Podcasts about Sterility

Take a sneak peek at this month's Fertility & Sterility! Articles discussed this month are:   (04:48) Advanced maternal age was associated with an annual decline in reproductive success despite use of donor oocytes: a retrospective study (15:16) Developing a decision support tool to optimize oocyte thawing for producing at least three euploid blastocysts (23:47) Effect of denosumab on semen quality in infertile men selected by serum level of antimüllerian hormone: a randomized controlled trial (31:06) Progestin prime ovarian stimulation provides comparable outcomes to GnRH antagonist in donor cycles with vitrified oocytes (41:13) Impact on clinical outcomes of membership in the Society for Assisted Reproductive Technology (48:58) Linzagolix with and without hormonal add-back therapy for symptomatic uterine fibroids: PRIMROSE 1 & 2 long-term extension and withdrawal study (56:30) Cumulative pretrigger progesterone levels are not superior to single-day levels for predicting a failed cycle in fresh embryo transfer cycles View the October 2025, Volume 124 Issue 4 of Fertility and Sterility at https://www.fertstert.org/issue/S0015-0282(25)X0010-8 View Fertility and Sterility at https://www.fertstert.org/  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: whether the optimal time interval for trigger varies depending on the trigger medication used (02:36), the mechanisms by which different trigger medications affect final oocyte maturation (16:05), how alcohol alters the blood-testis barrier function (31:10), and an analysis of the TikTok content specific to endometriosis-related infertility (45:15). F&S Reports: https://www.fertstertreports.org/article/S2666-3341(25)00114-X/fulltext   F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(25)00010-6/fulltext F&S Science:  https://www.fertstertscience.org/article/S2666-335X(25)00050-3/fulltext Consider This: https://www.fertstert.org/article/S0015-0282(24)00873-2/fulltext View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

Welcome to Fertility & Sterility Roundtable! Each month, we will host a discussion with the authors of "Views and Reviews" and "Fertile Battle" articles published in a recent issue of Fertility & Sterility.  This month, we welcome Dr. Lydia Hughes and Dr. Eric Widra to discuss the ethics of egg-sharing, or "split-cycles" for fertility preservation. This is where an egg donor freezes their eggs for their own future use for reduced or no cost in exchange for donating a portion of the cohort. Dr. Hughes is a second-year REI fellow at Northwestern University in Chicago, where she also completed her residency in Obstetrics and Gynecology. She earned her medical degree from the University of Alabama at Birmingham. Dr. Hughes's clinical and academic interests include reproductive ethics, PCOS, and ovarian aging.  Dr. Widra currently serves as Executive Senior Medical officer and Vice President, Development for Shady Grove Fertility and US Fertility, respectively.  He was formerly Chief Medical Officer of SG Fertility, and Associate Director of the Combined Federal Fellowship in Reproductive Endocrinology and Infertility, operated through the NIH, Walter Reed National Military Medical Center and SG Fertility. View Fertility and Sterility at https://www.fertstert.org/    

Fertility & Sterility on Air is at the European Society of Human Reproduction and Embryology 41st Annual Meeting in Paris, France (Part 2)! In this episode, our hosts Kate Devine, Eve Feinberg, and Micah Hill cover: Discussing the state of assisted reproductive technology in Brazil with Giuliano Bedoschi (01:01) Whole transcriptome and genome sequencing of standard embryo biopsies can potentially reduce failed euploid transfers with Kaylene Ready and Jeremy Grushcow (09:03)  The use of AI in ovarian stimulation with Eduardo Hariton (19:45)  Modeling embryonic adhesion at cellular resolution within a microfluidic endometrium-on-a-chip platform with Sofia Zaragozano (32:33)  Assessing the ploidy status of atypically fertilised embryos – recovery of embryos for potential clinical use with Sharyn Stock-Myer (40:41)  Role of micronutrients and probiotics supplementation on reproductive outcomes in an oocyte donation program with Sara Maggi and Silvia Bonta (42:47)  Male infertility, life expectancy, and long-term health risks: exploring what can sperm reveal about health with Omar Ammar (58:00) Mitochondrial DNA ‘reversal' is common in children born following meiotic spindle transfer, potentially reducing the efficacy of mitochondrial replacement therapies with Munuse Savash (01:05:57) View Fertility and Sterility at https://www.fertstert.org/  

Fertility & Sterility on Air is at the European Society of Human Reproduction and Embryology 41st Annual Meeting in Paris, France (Part 1)! In this episode, our hosts Kate Devine, Eve Feinberg, and Micah Hill cover:  outcomes from programmed ovulatory frozen embryo transfer cycles vs. modified natural frozen embryo transfer cycles with Philippos Edimiris (0:56), non-invasive preimplantation genetic testing using metabolomics with Sofia Nunes (9:23), optimizing timing of modified natural cycle frozen embryo transfer cycles with Amelie Johansen and Kristine Løssl (17:46), mechanisms and consequences of ovarian aging with Francesca Duncan (27:18), comparing pregnancy loss rates in natural cycle vs. artificial cycle endometrial preparation prior to euploid embryo transfer with Caroline Roelens (38:24), and endometrial health and reproductive outcomes with Shari Mackens(49:44). View Fertility and Sterility at https://www.fertstert.org/  

Take a sneak peek at this month's Fertility & Sterility! Articles discussed this month are:   04:20 Poor intracytoplasmic sperm injection outcome in infertile males with azoospermia factor c microdeletions 10:17 Patients with a body mass index of ≥45 kg/m2 can safely undergo oocyte retrievals and anticipate similar assisted reproductive technology outcomes 21:26 Increased endometrial thickness up to 12 mm is associated with increased odds of live birth among fresh and frozen-thawed autologous transfers with or without preimplantation genetic testing 34:21 The chorionic bump is a predictor of miscarriage: a retrospective analysis of 13,656 in vitro fertilization pregnancies 47:01 Prospective validation of anti-Müllerian hormone cutoff to determine polycystic ovarian morphology: HARMONIA study 58:21 Effect of glucagon-like peptide 1 agonist medications on weight loss in patients with and without polycystic ovary syndrome View Fertility and Sterility at https://www.fertstert.org/    

Welcome to Fertility & Sterility Roundtable! Each month, we will host a discussion with the authors of "Views and Reviews" and "Fertile Battle" articles published in a recent issue of Fertility & Sterility.  This month, we are excited to talk about State Level Advocacy with Elizabeth Carr, the first baby born via IVF in the United States, and Dr. Preston Parry. Elizabeth Carr is a passionate advocate for fertility rights and access. She has presented to audiences around the globe including at the United Nations, ASRM, ESHRE, and the national infertility association, RESOLVE. She has helped companies craft benefit packages and parental leave policies. Her professional experience in the field of journalism, marketing and events, and fundraising. She enjoys marathons and is a writer when not advocating.  Dr. Preston Parry completed residency in Ob/Gyn at Tufts and went south to Louisville for his fellowship in Reproductive Endocrinology and Infertility. He was in academic REI for 8 years, including as division chief, before opening his own practice, Positive Steps Fertility, in 2017. He is a past president of the Society of Reproductive Surgeons and is currently the chair of ACOG Mississippi. He also is on the Editorial Board of Fertility and Sterility.  View Fertility and Sterility at https://www.fertstert.org/  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: impact of environmental toxins on in vivo gametes (1:30); the effect of embryo vitrification on neonatal outcomes (15:40); impact of compressive force on gene expression in uterine fibroids (31:17); the role of automation in the IVF lab (42:25). F&S Reviews:  https://www.fertstertreviews.org/article/S2666-5719(25)00004-0/fulltext F&S Reports: https://www.fertstertreports.org/article/S2666-3341(25)00112-6/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(25)00048-5/fulltext Consider this: https://www.fertstert.org/news-do/potential-automated-ivf-lab View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

Take a sneak peek at this month's Fertility & Sterility! Articles discussed this month are:   08:57 Trends in Use of Preimplantation Genetic Testing for Aneuploidy Before Dobbs, After Dobbs Leak, and After Dobbs Final Ruling 20:12 The impact of PGT-A on time to live birth in IVF. 32:02 A Nationwide Analysis of the Trends in Permanent Contraception Utilization Before and After the Dobbs Ruling   37:28 Use of assisted reproductive technologies for male and female infertility and perinatal outcomes  50:50 Assisted hatching decreases pregnancy outcomes in vitrified donor oocytes 56:42 Use of medically assisted reproduction and the risk of multiple live birth across sexual orientation groups—results from a national longitudinal cohort   View the August 2025 issue, Vol 124: Issue 2 - https://www.fertstert.org/issue/S0015-0282(25)X0008-X View Fertility and Sterility at https://www.fertstert.org/  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: whether drug-free in vitro activation with immediate autotransplantation improved reproductive outcomes in patients with poor ovarian response and premature ovarian insufficiency (2:13); resident management of pregnancy of unknown location (16:42); integration of mental health treatment into the care of Mullerian agenesis (26:38), and a narrative review of blastocyst development as a surrogate for pregnancy outcomes (36:27). F&S Science: https://www.fertstertscience.org/article/S2666-335X(25)00040-0/abstract Consider this: https://www.fertstert.org/news-do/beta-book-beta-overlooked-exploring-systems-pul-surveillance-residency F&S Reports: https://www.fertstertreports.org/article/S2666-3341(25)00057-1/fulltext F&S Reviews:  https://www.fertstertreviews.org/article/S2666-5719(25)00008-8/fulltext View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org    

Get YDS Merch before July 25!!Support us on Patreon!This week on Your Diet Sucks, we're talking hormones: what they are, what they do, and why they've become the latest scapegoat for every diet culture grift on the internet. From adrenal fatigue (not real) to seed cycling (also not real), Zoë and Kylee cut through the pseudoscience and explain what actually supports hormone health—like eating enough, managing stress, and getting some damn sleep. We also take a look at the unhinged history of hormone manipulation (yes, monkey testicle transplants come up), why cortisol isn't your enemy, and what to do if your hormones actually feel off. If you've ever been told to “balance your hormones” with a supplement stack or juice cleanse, this episode is for you.Thanks to our sponsors:Get over 70 biomarkers analyzed and get personalized nutrition recommendations adn support, tailored specifically for athletes with Eternal's new Foundations membership. Try Tailwind's limited edition blueberry lemonade! Use YOURDIET20 for 20% OFF first order.Check out Janji's new summer shorts, sports bras, packs, and more! Use code YDS10 for 10% off!Run, bike, ski, with Microcosm Coaching. We coach humans, not just athletes. Book a free consultation call today!ReferencesBayliss, W. M., & Starling, E. H. (1902). The mechanism of pancreatic secretion. The Journal of Physiology, 28(5), 325–353. https://doi.org/10.1113/jphysiol.1902.sp000911Cadegiani, F. A., & Kater, C. E. (2016). Adrenal fatigue does not exist: A systematic review. BMC Endocrine Disorders, 16, 48. https://doi.org/10.1186/s12902-016-0128-4Cohen, P. A., Avula, B., Venhuis, B., Travis, J. C., Wang, Y. H., & Khan, I. A. (2014). Pharmaceutical ingredients in botanical dietary supplements: A review of the literature. Drug Testing and Analysis, 6(7–8), 587–596. https://doi.org/10.1002/dta.1525Duggan, C., Carbo, J. M., Wang, C. Y., et al. (2015). Effects of carbohydrate intake on the thyroid axis and reproductive hormones in healthy adults: A randomized controlled feeding study. Nutrition Journal, 14, 70. https://doi.org/10.1186/s12937-015-0054-6Hamilton-Reeves, J. M., Vazquez, G., Duval, S. J., Phipps, W. R., Kurzer, M. S., & Messina, M. J. (2010). Clinical studies show no effects of soy protein or isoflavones on reproductive hormones in men: Results of a meta-analysis. Fertility and Sterility, 94(3), 997–1007. https://doi.org/10.1016/j.fertnstert.2009.04.038Kantor, E. D., Rehm, C. D., Du, M., White, E., & Giovannucci, E. L. (2016). Trends in dietary supplement use among US adults from 1999–2012. JAMA, 316(14), 1464–1474. https://doi.org/10.1001/jama.2016.14403Messina, M. (2010). Insights gained from 20 years of soy research. The Journal of Nutrition, 140(12), 2289S–2295S. https://doi.org/10.3945/jn.110.124107Mountjoy, M., Sundgot-Borgen, J., Burke, L., et al. (2018). International Olympic Committee (IOC) consensus statement on relative energy deficiency in sport (RED-S): 2018 update. British Journal of Sports Medicine, 52(11), 687–697. https://doi.org/10.1136/bjsports-2018-099193Ross, A. C., Caballero, B. H., Cousins, R. J., Tucker, K. L., & Ziegler, T. R. (Eds.). (2020). Modern nutrition in health and disease (12th ed.). Wolters Kluwer.Takamine, J. (1901). The isolation of the active principle of the suprarenal gland. The Journal of the American Medical Association, 36(24), 1698–1698. https://doi.org/10.1001/jama.1901.02470350030010

Take a sneak peak at this month's Fertility & Sterility! Articles discussed this month are:   04:20 A Pilot Study to Investigate the Clinically Predictive Values of Copy Number Variations Detected by Next-Generation Sequencing of Cell-Free Deoxyribonucleic Acid in Spent Culture Media   17:16 The Impact of Microfluidics Sperm Processing on Blastocyst Euploidy Rates Compared with Density Gradient Centrifugation: A Sibling Oocyte Double-Blinded Prospective Randomized Trial   24:12 Prediction of Pregnancy-Related Complications in Women Undergoing Assisted Reproduction, Using Machine Learning Models   38:51 The Effect of Laser-Assisted Hatching on Vitrified/Warmed Blastocysts: The ALADDIN Randomized Controlled Trial   48:47 Assessment of Clinical Pregnancies in Up to Eight Ovarian Stimulation with Intrauterine Insemination Treatment Cycles in Those Unable to Proceed with In Vitro Fertilization   01:00:43 Intravaginal Exposure to Seminal Plasma After Ovum Pick-Up Does Not Increase Live Birth Rates after In Vitro Fertilization or Intracytoplasmic Sperm Injection Treatment:  A Double-Blind, Placebo-Controlled Randomized Trial   01:07:21 Predictive Models of Miscarriage on the Basis of Data from the Preconception Cohort Study   View this issue at https://www.fertstert.org/issue/S0015-0282(24)X0006-0 View Fertility and Sterility at https://www.fertstert.org/

Take a sneak peak at this month's Fertility & Sterility! Articles discussed this month are:   03:32 How Many Infants Have Been Born With the Help of Assisted Reproductive Technology? 11:33 Adding Short-Duration Gonadotropin-Releasing Hormone Antagonist and Gonadotropin to Natural Cycle Frozen Embryo Transfer Allowed Scheduling of Transfer Day Without Compromising Live Birth 24:42 Sublingual Progesterone Lozenges Are a Viable Alternative to Intramuscular Porgesterone-in-Oil for Programmed Frozen Embryo Transfer Cycles 33:08 Perinatal Outcomes of Progesterone in Natural Frozen-Thawed Embryo Transfer Pregnancies: Insights From 2 Randomized Controlled Trials 42:38 Cost Effectiveness Analysis of Uterus Transplantation vs. Gestational Carrier for Treatment of Absolute Uterine Factor Infertility in the United States AND Comparing Gestational Carrier with Uterine Transplantion in Uterine-Factor Infertility: A Cost-Effectiveness Analysis 01:03:28 Extended Intrauterine Balloon Stent Use to Prevent Adhesion Reformation After Hysteroscopic Adhesiolysis, A Randomized Trial View the July 2025 issue, Vol 124: 1-178 - https://www.fertstert.org/issue/S0015-0282(25)X0006-6 View Fertility and Sterility at https://www.fertstert.org/  

It began with a disagreement, and it led to the near total decimation of life on Earth. Those who survived hoped to rebuild society, but they faced foes in the forms of sterility and mutant frogpeople. Then came Sam Hell, and where he came was to Frogtown, and we won't touch the other obvious play on that verb. We're talking about the First Roddy Piper Lead Film Role... 1988's Hell Comes To Frogtown! And don't worry, there's a flap. We also recast the film in the MouthGarf Report and we see what each other did there in I See What You Did There! Plus, MEAT BEEF!Please give us a 5 star rating on Apple Podcasts! Want to ask us a question? Talk to us! Email debutbuddies@gmail.comListen to the archives of Kelly and Chelsea's awesome horror movie podcast, Never Show the Monster.Get some sci-fi from Spaceboy Books.Get down with Michael J. O'Connor's music!Next time: First Baseball Walk-Up Song

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: efficacy of hCG in restoring spermatogenesis in men using non-prescribed androgens (1:31), assessing prediction models for the risk of OHSS in women undergoing assisted reproductive technology (13:51), utilization of a 3D in vitro co-culture system to characterize embryonic mechanisms associated with implantation (25:09), and a look at TikTok's growing influence on supplement advice for patients with PCOS (33:38). F&S Reports: https://www.fertstertreports.org/article/S2666-3341(25)00050-9/fulltext F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00043-4/abstract F&S Science: https://www.fertstertscience.org/article/S2666-335X(25)00022-9/abstract  Consider this: https://www.fertstert.org/news-do/tiktok-replacing-doctors-rise-pcos-supplement-advice-online View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

Oba and Shango had a few problems in their marriage. Can they solve this problem? Tell us what you thought about this story.Reference: Brown, David H. Patakin: Orisha Stories from the Odu of Ifá

Fertility & Sterility on Air is at the Pacific Coast Reproductive Society 2025 Annual Meeting in Indian Wells, CA! In this episode, our hosts Kate Devine and Micah Hill talk with: PCRS leadership Alexander Quaas and Jason Franasiak discussing this and future conferences (0:41), Shannon Rainsford about Protamine 2 deficiency (9:54), Andria Besser about mosaic and segmental PGT-A results (16:15), Emily Patterson about comprehensive carrier screening (28:35), Esther Chung about a low-cost progestin protocol for oocyte cryopreservation (32:23) and Howard Li discussing the feasibility of microwave drying for long-term storage of human oocytes at non-freezing temperatures (41:28). View Fertility and Sterility at https://www.fertstert.org/  

Join current F&S editors Drs. Micah Hill, Kurt Barnhart, and Allison Eubanks in an engaging discussion with past Editors-in-Chief, Drs. Alan DeCherney, Craig Niederberger, and Antonio Pellicer!  View Fertility and Sterility at https://www.fertstert.org/  

Take a sneak peek at this month's Fertility & Sterility! Articles discussed this month are:   02:17 Effects of preimplantation genetic testing for aneuploidy on embryo transfer outcomes in women of advanced reproductive age with no more than three retrieved oocytes 15:30 Using National IVF Registries to Validate Clinical Outcomes Following IVF Covered by Health Insurance  29:38 Impact of corpus luteum number on maternal pregnancy and birth outcomes: the Rotterdam Periconception Cohort 39:15 Systematic review and Meta-analysis of the impact of the re-freezing and re-biopsy embryos on reproductive outcomes in patients undergoing freeze-thaw embryo transfer   50:20 A blastocyst's implantation potential is linked to its originating oocyte cohort's blastulation rate: evidence for a cohort effect 01:02:56 Linzagolix rapidly reduces heavy menstrual bleeding in women with uterine fibroids: An analysis of the PRIMROSE 1 & 2 trials  View Fertility and Sterility at https://www.fertstert.org/

Join us for a special episode of F&S On Air: an interview discussing the seminal article, "Target trial emulation of preconception serum vitamin D status on fertility outcomes: a couples-based approach." Host Micah Hill interviews authors Julia DiTosto and Sunni Mumford. Read the article:  https://www.fertstert.org/article/S0015-0282(24)01963-0/fulltext View Fertility and Sterility at https://www.fertstert.org/

Take a sneak peak at this month's Fertility & Sterility! Articles discussed this month are:   4:08 Classification system of human ovarian follicle morphology: recommendations of the National Institute of Child Health and Human Development - sponsored ovarian nomenclature workshop  12:32 Impact of Prednisone on Vasectomy Reversal Outcomes (iPRED Study): Results from a Randomized, Controlled Clinical Trial 21:38 Triggering oocyte maturation in IVF treatment in normal responders: a systematic review and network meta-analysis 33:57 Parental Balanced Translocation Carriers do not have Decreased Usable Blastulation Rates or Live Birth Rates Compared to Infertile Controls  45:28 A re-look at the relevance of TSH and thyroid autoimmunity for pregnancy outcomes: Analyses of RCT data from PPCOS II and AMIGOS View Fertility and Sterility May 2025, Volume 123, Issue 5:  https://www.fertstert.org/issue/S0015-0282(25)X0004-2 View Fertility and Sterility at https://www.fertstert.org/

Fertility & Sterility on Air brings you a panel discussion from Best of ASRM and ESHRE 2025. Join our host, Dr. Eve Feinberg and the following panelists:  Aleks Rajkovic - 01:04 Henriette Nielsen - 10:09 Thomas Ebner/Sangita Jindal - 20:20 Angela Lawson - 29:24 Antonio Capalbo/Catherine Racowsky - 46:24 Herman Tournaye - 01:02:00

Fertility & Sterility on Air brings you a panel discussion from AAGL 2024 in New Orleans, LA! We bring you a joint episode with ASRM and the American Association of Gynecologic Laparoscopists. Join Pietro Bortoletto, Rebecca Flyckt, Zaraq Khan, and Charles Miller discussing management of endometriosis and adenomyosis from the eyes of the reproductive surgeon. View Fertility and Sterility at https://www.fertstert.org/  

In this micro-episode, we bring you an interview with Richard Paulson and Pierre Comizzoli, editors of the F&S Reports Special Issue, “Bridging Studies in Wild Animal Species and Humans to Better Understand, Assist, and Control Reproduction." Join us to discuss the connection between wild animal research and reproductive medicine. This interview provides an overview of this special issue, which is a series of articles in F&S Reports on topics ranging from koala reproduction to rhino ovarian tissue cryopreservation, from the microbiome to stem cells. View F&S Reports, April 2025, Volume 6, Supplement 1S1-66:  https://www.fertstertreports.org/issue/S2666-3341(25)X0003-9 View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: how attacks on abortion access can threaten IVF (1:58), the prevalence of adenoymosis in young people (12:58), and the impact of short-term Western-style diet and hyperandrogenism on ovarian function (26:02). Consider This: https://www.fertstert.org/news-do/writing-wall-ivf-access-could-follow-abortion-s-path F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00040-9/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(25)00021-7/abstract View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

Take a sneak peek at this month's Fertility & Sterility! Articles discussed this month are:   01:47 Puberty progression in girls with Turner syndrome after ovarian tissue cryopreservation 14:55 Optimal Restoration of Spermatogenesis following Testosterone Therapy using hCG and FSH 27:58 Human embryos with segmental aneuploidies display delayed early development: a multi-centre morphokinetic analysis 39:56 Neurodevelopmental or behavioural disorders in children conceived after assisted reproductive technologies: A nationwide cohort study 45:23 Efficacy and safety of estetrol (E4) 15 mg/drospirenone (DRSP) 3 mg combination in a cyclic regimen for the treatment of primary and secondary dysmenorrhea: A multicenter, placebo-controlled, double-blind, randomized study 51:13 Ovulation trigger versus spontaneous LH surge on live birth rate following frozen embryo transfer in a natural cycle: a randomized controlled trial 60:29 A Cost Analysis of Clomiphene Citrate, Letrozole and Gonadotropin with Intrauterine Insemination using Outcome Data from the AMIGOS Trial   View Fertility and Sterility at https://www.fertstert.org/

Join us each week as we do a quick review of three compelling stories from the pharma world — one good, one bad, and one ugly. Up this week: The good — Cellares, Cabaletta validate automated CAR T production The bad — FDA warns Aspen over sterility issues The ugly — FDA rejects Hengrui, Elevar cancer combo again

Sterility assurance isn't just another checkbox in our workflows—it's a commitment to excellence! In this episode of Beyond Clean Canada, we're breaking down the critical steps of equipment, exposure, pack, and load monitoring—where errors can happen and how to prevent them. With high turnover rates in MDR departments, Leeanne Ismail, Clinical Specialist at Solventum, stresses the need for ongoing education, industry collaboration, and forward-thinking solutions to maintain the highest patient safety standards. She also shares how advancements in sterilization technology are shaping the future of reprocessing and quality assurance. So, turn up the volume and join this can't-miss conversation today! A special shout-out to Solventum for sponsoring Season 1 of the Beyond Clean Canada Podcast! Make sure to follow us on LinkedIn and Facebook so you're always in the loop for every episode! #BeyondCleanCanada #MDR #SterileProcessing #EveryLoadMonitoring #Safety #Podcast #Solventum

Take a sneak peek at this month's Fertility & Sterility! Articles discussed this month are:   01:46 It is time to rethink coordination of fresh oocyte retrievals with microscopic testicular sperm extraction 02:55 Rescue intracytoplasmic sperm injection improved cumulative live birth rate for cycles with second polar body extrusion rate

SpaceTime Series 28 Episode 29The Astronomy, Space and Science News PodcastExploring Callisto's Ocean Potential, Laser Fossil Detection on Mars, and ISS Cleanliness ConcernsIn this episode of SpaceTime, we dive into exciting new research suggesting that Jupiter's moon Callisto may harbor a subsurface ocean, potentially making it another ocean world in our solar system. This revelation builds on data from NASA's Galileo spacecraft, which hinted at the presence of a salty liquid water ocean beneath Callisto's icy crust. Advanced modeling techniques have strengthened these claims, setting the stage for further exploration by NASA's Europa Clipper and ESA's Juice missions.Lasers on Mars: Searching for Ancient LifeWe also discuss innovative research that proposes using lasers to identify ancient microbial fossils on Mars. Scientists have successfully detected microbial fossils in gypsum on Earth, raising hopes that similar techniques could uncover evidence of past life on the Red Planet. The findings suggest that gypsum deposits on Mars could conceal traces of ancient life, preserved in mineral formations that formed when water evaporated billions of years ago.Health Implications of Sterility on the ISSAdditionally, we explore a new study indicating that the overly sterile environment of the International Space Station may be negatively impacting astronaut health. The research suggests that introducing a diverse range of microbes could potentially alleviate immune dysfunction and other health issues experienced by crew members during long missions in space.00:00 Space Time Series 28 Episode 29 for broadcast on 7 March 202500:49 New findings on Callisto's potential subsurface ocean06:30 Implications for future missions to Jupiter's moons12:15 Using lasers to detect ancient life on Mars18:00 Analysis of gypsum deposits and their significance22:45 Concerns regarding ISS cleanliness and astronaut health27:00 Overview of March's night sky and celestial events30:15 Celebrating PI Day and its significance in astronomywww.spacetimewithstuartgary.comwww.bitesz.com

Send us a textThe two-week wait after fertility treatment can feel endless, but what if a single blood test could give you insight into your pregnancy's future? In this episode of Taco Bout Fertility Tuesday, we break down the science behind hCG levels at 16 days post-ovulation and how they predict pregnancy outcomes. We'll discuss the role of hCG beyond just a pregnancy test, how it rescues the corpus luteum to sustain early pregnancy, and why progesterone supplementation changes how miscarriages present in fertility treatments. Plus, we analyze a key study from Fertility & Sterility (2000) to understand how different hCG levels correlate with pregnancy success or loss. Whether you're in the midst of an IVF cycle or just love diving into the science of fertility, this episode is packed with valuable insights. Tune in to learn what your hCG levels really mean and how to interpret them with your doctor!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.

Take a sneak peek at this month's Fertility & Sterility! Articles discussed this month are:   01:03 (Not) My body, my choice? - Should physicians be facilitating gestational carrier arrangements in the absence of medical indication? 05:22 Morphological changes of endometriomas during pregnancy and after delivery detected using ultrasound 12:17 Hormone-free vs. follicle-stimulating hormone–primed infertility treatment of women with polycystic ovary syndrome using biphasic in vitro maturation: a randomized controlled trial 24:37 Association of in vitro fertilization with severe maternal morbidity in low-risk patients without comorbidities 33:59 The association between primary ovarian insufficiency and increased multimorbidity in a large prospective cohort (Canadian Longitudinal Study on Aging) 41:28 Target trial emulation of preconception serum vitamin D status on fertility outcomes: a couples-based approach 52:59 Predicting a successful match among applicants to reproductive endocrinology and infertility fellowship View Fertility and Sterility February 2025, Volume 123, Issue 2:https://www.fertstert.org/issue/S0015-0282(24)X0015-1 View Fertility and Sterility at https://www.fertstert.org/

Take a sneak peek at this month's Fertility and Sterility! Articles discussed this month are:   02:59 Preimplantation genetic testing for aneuploidy is associated with reduced live birth rates in fresh but not frozen donor oocyte in vitro fertilization cycles: an analysis of 18,562 donor cycles reported to Society for Assisted Reproductive Technology Clinic Outcome Reporting System 19:37 Sperm concentration remains stable among fertile American men: a systematic review and meta-analysis 26:02 Preovulation body mass index and pregnancy after first frozen embryo transfer in patients with polycystic ovary syndrome and insulin resistance 36:54 A retrospective comparison of the impact of industry payments on assisted reproductive technology practice and outcomes 44:55 Preimplantation genetic testing for aneuploidy in unexplained recurrent pregnancy loss: a systematic review and meta-analysis 61:03 Initiation and outcomes of women pursuing planned fertility preservation 65:49 First successful ovarian cortex allotransplant to a Turner syndrome patient requiring immunosuppression: broad implications   View Fertility and Sterility October 2025, Volume 123, Issue 1: https://www.fertstert.org/issue/S0015-0282(24)X0014-X View Fertility and Sterility at https://www.fertstert.org/

On this episode of the Spot Radio Podcast, host Charlie Webb CPPL sits down with Elon Goldbaum from the Network Partner Group to delve into the intricacies of performing a Corrective and Preventive Action (CAPA). They discuss the framework that underpins the CAPA process, highlighting its crucial role in ensuring product quality and compliance in the medical device industry.Charlie and Elon explore the vital importance of the CAPA process, shedding light on how it helps organizations identify, address, and prevent potential issues. They also share valuable tips and strategies to make the CAPA process more manageable and effective, ensuring that businesses can maintain high standards of safety and quality.Tune in to gain insights from industry experts and learn practical advice that can be applied to your own CAPA initiatives. This episode is a must-listen for anyone involved in quality assurance, regulatory affairs, or medical device manufacturing.About our guest:As Vice President, Client Solutions for Network Partners Group, Elon (Lon) brings over 20 years of experience in the medical device field specializing in packaging, labeling, quality management systems, CAPA and sterilization. Lon's multifaceted background provides support and leadership to Network Partners' packaging consulting, quality assurance, labeling, and the Apprentice Leadership Program.Prior to joining Network Partners, Lon held various roles with Baxter Healthcare, Edwards Lifesciences, Endologix and Danaher with a wide range of responsibilities. Lon earned his Bachelor of Science degree in Packaging from Michigan State University.Elon Goldbaum e-mail: elon.goldbaum@onenpg.com

Take a sneak peek at this month's Fertility and Sterility! Articles discussed this month are:   01:48 Trustworthiness criteria for meta-analyses of randomized controlled studies: OBGYN journal guidelines 06:24 Playing the long game for reproductive rights 08:04 Limiting the number of fresh donor oocytes inseminated with sperm as a strategy to minimize supernumerary embryos 15:38 Effectiveness of degradable polymer film in the management of severe or moderate intrauterine adhesions (PREG-2): a randomized, double-blind, multicenter, stratified, superiority trial 26:37 Aneuploidy rates and likelihood of obtaining a usable embryo for transfer among in vitro fertilization cycles using preimplantation genetic testing for monogenic disorders and aneuploidy compared with in vitro fertilization cycles using preimplantation genetic testing for aneuploidy alone 38:13 Antimüllerian hormone levels are associated with time to pregnancy in a cohort study of 3,150 women 47:50 Racial disparities in the outcomes of euploid single frozen-thawed embryo transfer cycles – analysis of the Clinical Outcome Reporting System of the Society for Assisted Reproductive Technology 2016–2018 data 57:14 No association between celiac disease and female infertility: evidence from Mendelian randomization analysis   View Fertility and Sterility October 2024, Volume 122, Issue 6:  https://www.fertstert.org/issue/S0015-0282(24)X0013-8 View Fertility and Sterility at https://www.fertstert.org/  

Take a sneak peek at this month's Fertility and Sterility! Articles discussed this month are:   04:20 LGBTQ+ family building: progress but lots more to do/Therapeutic donor insemination for LGBTQ+ families: a systematic review 09:52 Confirmation and pathogenicity of small copy number variations incidentally detected via a targeted next-generation sequencing-based preimplantation genetic testing for aneuploidy platform 23:40 Trends and outcomes of fresh and frozen donor oocyte cycles in the United States 34:11 A survey study evaluating donor gamete utilization rates, patient satisfaction, and fertility treatment outcomes according to desired race and ethnicity 39:29 Racial and ethnic disparities in wait times for donor oocytes 41:16 Return rates and pregnancy outcomes after oocyte preservation for planned fertility delay: a systematic review and meta-analysis 49:23 Longer duration to optimal endometrial thickness in women with premature ovarian insufficiency is associated with clinical pregnancy rate in donor egg cycles 56:30 Feasibility and efficacy of a subcutaneous catheter for controlled ovarian stimulation 01:00:23 International Committee for Monitoring Assisted Reproductive Technology world report: assisted reproductive technology, 2015 and 2016 View Fertility and Sterility October 2024, Volume 122, Issue 5:  https://www.fertstert.org/issue/S0015-0282(24)X0012-6 View Fertility and Sterility at https://www.fertstert.org/

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: a review of segmental aneuploidies and mosaicism (2:00), early removal of zona pellucida to improve embryo fragmentation (18:12), inflammatory markers in female infertility (31:53), and debating the role of adult content in collection rooms (44:51). F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00039-2/abstract F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00092-8/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(24)00078-8/abstract Consider This: https://www.fertstert.org/news-do/providing-adult-material-fertility-clinics-antiquated-and-nonessential View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

3 sections- series of potential solutions to cure jaundice, when allowed/not to drink "kos shel ikarin " that causes sterility, using vinegar on Shabbat for toothache or smears for loin-pain

3 sections- series of potential solutions to cure jaundice, when allowed/not to drink "kos shel ikarin " that causes sterility, using vinegar on Shabbos for toothache or smears for loin-pain

Take a sneak peek at this month's Fertility & Sterility! Articles discussed this month are:   03:06 Embryos derived from single pronucleus are suitable for preimplantation genetic testing 09:59 Clinical factors impacting microdissection testicular sperm extraction success in hypogonadal men with nonobstructive azoospermia 24:46 Educational gradients in the prevalence of medically assisted reproduction births in a comparative perspective 32:14 Minimum number of mature oocytes needed to obtain at least one euploid blastocyst according to female age in in vitro fertilization treatment cycles 40:02 In vitro fertilization and perinatal outcomes of patients with advanced maternal age after single frozen euploid embryo transfer: a propensity score-matched analysis of autologous and donor cycles 46:57 Imprinting disorders in children conceived with assisted reproductive technology in Sweden View Fertility and Sterility October 2024, Volume 122, Issue 4:  https://www.fertstert.org/issue/S0015-0282(24)X0010-2 View Fertility and Sterility at https://www.fertstert.org/  

Fertility and Sterility On Air brings you the best of ASRM 2024! In Part 1, our hosts bring you: in vitro maturation with Christian Kramme (1:40), uterine transplant data updates with Leigh Ann Humphries (9:21), novel characterization of ploidy abnormalities with Ludovica Picchetta (21:50), maternal age and euploid transfer success with Philip Romanski (24:45), ultrasound assessment of ovarian stiffness to evaluate reproductive aging with Elnur Babayev (32:45), cost effectiveness of PGT-A in good prognosis patients with Ariel Dunn and Josh Combs (42:33), long-term follow up of oocyte donors with Jerrine Morris (51:16), and combining platforms to improve identifiation of mosaic embryos with Christopher Weier (58:28). View Fertility and Sterility at https://www.fertstert.org/  

Fertility and Sterility On Air brings you the best of ASRM 2024! In Part 2, our hosts bring you: home semen testing with Dan Greenberg (0:40), state insurance mandates for fertility coverage with Adeola Adeyeye (7:13), resource utilization difference between programmed and natural transfers with Ben Peipert (12:23), patient perspectives on embryo donation with Deb Roberts (21:37), corpus lutea and preeclampsia risk after embryo transfer with David Huang (35:02), exercise during stimulation with Maren Shapiro (40:57), combination of letrozole and clomiphene with Rachel Mejia and Jessica Kresowik (49:07), the impact of Alabama's personhood bill with David Monroe (54:06), and embryo quality and polygenic risk with Jordan O'Donnell (58:40). View Fertility and Sterility at https://www.fertstert.org/  

Take a sneak peek at this month's Fertility & Sterility! Articles discussed this month are:   02:17 In vitro fertilization practice in patients with absolute uterine factor undergoing uterus transplant in the United States 21:22 Classification and treatment of vaginal strictures at the donor-recipient anastomosis after uterus transplant 31:18 Impact of time interval from cesarean delivery to frozen embryo transfer on reproductive and neonatal outcomes 37:37 Multiplexed serum biomarkers to discriminate nonviable and ectopic pregnancy 50:20 Urinary benzophenone-3 concentrations and ovarian reserve in a cohort of subfertile women 53:38 Assessment of pregnancy outcomes in donor oocyte thaw cycles comparing fresh embryo transfer to cryopreserved-thawed embryo transfer: a sibling oocyte study View Fertility and Sterility September 2024, Volume 122, Issue 3:https://www.fertstert.org/issue/S0015-0282(24)X0009-6 View Fertility and Sterility at https://www.fertstert.org/  

In today's Egg Whisperer Show Podcast, I'm so excited to be joined by Dr. Paula Amato. She is a fertility specialist who froze embryos in her 30s using sperm from an anonymous donor. Later, Dr. Amato decided to donate her embryos. She shared about this journey and what she learned as a fertility doctor in a recent article published in Fertility and Sterility titled: "The fertile window: what donating my embryos taught me about being a fertility doctor." We're going to talk all about her decision to donate her embryos, what looking into the genetics of those embryos taught her, and what she learned from the process. It's an amazing story, and it's interesting to hear a fertility specialist talk about her experience as both a doctor, and a patient. Dr. Paula Amato is a Professor of Obstetrics and Gynecology, at the Oregon Health & Science University School of Medicine in Portland, Oregon. She also is a Reproductive Endocrinology & Infertility Specialist and has over 33 years of experience in the medical field. She graduated from University of Toronto medical school, and did her fellowship at UC San Diego. Thank you for joining me, Paula!   Read the full show notes on Dr. Aimee's website. You can read her article here: https://www.fertstert.org/article/S0015-0282(21)02289-5/fulltext Would you like to learn about IVF?Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, April 22, 2024 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom. Listen to this episode on Dr. Aimee's website. Subscribe to my YouTube channel for more fertility tips! Subscribe to the newsletter to get updates  Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org.

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: mechanical contractions and fibroid progression (2:22), endometriosis classification and risk of infertility (15:15), the roles of endometrial and mesothelial cells in endometriosis formation (29:36), and fertility coverage for military personnel (43:30). F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00036-7/fulltext F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00090-4/fulltext F&S Science: https://www.fertstertscience.org/article/S2666-335X(24)00053-3/fulltext Consider This: https://www.fertstert.org/news-do/building-family-while-serving-our-nation   View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

Dr Hernandez Rey specializes in treating patients with polycystic ovary syndrome (PCOS), recurrent pregnancy loss (miscarriage), and severe endometriosis. He is especially interested in fertility preservation (egg freezing) for patients who must delay childbearing for personal or medical reasons, including cancer and systemic lupus erythematosus. As one of only two fertility specialists offering robotic surgery in Miami, Dr. Hernandez-Rey is able to offer minimally invasive surgeries with faster recovery times and minimal scarring, often as an alternative to advanced treatments such as IVF. He has performed numerous tubal reanastomosis procedures (tubal ligation reversal), myomectomies (removal of fibroids), and surgery for severe cases of endometriosis for the management of infertility.Dr. Hernandez-Rey has made dreams come true for hundreds of families from South Florida and across the world. He prides himself on being accessible to his patients to ensure they are calm and reassured, a key component to his success. Dr. Hernandez-Rey is an assistant clinical professor at the Herbert Wertheim College of Medicine at Florida International University and serves as an ad-hoc reviewer for the prestigious peer-reviewed journal, Fertility and Sterility.

In this month's Fertility & Sterility: Unplugged, we take a look at articles from F&S's sister journals! Topics this month include: radiofrequency ablation of fibroids (3:00), an opinion piece on testing embryos to reduce type 1 diabetes risk (17:42), preeclampsia risk with abnormal semen analysis (29:34), and a review of PCOS and miscarriage (44:33). F&S Reports: https://www.fertstertreports.org/article/S2666-3341(24)00078-3/fulltext Consider This: https://www.fertstert.org/news-do/preimplantation-genetic-testing-type-1-diabetes F&S Science: https://www.fertstertscience.org/article/S2666-335X(24)00055-7/abstract F&S Reviews: https://www.fertstertreviews.org/article/S2666-5719(24)00035-5/abstract#:~:text=Some%20studies%20have%20suggested%20an,receptivity%2C%20and%20the%20uterine%20environment View the sister journals at: https://www.fertstertreviews.org https://www.fertstertreports.org https://www.fertstertscience.org  

Take a sneak peak at this month's Fertility & Sterility! Articles discussed this month are:   04:19 Assessment of obstetric characteristics and outcomes associated with pregnancy with Turner syndrome 13:55 Effect of postthaw change in embryo score on single euploid embryo transfer success rates 22:38 Effectiveness of preconception weight loss interventions on fertility in women: a systematic review and meta-analysis 37:17 Functional evidence for two distinct mechanisms of action of progesterone and selective progesterone receptor modulator on uterine leiomyomas 43:47 Predicting risk of endometrial failure: a biomarker signature that identifies a novel disruption independent of endometrial timing in patients undergoing hormonal replacement cycles 54:28 Analysis of factors affecting the prognosis of patients with intrauterine adhesions after transcervical resection of adhesions 01:05:29 Effects of a eucaloric high-fat diet on anterior pituitary hormones and adipocytokines in women with normal weight View Fertility and Sterility August 2024, Volume 122, Issue 2: https://www.fertstert.org/issue/S0015-0282(24)X0008-4 View Fertility and Sterility at https://www.fertstert.org/  

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

Dr. Natalie Crawford reviews three of the latest research studies by Fertility and Sterility. These studies include AMH and Vitamin D, AMH and PCOS, and periods and the lunar cycle. Dr. Crawford has a masters degree in clinical research, so staying up to date on the latest data is something she is very passionate about. You can't make decisions on data you don't know. Natalie answers your questions in FFS-For Fertility's Sake I'm trying to conceive while postpartum and my period has not returned. Do you have any tips? I'm trying to conceive while postpartum and my period has not returned. Do you have any tips? can high intensity exercise be a cause of a luteal phase defect? We have moved Fertility In The News to the weekly newsletter in order to keep the podcast more evergreen. If you want to sign up go to nataliecrawfordmd.com/newsletter to sign up! Don't forget to ask your questions on Instagram for next week's For Fertility's Sake segment when you see the question box on Natalie's page @nataliecrawfordmd. You can also ask a question by calling in and leaving a voicemail. Call 657–229–3672 and ask your fertility question today!      Thanks to our amazing sponsors! Check out these deals just for you: Quince- Go to Quince.com/aaw for free shipping on your order and 365-day returns Ritual-Go to ritual.com/AAW to start Ritual or add Essential For Women 18+ to your subscription today. Rocket Money - Cancel your unwanted subscriptions by going to RocketMoney/com/AAW Apostrophe- Get your first visit for only five dollars at Apostrophe.com/AAW or use the code AAW at checkout. Prose- Go to prose.com/aaw and take your FREE in-depth hair consultation and get 50% off your first subscription order PLUS 15% off and free shipping every subscription order after that! If you haven't already, please rate, review, and follow the podcast to be notified of new episodes every Sunday. Plus, be sure to follow along on Instagram @nataliecrawfordmd, check out Natalie's YouTube channel Natalie Crawford MD, and if you're interested in becoming a patient, check out Fora Fertility. Studies reviewed: Association between serum 25-hydroxyvitamin D and antimüllerian hormone levels in a cohort of African-American women Subramanian, Anita et al. Fertility and Sterility, Volume 121, Issue 4, 642 - 650 The menstrual cycle is influenced by weekly and lunar rhythms Ecochard, René et al. Fertility and Sterility, Volume 121, Issue 4, 651 - 659 Antimüllerian hormone level predicts ovulation in women with polycystic ovary syndrome treated with clomiphene and metformin Komorowski, Allison S. et al.Fertility and Sterility, Volume 121, Issue 4, 660 - 668 Learn more about your ad choices. Visit megaphone.fm/adchoices