight” as a solution. In this episode, I'm joined by Rachelle LaCroix Mallik. We'll take a deep dive into the limitations of studies claiming that weight loss boosts health. Spoiler alert: these studies often miss the mark by not considering other crucial factors like specific eating habits, physical activity, and improved glucose metabolism. Imagine that! Rachelle (Rachel) LaCroix (LaCwa) Mallik (Mal-ick), MA, RD, LDN. She is a dietitian and founder of The Food Therapist, a virtual private practice specializing in nutrition counseling and education for reproductive health. Rachelle supports clients who are trying to conceive, pregnant, postpartum, breastfeeding or managing conditions like PCOS and endometriosis with a weight-inclusive approach that focuses on nourishment rather than restriction. Rachelle has been working in reproductive health for 18 years, starting as an IVF patient coordinator at the Weill Cornell Center for Reproductive Medicine, and is a mom to two young children. Rachelle is a member of the Academy of Nutrition and Dietetics, including the Women's Health Dietetic Practice Group. She is also an active member of the Nutrition Special Interest Group of the American Society for Reproductive Medicine (ASRM). Rachelle serves as the reproductive nutrition content expert for the Nutrition Care Manual. She has presented for the Chicago Academy of Nutrition and Dietetics and at the ASRM Scientific Congress, and advocates for the role of nutrition and dietitians in multidisciplinary reproductive healthcare. Note: We're celebrating three amazing years of the Understanding Disordered Eating podcast! Just as a reminder, we're taking a two-week break at the end of August. We'll be back with fresh content after Labor Day weekend, on September 10th. In the meantime, catch up on our older episodes—they're still gems! Tweetable Quotes "Intentional weight loss doesn't necessarily improve your IVF outcomes." - Rachelle LaCroix Mallik "If any of the information that you are consuming, whether it's on this podcast or outside, especially in regards to fertility, if it makes you stressed and anxious, it is not for you." - Rachelle Heinemann "We all have to eat, so let's use nutrition to really work for us and help us feel as good as we can along that journey." - Rachelle LaCroix Mallik "Nutrition may have an impact on both natural conception as well as fertility treatment outcomes." - Rachelle LaCroix Mallik  Resources Connect with Rachelle here: http://www.rachellemallik.com Find Rachelle on Instagram! @rachellemallik Learn more about her Fertility Foundations nutrition course here Grab my Journal Prompts Here! Grab the Replay of the Resistance in Treatment Webinar Now accepting new clients! Find out if we're a good fit!    LEAVE A REVIEW + help someone who may need this podcast by sharing this episode. Be sure to sign up for my weekly newsletter here! You can connect with me on Instagram @rachelleheinemann, through my website www.rachelleheinemann.com, or email me directly at rachelle@rachelleheinemann.com

Since Dobbs v. Jackson Women's Health Organization, state courts and legislatures have grappled with its legal and policy implications, especially as they pertain to abortion and IVF. In LePage v. Center for Reproductive Medicine, for example, the Alabama Supreme Court held that frozen embryos should be regarded as “children” for the purposes of Alabama's Wrongful […]

Wtf just happened with frozen embryos, fertility clinics and IVF in Alabama?? Get ready for the un-true crime, sci-fi Jesus saga of LePage v Center for Reproductive Medicine. As in, the case behind the Alabama state supreme court's ruling that frozen embryos for IVF are “EXTRAUTERINE CHILDREN” in a “CRYOGENIC NURSERY” and therefore are full-ass people?? Cristen ragesplains how this anti-abortionist legal buffoonery happened, the fetal personhood of it all and why “save IVF” is a bait and switch. Learn more about your ad choices. Visit megaphone.fm/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Wtf just happened with frozen embryos, fertility clinics and IVF in Alabama?? Get ready for the un-true crime, sci-fi Jesus saga of LePage v Center for Reproductive Medicine. As in, the case behind the Alabama state supreme court's ruling that frozen embryos for IVF are “EXTRAUTERINE CHILDREN” in a “CRYOGENIC NURSERY” and therefore are full-ass people?? Cristen ragesplains how this anti-abortionist legal buffoonery happened, the fetal personhood of it all and why “save IVF” is a bait and switch. Learn more about your ad choices. Visit megaphone.fm/adchoices