Podcasts about Unexplained infertility

On today's episode of The Wholesome Fertility Podcast, I'm joined by Jiaming Ju @kunhealth, a second-generation traditional Chinese medicine (TCM) practitioner and health economist who co-founded Kun Health with her father. From leading one of the world's largest longevity data projects to creating personalised Chinese herbal formulations, Jiaming brings a rare and fascinating perspective to holistic fertility care. We dive deep into the roots of Chinese medicine and its powerful role in treating unexplained infertility, recurrent miscarriage, and postpartum recovery. Jiaming shares why customized herbal medicine—rather than a one-size-fits-all approach—is key, and how stress, liver qi stagnation, and over-medicalisation can often stand in the way of conception. We also discuss the importance of preparing the body and mind for pregnancy, how men's health is often overlooked in fertility journeys, and the practice of wu wei—doing nothing—as a healing principle. This is an eye-opening and empowering conversation for anyone navigating fertility or seeking a deeper understanding of the interconnectedness of health, mindset, and tradition. Key Takeaways:  Chinese herbal medicine offers a deeply personalized and effective approach to treating fertility challenges, especially unexplained infertility and miscarriage. Liver qi stagnation and chronic stress are common root causes in fertility struggles. True healing goes beyond quick fixes—it involves preparing the whole body and mind for pregnancy, not just aiming for a positive test. Partner health, especially sperm quality, is often under-acknowledged and under-tested in fertility journeys. Practicing wu wei—intentional rest and non-productivity—can help calm the nervous system and enhance reproductive health. Guest Bio: Jiaming Ju is the co-founder of KUN Health, where she partners with her father to offer personalised Traditional Chinese Medicine (TCM) care rooted in decades of lineage and wisdom. Before stepping into the world of herbal medicine, Jiaming led one of the largest global data projects on aging, spanning from New York to Singapore. With a background in health economics and longevity research, she brings a unique perspective to healing—bridging ancient Chinese traditions with modern insights. Together with her father, she helps individuals restore balance, improve fertility, and honour the heritage of Chinese medicine through customised herbal formulations and deep one-on-one care. Websites/Social Media Links: Learn more about KUN Health hereFollow Jiaming Ju in Instagram —------------- For more information about Michelle, visit www.michelleoravitz.com To learn more about ancient wisdom and fertility, you can get Michelle's book at: https://www.michelleoravitz.com/thewayoffertility The Wholesome Fertility facebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/ Instagram: @thewholesomelotusfertility Facebook: https://www.facebook.com/thewholesomelotus/ _____ Transcript: **Michelle Oravitz:** [00:00:00] Welcome to the podcast Jiaming.  **Jiaming Ju:** Thank you for having me.  **Michelle Oravitz:** Yes. I would love for you to share your background. I know you're second generation, um, traditional Chinese medicine practitioner, which is really cool. Um, I love the fact that you actually have your roots there and your father does too, and I feel like. That kind of takes it to a whole other level when you're working and learning from your parents. So I'd love to hear your background and have you share it with the listeners. **Jiaming Ju:** Uh, so I'm a health economist first. So I was in health, I was in economics basically for 10 years. Um, and. I think before Covid I was running one of the largest think tank on longevity, uh, data collecting in the world at the time in Singapore. Um, and then I came back to the States in 2019 and decided to [00:01:00] retrain for four years. It takes four years in California. And then, um, that's when also around the same time I opened Quinn.  **Michelle Oravitz:** Awesome. So, um, do you Longevity? I think of longevity and I think about fertility. 'cause a lot of times when we treat fertility, we're actually doing a lot of anti-aging. Um, we don't call it that 'cause we're working on mitochondria and really kind of getting the health, um, of the eggs and the uterine lining. So tell us about your experience with fertility and what you've, um, what you've seen. In practice. **Jiaming Ju:** Well, I mean, I work with a lot of people who have unexplained infertility. That's actually an area that, um, that I work a lot in. And, uh, this applies to both men and women among my patients. So I will have. A lot of patients who, uh, you know, they probably had a failed, failed rounds of IVF. [00:02:00] Um, and then that's when we work together. I also have a lot of patients, um, who have repetitive miscarriage, uh, which is increasingly, uh, common, unfortunately. And then I also work with a lot of women on postpartum, which is more on the traditional side, as you know, in Chinese medicine.  **Michelle Oravitz:** Yes, and so I know that we often get asked this, and I get asked this too, but I love always hearing the different perspectives on Chinese medicine. To explain to people in layman terms, why does acupuncture and Chinese medicine, I know Chinese medicine's a big umbrella. Acupuncture is really one part. I think most people think just acupuncture, but of course there's MOA herbs. I mean, there's so many different things. There's also auricular, you can get really detailed on that. So can you explain what Chinese medicine could do really to regulate periods, to regulate ovulation? Just kind of help fertility.[00:03:00]  **Jiaming Ju:** Well, I mean, first off, I think I grew up in the Chinese medicine family business, so to me it's very bizarre when people separate them. Um, you  **Michelle Oravitz:** the acupuncture and the herbs and the, **Jiaming Ju:** treatment from the, herbal treatment. However, I think, um, customized herbal formulation has always been the elitist form of Chinese medicine. It takes a lot of family lineage. Um, you know, pre bottled stuff aside for the modern human really, you know, whether you have fertility issues or not is really that one has to take a one-on-one approach to effectively treat something that's very complex. So having said that, um, I only work at Quinn for customized herbal formulation, so we don't do, although I'm licensed, I don't do acupuncture, uh,  **Michelle Oravitz:** Oh, got it. Oh, I didn't know that. I thought you did acupuncture as  **Jiaming Ju:** no I don't.  **Michelle Oravitz:** Oh, okay.  **Jiaming Ju:** We have all of you guys who are.  **Michelle Oravitz:** actually, um, I know in China they do separate it. A lot of times people will get really, really [00:04:00] focused on one aspect.  **Jiaming Ju:** Um, yes and no. I think in if, because in China and Korea they have TCM hospitals, right? So you have different departments where post-stroke, you go first off to the acupuncture people, which is the physical therapy part of Chinese medicine. And then. Depending on the severity of the stroke, you likely will get customized herbal formulation on top of that. Um, I usually say that, um, acupuncture is amazing, is like a great deep spring cl that everyone needs it often, um, customized herbal formulation and diagnosis is more like a renovation, so they're entirely different projects. I think when you consider a human as a house, right, you're building a house, you need, you have different needs. Um, in terms of female, I think we go back to the topic. I always like to talk about how, uh, women are fundamentally very, very important in Chinese medicine [00:05:00] because Chinese historically are obsessed with babies. Um, so this is the reason why a long time ago in all these empress, like, you know, like palaces, you will have. Uh, a whole college of hundreds of royal physicians, and they're all Chinese medicine doctors. And their goals are not only to keep, to make sure the emperor can live for as long as possible, is to make sure all these concubines can produce as many kids as possible. So this is why I think the, the practice, um, has a lot more interest in the history, right? The history is being that. We love kids and you want, China has one of the largest population in the world throughout history and you know, so it has a lot of that. You want kids and you need to care about women's health. So in a nutshell, I really like what you mentioned before, like when I actively worked as a, basically a longevity economist and my job was to advise countries in terms of, um, you know, fertility policies, aging population, right? How can you encourage, [00:06:00] and I often say that women's. Women friendly policies are essentially longevity policies. You don't have women giving birth to kids, then you won't have a, you know, sustainable population. This is one of the same. So I really liked you pointed that out. That is totally right. I think not many people think like that. Um. And so in a nutshell, like there is the historical interest then that would mean that in terms of research, there is the interest in the research, there is interest in data, there is, uh, Chinese medicine has been around for 3000 years and gynecology in particular in that field has been around for 3000 years. This is very different with how western medicine has developed. Right? Like c-section technique for example, was developed, I dunno, a hundred years ago, like it is very. It's, it is, it is. So it's really like not comparable in terms of history, even sheer patient number and uh, patient cases. So I think Chinese medicine really in many ways excel in understanding women's health [00:07:00] and fertility. I.  **Michelle Oravitz:** For sure. And I, I always say like with medicine, one of the key things that you wanna look at is how well does it age And Chinese medicine ages really well. So a lot of times you'll see new things, new pharmaceuticals, and then a couple years later you find out it's not as great and then something else comes out with Chinese medicine. I mean, it looks at nature, it really looks at like the elements of nature. That is something that is consistent. It's just part of really understanding that and then understanding ourselves. So I think that that is so cool about Chinese medicine. **Jiaming Ju:** Right. The internal is very much so the physical, right. I have, I'm sure you have too, a lot of patients who on the surface they're like. Really healthy. Uh, but they haven't had a period for three years. So, you know, this is, this is not, and then they will spend the money on Botox. But which then you're like, okay, you look good for maybe a [00:08:00] month, and then you have to do this again. Right. It, it is very different perspective. I think, um, many people say that, you know, why do, for example, in the practice of, uh, postpartum recovery, right? I'm sure you see it, and I see it a lot from the practice where. People who don't have, who are not on top of their health condition, especially in terms of digestive health. I'm more prone to have thyroid issues or, you know, uh, preeclampsia in the last trimester and then post burst. This doesn't only drag their health just downhill. And then also impact how you're going to have a second kid or a third kid if you want to. It really completely like, you know. Like it really completely wrecks your house in a ways that you didn't even see this coming. And that is a completely different perspective, right? Because often I will have patients who say that, oh, you are the first person who listens. How do you know I have these issues? Before I even tell you, I. It is really patterns. And I go back because [00:09:00] I am a nerd and I am an economist. Like I go back to data collecting Chinese medicine like in my father's, you know, practice. Like he will start seeing a kid at the age from the age of five and then she's, he sees the same kid when the kid is 35. You see a person's in a whole families right Conditions throughout their whole life, and That's The best possible data collection you can dream of, and you can think of. This is not just a, oh, here is some pills for antidepressant, for postpartum depression. Like give a women a pill like that. They will still have gazillion other issues, like what does this solve? And you will hear often for people who have postpartum depression, for example, right? Like they will then be dependent on depre antidepressant for the rest of their life. Then one questions. What does that serve? Right? Where does that put you as a human? Do you feel like you are out of control for your own health? Um, so Yeah. it's a different approach.  **Michelle Oravitz:** Yeah, completely. Uh, it's interesting you say about [00:10:00] antidepressants because I feel like it's almost, um, a screen in between me and the person. I feel like I'm not able to fully get through to the person with the treatments because there's something in the middle, in the way I. And um, and of course I don't tell them just stop because I know that that is a whole process. They have to be under the care of a doctor and tell them how to come out of it, because it's not something that you can just suddenly take out. I often feel like that. And I'd much rather if I can just treat it with nothing else, it'll be a lot easier. And then another thing too is um, that I thought you said that was really interesting and true is, um, you know, I think a lot of times often people just want that positive pregnancy, but you talked about something that is actually crucial. If people want a healthy pregnancy and then also healthy afterwards for more kids, you really have to think big picture and not just quick fix. And I [00:11:00] think that we're so conditioned for the quick fix that we don't think about the whole garden and really tending the soil. And I always think about it like that. It's like, yeah, we could throw a seed in and maybe that's gonna sprout. But if we don't give it the conditions it needs, those roots aren't gonna go deep and it's not gonna be a sustainable, like rooted sprout, which I think similar with pregnancy, you want not just pregnancy, but you want a healthy pregnancy, and you also want a healthy mom and baby. You need it all. It's not like you can have an unhealthy mom, healthy baby. You have to have the whole picture working together. **Jiaming Ju:** I think that's why like many people getting on IVF, and if you consider it a percentage of success rate for IVF is actually not that high. Right? Um, and then everyone is, and a lot of people are disappointed because they feel like I paid all this money and I, I, I got it. Why is it not happening? I think first off is because we're all conditioned to think that pregnancy is such a simple thing, right? You do it and you'll get [00:12:00] pregnant. Uh, the, in Chinese medicine we always say mental is the physical and vice versa. The impact of stress of our day-to-day demand, of being a modern human, whatever, whatever that means, has a huge number in other fertility potential, right? I often says to, I often say to my, uh, patients, um, and I say like, you know, often because. My patients might, in the middle of it, they're, they didn't come to see me For, fertility, but like after they healed from like long covid or something, they're like, I want to have kids. You know? Now I can really think about it and I will usually say that, you know, definitely be careful with like when you wanna get pregnant, because the healthier you are, the fertile you are, the more fertile you are. Often I think in this society where we talk about IVF technology, ever since it has been introduced, it has become a thing where people feel like, oh, so long as I do it right, I will, it will happen. And often people get very disappointed when [00:13:00] it doesn't happen. And I'm sure you see in your practice a a lot in recent, in the past five years, you know the, there is an increasing percentage of people who have to DOIs. IVF like twice or three times and still maybe without success. Right? Um, so I think there is a lot of, um, a lot to be said about looking at fertility, not just as a functionality that you as a woman or you as a human will just somehow have, but it's really about your overall health, right? Like, and I often talk to people who have repetitive miscarriage. I'm like, your digestive health is everything. Who is gonna carry the baby is gonna be you. Now, if you are having, already having like nausea, dry gagging, like five times a day, even when you're not pregnant, your chances of basically having repetitive miscarriage is probably quite high, right? So we have to fix what's, what is the fundamental thing. It is. Not that let's have a kid, because often [00:14:00] I, um, and I very, I talk about this not very often. But I do treat kids, and you often see a lot of kids who have incredible intolerance for food early in age is due to the fact that mother had a very difficult pregnancy.  Um, so this is very much so linked. It's not, like you said, it's not like the mother has to be in perfect house. So you have a chance, the mother and father in perfect house. So you have a chance of this baby being in perfect house often, even if you could get pregnant, if you have a kid who has so many problems, um, in the first two or three years there, basically. Um, you know, there was one time with a patron of mine who, when he came to see me, he was two and a half years old and he was basically deemed a failure to thrive because he couldn't gain weight and he was having leg diarrhea. Often. He was having crazy eczema. And then you find out the mom during [00:15:00] pregnancy and before pregnancy had a lot of issues. So this is all interlinked. Yeah.  **Michelle Oravitz:** it really is. Another thing I see often is people who do IVF and then they go to the doctor and the doctor says, well, you barely have anything. You really need to start immediately. And I always encourage them, spend a little time prote, you know, preparing yourself if they've never, if they haven't come to me and I say, you're much better off waiting a few months. Taking care of yourself, nourishing yourself, then doing IVF, then rushing into it. 'cause we're just looking at numbers and not kind of thinking about the quality and the preparation.  **Jiaming Ju:** Mm-hmm. ' **Michelle Oravitz:** cause in three months, it's not like you're gonna just lose everything. It's gonna just drop off a cliff. I mean, it's gonna be a few more months. You're gonna be in much better position. **Jiaming Ju:** I think that's totally true. I mean, in, in the old country, in East Asia, when you prepare for pregnancy, six months is very standard. That's when your partner quits smoking. They quit drinking, you know, you both eat [00:16:00] healthy. All of those stuff, Right. Um, and in this country we don't, it's almost like nobody necessarily prepare it. Everyone just expect it would just happen until it doesn't happen after a while and suddenly it goes from, oh, I'm really casual about it, to now I'm in a panic. I must do IVF. Right? Um, and. A large, obviously unexplained infertility has a lot to do with, there are multiple root causes. One of the most common ones I have seen is actually intense liver g stagnation, where often a women consider themselves as a failure for not being able to get pregnant. And the more you and I usually be able to tell with a patient when the first, for the first consultation, they'll say, I need to be pregnant by this date. **Michelle Oravitz:** Right. **Jiaming Ju:** You're not a machine, we're not ai. It doesn't work like that. And often, I also, I don't know whether you experienced this in your practice as well, but I [00:17:00] often, uh, I always ask about better the partner, uh, or whoever, is the sperm donor better? They have tested, oftentimes they have not.  **Michelle Oravitz:** Yeah, I agree.  **Jiaming Ju:** has done all the  work then,  **Michelle Oravitz:** I've seen that a lot and and sometimes the doctors don't even mention it.  **Jiaming Ju:** Right. And it is shocking to me because as we all know. through research, uh, I believe it was the newest study done using collective data from Europe, uh, the sperm quality, both in terms of speed and quality per say, is 50% lower than like. 20, 30 years ago, and this is understandable due to drugs, due to not sleeping, due to not taking care of ourselves, Right. Due to stress. So why is it always that we're plowing the field of a women? And I always say this, I said the worst thing would be I'm p plowing your field. And the seed is subpar then. So,  **Michelle Oravitz:** Correct.  **Jiaming Ju:** right? Like, it's so, like, it's So easy. for the man to get checked. [00:18:00] It takes no time at all.  **Michelle Oravitz:** I know. **Jiaming Ju:** So like how is it in this, like, you know. this is almost common sense both in terms of money, in terms of time, get your, get your sperm donor, you know, partner  checked first. Um, it's, uh, It is interesting. **Michelle Oravitz:** It is for sure. And then also, I mean it's, what's interesting is, yeah, you can get checked and everything looks normal and they're like, everything's perfect. But then the DNA might have something off, which. A normal analysis does not cover that. It's a special test that people take after, and usually they won't do that unless there were like miscarriages or there were failures with, um, the embryos to grow. So they'll, they'll then they'll check the sperm. DNA fragmentation. **Jiaming Ju:** It is always a little too late. And interestingly, um, I think even given my own experience, like I have two kids and they were born in different, two different countries, and I. Uh, [00:19:00] the second one who was born in the us I think the, the, even the md, the gynecologist like checkup is very minimum. There was, you know, like if you want like a, a better, clearer picture, you gotta pay more. Like there is like, I think the, the, the standard of what women are provided in this country in terms of like basic, you know, um, like a, a basic kind of gynecological service, um, throughout is very low compared to other countries. Uh, but I mean that also creates a lot of. Tension and anxiety from first time moms. Right. You don't know. And then you show up and then you said you're having some pain and doctor's like, it's okay. And then You know, there  **Michelle Oravitz:** supported because you know, internally something's off. Like, you're like, I know something's off. I'm not crazy, but like, ah, you're fine. It's in your head.  **Jiaming Ju:** right. And I think through and, and I think that's really the fundamental difference between [00:20:00] Chinese medicine and western medicine. Right. Chinese medicine. This is why a lot of people ask me, they're like, you're a Columbia educated economist. You wrote for the Economist magazine, and then you know, you run Nobel Prize winner think tank like, but like Chinese medicine, it must be so different. It's actually not. Health economics is all about getting subjective health data from. The person you interview, that's not so different from what, what we do in Chinese medicine. It's about you being the patient who knows best about your health, right? So if you say you have a pain, you have a pain, I'm, I'm don't live in your body. I don't get to judge you. I think this is also the reason why so many people feel heard. Chinese medicine clinics, um, where they feel like you're just another pregnant person, like time is up, you are leaving. So it's um, it's a very different process. Yeah.  **Michelle Oravitz:** It is such a different process and I actually remember myself the first time I went to an [00:21:00] acupuncturist. This is like kind of what started it all. I was, uh, in a completely different career and I all I could get from every single doctor I went to was the birth control pills. And people hear hearing this, a lot of my listeners already know my story, but it was just basically I had irregular periods and that was the only answer I can get. Never made sense to me on a intuitive sense. I was like, this just doesn't make sense. There's gotta be something. They're like, Nope, that's just your body. The only time you can have normal periods is if you take this. So I went through 12 years of that and the first time I met. My first doctor, Dr. Lee, who's from China, and he actually happened to specialize in gynecology. He sat with me and one of the biggest takeaways, like the biggest impacts that it had, was him listening to me and asking me questions and showing me interest in every part of my life. And I was like, wow, this is crazy. This is so cool. I've never gotten this much attention from anybody [00:22:00] on like, what's going on in my body? **Jiaming Ju:** right.  **Michelle Oravitz:** And then, um, so that was really fascinating. Of course, that did change my period and I was resolved. I, I did the, you know, real raw herbals and the acupuncture. But then also, uh, looking back when I went to school, one of my teachers said, and it kind of like never left my mind that part of the healing, like the therapy starts before a needle goes in. Just by listening and the second you feel heard, that by itself has an impact on your healing. **Jiaming Ju:** Right. The, the physical is mental and that is, um, observed and in every single way we treat patients. I have, I would just say like 90% of my patients not only have like physical ailments, they have a lot of like mental. Concerns as well. Right. Um, and usually as both the, the [00:23:00] mental improved physical improvement and vice versa. And this usually seems very, like, it's like a huge surprise or a big relief to the patients because they're like you. I mean, I, I didn't have to take antidepressant pill for this whole time. Right. Um, it's, I think is, is is, it is a very interesting. Myth we are told, um, and I, I don't mean this as a, as a, something like a, like I'm simply raising this as a question. How is it that we all come in different shape and form, race, color, experience, lifestyle, choices, all of that, and sexes. And then when you say, okay, someone is suppressed, you give everybody exactly the same. The only thing that varies is in the dosage. **Michelle Oravitz:** Yep. **Jiaming Ju:** Isn't that weird?  **Michelle Oravitz:** Mm-hmm.  **Jiaming Ju:** Right? Like it, and if you ask people who are depressed, um, I'll give you an example because I have a lot of A DHD patients, um, [00:24:00] especially, um, and The first thing I always ask when I examine the tongue, um, for A DHD patients is better. You have anemia. And often they do. Um, but as we know in Chinese medicine, even if the lab says you don't have anemia, your tongue can tell me you have anemia. The, the chance of you being anemic and showing a DHD symptoms is very high. So is that actually a DHD or not? Oftentimes is actually not true. A DHD. This is the reason why a lot of women who, uh, thought they have a DHD got on A DHD medication and then they crash when they don't take the medication, right, their energy crash, their focus crash. Then if, I mean, this is really a questions like if you take something, it works. The minute you stop, it doesn't work. Did they ever work? Right. It's almost  **Michelle Oravitz:** it resolve it? It's not resolving, it's not a, a true solution.  **Jiaming Ju:** Right. And then [00:25:00] when we talk about pregnancy, it's a similar process, Right. Is this just we implant a child in your body? Great. I'm glad technology works, but I think if I recall back in the days when, uh, IVF was invented, It was not supposed to be used so widely in today's environment. It was for, I believe, for specific reason, Right. There was a, a really strong infertility, I believe structurally for. Was it the researcher? We invented it. So like it was not supposed to be. It's the same thing with C-section. It was not supposed to be widely used. Like today's, I remember when I lived in Singapore, uh, C-section was so popular. It was like, you can pick your date. It was a thing you can pick, pick a auspicious date to give birth to your child, and everyone goes to have a csection on the same day. It wasn't designed like that. It wasn't meant to be used like that. So I think. Modern human need of getting things done. [00:26:00] Like I need to have a child. Here is the child, and here the child is delivered like this need of doing, boom, boom, boom. Just click on your life. To-do list is preventing us to see the garden you talked about is preventing us from really taking care of ourselves and really do the way that we are supposed to do that. Nature enables it because we probably wants too much. I don't know.  **Michelle Oravitz:** It's a too quick to, you know, quick fix. It's, it's going against the dao. It's going against that present moment, that being present because I, my theory or 'cause it wasn't really something that I specifically learned, but like, the more present you are, the more life force q you have because you, in this portal, your energy, your attention, like you said, no separation between the mind and the body. So the more present we are, the more energy could be here. If our minds are here and then it's somewhere else, or our bodies are just here and our minds somewhere else, we're scattered all over the place. [00:27:00] And, uh, so let's actually go back 'cause I thought that was really interesting what you were saying about the liver chi, like really, really severe liver cheese stagnation. Uh, for people listening, I've talked about the liver before, but liver cheese stagnation is severe stress. It's really being, to me it's kinda like being in major fight or flight chronically. **Jiaming Ju:** Mm-hmm. And it is interesting because the liver store is the blood. So some people will say like, especially, it's funny because I lived in New York for a long time and I will always spot a patient from New York, uh, from a mile away because whenever you ask them like, are you stressed? They're like, no, they look really stressed, but they're like, no, I can't handle it. This is intense Stress.  Handling it, you know,  doesn't  **Michelle Oravitz:** first of all, I lived in New York, so I know exactly what you're talking about. 'cause I'm a re recovering New Yorker. And then secondly ahead, I have a, like, I have a patient I could just picture in my head right now. I'm like, how are you doing? Everything's perfect. Everything's fine. Sleep is good. Good, good, good. Great. You know, and I'm like, she, and, [00:28:00] and then like every needle that goes in, oh, oh, you know, she's. **Jiaming Ju:** I think this is the hardest lesson in life. Um, I feel. Um, is to desire something and not getting it, like, either, not on your timeline or like not the way you want it. And I think, um, liver cheese stagnation is exactly that. I mean, traditionally we say, oh, it's anger is more manifested in road rage. But really in today's society, I like to interpret liver cheese technician manifested in ways. That is like a mild, like a irritability, like a constant irritability. You're just waiting people to, to do something wrong and you are snap at them, right? We are all familiar with that kind  **Michelle Oravitz:** It's resistance. It's resistance to life.  **Jiaming Ju:** frustration, right? You're like constantly frustrated. Someone [00:29:00] else got a promotion, you think you are deserve the promotion, you're not seeing anything frustration. It is. What you think in your head you deserve. And the reality, and there is a gross, like mismatching here. Um, and I, every single time I have a patient who comes because of, you know, infertility issues and I will always spend so much time talking to them about their psychology, like mental health. I, the way I do consultations. I have a huge part, at least I think. Total 30% of my total questions about the mental this matters in particular to people who have been having difficulty pregnant because, and I explain it to my patients like this, if you are so stagnant, if your body is so full of stagnation and cheat, where do you think a baby can sit? The baby. The baby has nowhere to sit. There is no room for the child. And [00:30:00] that in a way. Is indeed the hardest lesson because to be pregnant, to be a parent to me personally, I think is the hardest thing in life is, is the uncertainty. You can do everything you do. Right, right. In, in parenthood. You don't know how it's gonna turn out, and this is, this process actually start from getting pregnant. Like so many people feel so certain, oh, I just do it, you know, a couple of times. And during ovulation I will be pregnant. It doesn't work like that in Chinese medicine. You know, when it advocates for healthy pregnancy, it is the Jing, it is the Chi, it is the Ansys, it is the spirit and body of you and your partner.  **Michelle Oravitz:** Yep. **Jiaming Ju:** I'm not even a religious person, but I would say that is rather agno agno agnostic like process, right? Because it depends. You need a bit of luck For a [00:31:00] person who is intensely chi stagnant, they don't believe in luck. You, I'm, I don't know whether you've checked this with your patients,  **Michelle Oravitz:** yeah. No, they, they put everything on their shoulders. They think that it's all up to them, and that's why they feel like they need to control, and it's being in that fight or flight because you're in survival mode. And when you're in survival mode, there's not plenty to go around. You need to scrounge and you need to work, and you need to fight to get whatever you need. And that's, um, that's ultimately, you know, from an observer's perspective. Yeah, that's what I see. **Jiaming Ju:** Right. And it is, you will see whenever that happens, you know, it's almost like you as a provider, you are being told like. This is the only thing you're doing. You're, you're giving me a child and then like, this is never gonna work. This is never gonna work because liver cheese stagnation. Really, I feel like clinically is one of the major reasons for unexplained fertility. And that in turn frustrates the person even more because you're telling them structurally there is nothing wrong, [00:32:00] but they just cannot get pregnant no matter what they do. Right. Um, so this is already a deeply frustrating process and telling them that, leave it to. Just follow the protocol and leave it to fate. And you, I will always notice that 50, not 50%, like you always have like 20% of people or 30% of people who are just not, they'll ask you like, what are the best thing I can eat to make this happen faster? Right? Like, what, what is, um, you're going against what you, you know, you're, you're doing exactly the opposite of what you're supposed to. Um, but that is hard. I think  **Michelle Oravitz:** It is hard. Yeah. It, it's, it's one of those things that is often missed and I, I, I actually wrote a book about that. 'cause in the book I don't give any diet tips or anything. Like, I'm like, that's not what's needed. Because everybody can look up like the best diet and there's plenty of great books about what can help. And of course everybody's different and, you know, really understanding kind of your own sensitivities and et cetera. But. [00:33:00] My point is, is that many times people going through the fertility journey are actually very smart. They're very educated, and they educate themselves on. Supplements and what to do. And so they're, they, they have that down, but that's not what it's about. I mean, it's about also the nervous system and I, I say the nervous system 'cause it's more late layman terms, but it's ultimately what the QI does. Like the QI needs to move and to flow. And if we're in this fight or flight, it's stagnates. And so you see that often? **Jiaming Ju:** I think that's really true because it is really about the difficult, the most difficult thing in life is to dive into uncertainty.  **Michelle Oravitz:** Mm-hmm. **Jiaming Ju:** You have two types of people who, well, you have three types. One type who just like go with the flow, right? Nothing wrong with that. You have one type who always wanna get ahead before everybody else. They always wanna know everything that's supposed to be done, it comes to being pregnant, having a healthy delivery, [00:34:00] that's actually not how it works. And I think that's, you gotta have a openness. To say, I'm going to dive into this uncertainty because you know what, when a baby is here, when you have to raise this child, right, um, you're gonna need that when they start going to school or even when you homeschool them. It doesn't matter. Like you cannot control everything. And I think that is a very important thing that, uh, really starts even during pregnancy preparation.  **Michelle Oravitz:** You know, I will say it's kind of like meeting the love of your life  **Jiaming Ju:** Right,  **Michelle Oravitz:** and you're not like, you are gonna be the one that I marry. You know, you can't, you, it doesn't work like that. Then the person's gonna wanna run, run away.  **Jiaming Ju:** right. you. can't just come with your list and be like, well, You check every single list here. Right. Um.  **Michelle Oravitz:** it's gotta be a little more romantic and have those, you know, moments of quiet and silence and, and kind of have this dance [00:35:00] happen. **Jiaming Ju:** Yeah. But you know, I, I think the world has in increasingly, has increasingly become a place where. People want bandage solutions. And I think that where, uh, the economy, if you're looking at some like rising industries, that that's what it gives like, right? A product. This is especially the case in America where it's all about something has a product, right? Like what is the one-off solution you could give to that? But things where humans have been doing for centuries, like procreation. Defies the odd of that, no matter how many one-off Band-aid solutions you're gonna have, it's not going to click. And I keep telling this to all my patients who not only just for fertility, but for every odd syndromes under sun, as I have a lot of patients who have very difficult, complex disorders, [00:36:00] is that. When you commit to something that is trying to get pregnant or trying to get better, it's like when you go to a Taoist pimple or you go to any church or any religious place you go and you put a slice of your peace of your heart and peace of your mind there because you are really committed right in that given moment. And that's all I'm asking for as a provider. Um, I always don't always go into it with. But what about this? What about this? What about this? Like, why don't we settle this one first? Um, so, you know, talk about nervous system. You can come down first. Otherwise your nervous system is all over the place where you are like, you're not doing anything like, you know, fully. So.  **Michelle Oravitz:** And what other suggestions do you ever give people, um, suggestions that they could do outside of the. What you're helping [00:37:00] them with. Because I would typically say even like you can come in, do the acupuncture, even take the herbs and supplements. But if you're going back and having a crazy stressful time, then it's going to pretty much negate a lot of what we did. So I'll suggest things even like rounding or spending a little time in the morning of silence or peace just to kind of get themselves into a partnership really with me on their health. **Jiaming Ju:** Um. We have a 16 page behavior report that we customize for every single new patient, um, that I will hold 'em to it. That includes  nutrition and also lifestyle tips for people who try to get pregnant specifically. Um, I give, like, I consider this not as tips. I consider this as just like you need to do it is to get your [00:38:00] husband or your partner or whoever donates the sperm tested as soon as possible and making sure they're not drinking like six. Bottles of beer a day. Like, you know, like if you're in this like, you know, situation prep, pre uh, preparing for pregnancy, they should too. Um, and I usually advocate for morning intercourse rather than night intercourse. During ovulation to increase the chances. Um, and there are a bunch of specific ones. I usually give like on a patient to patient base, but I also will tell people to, um, spend at least one or two hours of, of a day to practice the Daoist principle of Uwe. **Michelle Oravitz:** I love that. That's my favorite, by the way.  **Jiaming Ju:** and I, you know, your New York patients will be like, no. But like, um, can I actually go cycling during that time? I'm like, no. The point of Uwe is you do nothing productive. [00:39:00] Then they have, you put them in a conundrum because they're like, then I'm just wasting my time. I'm like, no.  **Michelle Oravitz:** Wait, so people who don't know wwe, can you explain. **Jiaming Ju:** So WWE is the Daoist principle of doing nothing. Um, it's a practice I regularly issue to people to forcefully calm their mind. So I give a bunch of suggestions through what you can do for your wwe. Like for example, uh, you can knit, but not because. You're knitting for a nephew or something, you're learning to knit, not because you're good at it, it is because you want to. So it's to completely deviate from a lifestyle where we are chasing daily achievement all the time, right? It's more about resting your body and mind and focus on what matters on the present, which traditionally you to think it doesn't matter. So one of my favorite thing, even when I lived in New York City, was to really sit in a random coffee shop and just sit there, read my book or like judge [00:40:00] people's sense of fashion. So I will like people judge when I'm in the cafes. Like, what did you do during that time? Nothing. But I always feel like, great.  **Michelle Oravitz:** But it's like effortless effort. You're still there. It's not like you're totally inactive. You're, you're still there, but you're like in this neutral flow  state.  **Jiaming Ju:** Right, and then that's very important because there is nothing more difficult to a person who tries to get pregnant than thinking they're losing time. They're being told that they're losing time. They're late by every possible doctor under the sun. But you know, that is a time, is a, being late or not is a relative concept, as we say in Chinese medicine,  **Michelle Oravitz:** It's true. **Jiaming Ju:** So oftentimes you'll see people like signing off for IVF, not because they're physical ready, It's because they are told they are short on time, right? You don't do this now, you can't do it in three months. But statistics don't work like that. Like you said, you know, [00:41:00] within three months, your body's not going to dramatically change. You, you must well spend the time to take care of yourself, then really increase your chances rather than, I'm gonna dive into this when I'm super stressed. Um, pinning so much hope on this. Um, so yeah, again, I mean, I, I think that's really the thing, like having a child and being pregnant is not just something you must do in life. It's a, it's more than that. It's a mild, it's, it's, um. It's a face in life. One doesn't have to have it, but if you do decide to have it, I, I really think that people need to take a broader view on it.  **Michelle Oravitz:** 100%. I think that is so beautifully put because it is a big picture and it's um, you can't just take the part and then look at the part and say, okay, that's it. You have to look at like. How it interplays and works together as a [00:42:00] whole organism. And that's when you get the big picture. And, um, yeah. And I think about like, you know, the yin and the yang, you know, being too young all the time, you're gonna burn out the yin and that's ultimately the nervous system right there, having that balance. **Jiaming Ju:** Yeah, exactly. I think the society demands us to constantly deliver.  **Michelle Oravitz:** Mm-hmm. **Jiaming Ju:** The question is, what are you delivering? There isn't a return policy for a parent once the child is here. You are responsible for them for life. Um, so this is not just, I'm just, I just wanna get pregnant. This is a how it's going to completely transform your life wrecking you because your identity will be rewritten the minute you are pregnant, uh, when you become a parent. Um, and I think people need to probably, you know, take it, I always say like, take it more seriously, but [00:43:00] also take it less seriously. I. Because I think people take it really seriously on the, am I pregnant or not pregnant part, Right. But that don't take that too seriously, but like people need to consider what that means. The implication at your health more seriously.  **Michelle Oravitz:** Yeah, for sure. And so if people, and it's, it, it really helps to have somebody to work with because I think that. There's a lot of reminders that can be done from somebody who's looking at it more objectively and not in it because it's very hard to understand, um, what you're sharing if you're not working with somebody else. And I think that that's like the benefit on top of obviously getting the therapy, but also getting, you know, the treatments and also. Getting that perspective because when you're too in it, it's very hard to decipher. So I think that that is very priceless. Um, so for people who want to work with you, what do you offer? **Jiaming Ju:** [00:44:00] I think the, if you're interested in, and I always say this as a dare and those are kinds of my favorite tongue, tongue readings to do, is that people who say like, no, I won't tell you anything. I just give you my tongue, and then they're completely in shock when I spell out all your, their life secrets. So I think That's the number one thing you can do. Um, and in these tongue readings, I also give three quick suggestions, but I give a very good overview of like what you're not telling me about what's happening, wizard Health. Um, and that's a very fun thing to do. 'cause everyone has a tongue, right? And tongue reading is one of the most traditional things we offer in Chinese medicine. Uh, but usually the serious, more serious part. Is the one-on-one consultation with me online. And um, and then customized herbal formulation. I would say like 95% of my one-on-one patients on customized herbal formulation. And then. We do the monthly follow up for [00:45:00] that. And then there is also a bunch of digital small booklets, recipe books like that we, um, that I have written. For example, I have a postpartum recipe booklet that I highly recommend for anybody who is pregnant. And you don't know what, what really you heard about this myth about Chinese women eating different things postpartum. You don't know what that is. Uh, I wrote. A 20 page I believe, recipe book that  includes breakfast, lunch, and dinner and snack. Uh, for that. So That's a lot of like self study resources as well. Yeah, **Michelle Oravitz:** That's great. Um, sounds awesome. And you do raw herbs.  **Jiaming Ju:** no, I only do gran.  **Michelle Oravitz:** Oh, granule, which is so easy, but it also is effective because it's easy to digest, easier  **Jiaming Ju:** right. And everything is made to order. So we have patients from Scotland to, to Singapore. It's, it. is we, so it's, uh, everything is made to order and I co-write a formula with my dad for every single [00:46:00] patient. So,  **Michelle Oravitz:** Fantastic. And how can people find you? **Jiaming Ju:** Uh, you can follow us at Quinn House, KUN House. Uh, I believe we're on TikTok as well, but I never check TikTok. I'm a little bit scared of TikTok, so, um, Instagram is my  **Michelle Oravitz:** It's funny, I never got into TikTok too. I just do reels on Instagram. I just love Instagram. **Jiaming Ju:** Yeah, I think TikTok is a little bit of a wild scenario, but, um, yeah, Instagram is where I, I think do the most, so.  **Michelle Oravitz:** Awesome. Well, it was such a pleasure talking to you. You sound like a wealth of knowledge and I love your perspective and really how you understand, um, really from diet and, and also herbals, which is an art in itself. So thank you so much for coming on today. It was such a pleasure talking to you.  **Jiaming Ju:** you. [00:47:00]     

Many women with hypothalamic amenorrhea end their journey there. They resolve the period and get pregnant within months. Yay! And to be clear, that IS the case for most women.Every now and then though, someone continues to be a part of the unexplained infertility statistic. Cycling beautifully but not falling pregnant. Getting pregnant but miscarrying within days or weeks. Why? We still don't always know, and sometimes you wont.In our work, we've had a few of these clients. The beautiful part is that most of them don't give up and they keep going, which makes me feel emotional just to type about. Today is one of those stories.Join The HA Societyhttp://thehasociety.com/joinWork 1:1 with us to get your period backhttp://thehasociety.com/coachingVisit us on YouTubehttps://youtube.com/c/danisheriffFollow us on IGhttp://instagram.com/thehasocietyhttp://instagram.com/danisheriffhttps://instagram.com/ashley_marie_smith_https://www.instagram.com/itsmishigarcia/The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician.Support this podcast at — https://redcircle.com/the-hypothalamic-amenorrhea-podcast/donations

In episode #368 of The Hormone Puzzle Podcast, our guest Dr. Miranda Naylor, talks about Explaining Unexplained Infertility. More about Dr. Miranda: Dr. Miranda Naylor is a board-certified Family Medicine and Functional Medicine Doctor specializing in women's hormonal health and fertility. She uses a root-cause approach to help women get to the bottom of symptoms and optimize their health from the ground up. Thank you for listening! This episode is made possible by Puzzle Brew's Fertility Tea: https://hormonepuzzlesociety.com/fertility-tea Follow Dr. Miranda on Instagram: @‌drmirandanaylor Follow Dr. Kela on Instagram: @‌kela_healthcoach Get your FREE Fertility Meal Plan: https://hormonepuzzlesociety.com FTC Affiliate Disclaimer: The disclosure that follows is intended to fully comply with the Federal Trade Commission's policy of the United States that requires to be transparent about any and all affiliate relations the Company may have on this show. You should assume that some of the product mentions and discount codes given are "affiliate links", a link with a special tracking code This means that if you use one of these codes and purchase the item, the Company may receive an affiliate commission. This is a legitimate way to monetize and pay for the operation of the Website, podcast, and operations and the Company gladly reveals its affiliate relationships to you. The price of the item is the same whether it is an affiliate link or not. Regardless, the Company only recommends products or services the Company believes will add value to its users. The Hormone Puzzle Society and Dr. Kela will receive up to 30% affiliate commission depending on the product that is sponsored on the show. For sponsorship opportunities, email HPS Media at media@hormonepuzzlesociety.com

If you're trying to conceive and have experienced recurrent miscarriage, unexplained infertility, or you're just desperate for answers your GP hasn't given you, this episode is essential listening. In this eye-opening mini-series edition of The Worst Girl Gang Ever, Bex and Laura welcome back fertility nutritionist Alison Hall to break down one of the most overlooked — but critical — factors in pregnancy outcomes: the vaginal microbiome.

Loren struggled to conceive and was told IVF was her best hope. Thankfully, that wasn't the case. But it took a lot of courage -- and investigation -- on her part to find out exactly what she and her husband needed. Today, she joins us to share her story with our listeners in order to provide hope and encouragement along the way. NOTE: This episode is appropriate for all audiences, but does reference IVF, infertility, and pregnancy loss. Show links:Ep. 64: Unexplained InfertilityEp. 96: Theological Considerations with IVFEp. 122: IVF Alternatives for friendsEp. 147: Emotional Healing after IVFSend us a textSupport the showOther great ways to connect with Woven Natural Fertility Care: Learn the Creighton Model System with us! Register here! Get our monthly newsletter: Get the updates! Chat about issues of fertility + faith: Substack Follow us on Instagram: @wovenfertility Watch our episodes on YouTube: @wovenfertility Love the content? The biggest gift you could give is to click a 5 star review and write why it was so meaningful! This podcast is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or other qualified health provider regarding a medical condition. If you think you may have a medical emergency, call 911 or go to the nearest emergency room immediately. Neither Woven nor its staff, nor any contributor to this podcast, makes any represe...

Join Dr. Isabelle Amigues, rheumatologist, and Dr. Sarah Pederson, OBGYN specializing in infertility, as they dive into the connection between unexplained infertility and positive ANA. Discover how a collaborative approach can uncover hidden causes and optimize health for successful pregnancies. Don't miss this expert discussion packed with insights and actionable advice!More About Dr. Sarah Pederson at Vera Health & Fertility:She is a board-certified OBGYN who specializes in fertility, holistic medicine, and surgery. Originally from Phoenix, Arizona, she studied Biomedical Engineering (nerd alert!) at USC (University of Southern California) in Los Angeles, where she also attended medical school. After completing her OBGYN residency at UAB (University of Alabama at Birmingham), she moved to Denver, where she has been ever since.Her journey in women's health started when she was diagnosed with a large ovarian tumor and had to undergo major surgery. That surgery not only improved her fertility but also led her to have four beautiful kids. She is a Creighton Model Napro practitioner and has additional training in restorative reproductive surgery. When she's not working, she and her husband love traveling, camping, hiking, and skiing.You can find her here! https://verafertility.com/------------------------------------------------------------✨ Support my other channel, Rheumatology 101, for top Rheumatology tips, natural remedies, expert care, holistic healing, and the best treatment guidance for a healthier, pain-free life!https://www.youtube.com/@Rheumatology101/?sub_confirmation=1 

In this solo episode, I address the misconception that normal lab results always indicate optimal fertility or that there aren't any underlying issues present. Using a case study from one of my clients, I illustrate how a deeper, holistic analysis can uncover underlying issues affecting fertility that standard labs might miss. I highlight the importance of analyzing the whole body, including (but not limited to) hormone tests like the DUTCH Test, lifestyle factors, nutrition and environmental influences. The episode also emphasizes the need for personalized approaches to fertility.

From being told it was unexplained infertility to a BFP with the right support, in this week's episode I share an inspiring client story from Fertility Confidence Method. I share the importance of comprehensive testing, exploring male factor fertility and considering more advanced testing and treatment options - and how these steps drastically changed the outcome for this particular client. If you feel like there's more to your story that isn't being addressed, you're probably right. I hope this story inspires you to build your care team around you.   Thank you to our amazing podcast sponsor, Needed. Check out their amazing products at thisisneeded.com and use the code DRKELSEY for 20% off your first order. Curious what a full fertility work up looks like? Check out Fertility Labs 101 to understand what labs to advocate for, what they mean, and what the optimal (not just normal) levels actually look like. ttc.kelseyduncan.com/fertility-labs

On today's episode of The Wholesome Fertility Podcast, I am joined by world-renowned fertility specialist and Harvard-awarded scholar, Gabriela Rosa @dr.gabrielarosa, founder of The Rosa Institute. Gabriela has dedicated her career to helping couples overcome infertility, miscarriage, and failed treatments to create healthy families. With over 20 years of experience, her Fertility Breakthrough Program™ boasts a remarkable 78.8% success rate, even for couples who had previously faced long-standing fertility challenges. In this episode, Gabriela explains why infertility is a symptom of deeper health issues and shares how addressing these root causes not only improves fertility but also enhances overall health. She also delves into her innovative, evidence-based approach that combines modern science and natural medicine to deliver transformative results. Be sure to tune in for this enlightening conversation packed with practical advice and hope for anyone navigating the fertility journey! Key Takeaways: Infertility, miscarriage, and failed treatments are symptoms of deeper health imbalances. Gabriela's Fertility Breakthrough Program™ has helped thousands of couples worldwide overcome complex fertility challenges. Addressing the root causes of infertility leads to better reproductive outcomes and long-term health benefits. Low AMH does not mean no baby—natural conception is possible with the right interventions. Fertility challenges are clues pointing to underlying health issues that need attention. Thorough testing and a personalized approach are key to addressing unexplained infertility. Integrating natural and modern medicine optimizes fertility outcomes and overall health. Ignoring infertility as a symptom can increase the risk of chronic illnesses like diabetes and cardiovascular disease. Fertility is a whole-body process—issues with egg or sperm quality often stem from broader health concerns. Community and support are essential for navigating the emotional challenges of infertility. Guest Bio: Gabriela Rosa @dr.gabrielarosa is a world-renowned fertility specialist, author, and Harvard-awarded scholar. She is the founder of The Rosa Institute and creator of the Fertility Breakthrough Program™, which has transformed the lives of over 140,000 couples in 110+ countries. Gabriela's work focuses on addressing the root causes of infertility using an evidence-based approach that combines modern science with natural medicine. With extensive training in reproductive health, naturopathy, and public health, Gabriela is passionate about empowering couples to achieve their dream of parenthood while improving their long-term health and well-being. Websites/Social Media Links: Website: https://fertilitybreakthrough.com/ Facebook: https://www.facebook.com/FertilitySpecialistGabrielaRosa  Instagram: https://www.instagram.com/dr.gabrielarosa/  Fertility Breakthourgh Instagram: https://www.instagram.com/fertilitybreakthrough/  Fertility Breakthourgh Facebook: https://www.facebook.com/rosainstitutefertilitybreakthrough  For more information about Michelle, visit www.michelleoravitz.com  To learn more about ancient wisdom and fertility, you can get Michelle's book at: https://www.michelleoravitz.com/thewayoffertility  The Wholesome Fertility facebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/  Instagram: @thewholesomelotusfertility Facebook: https://www.facebook.com/thewholesomelotus/  Transcript: [00:00:00]  [00:00:04] [00:01:00]  [00:01:47] ​ [00:01:47] **Michelle Oravitz:** Welcome to the podcast, Gabriela. [00:01:55] **Gabriela Rosa:** Thank you so much, Michelle. It's so lovely to be here. [00:01:58] **Michelle Oravitz:** So lovely meeting you. We just [00:02:00] had a really nice pre chat and I would love for you. I always like to hear an origin story. I would love to get your background and how you got into the work that you're doing right now. [00:02:11] **Gabriela Rosa:** And sure. Look, I think if for me, I've been doing this work since 2001. So it feels like a very long time, probably because it is. when I start seeing my patience, babies graduating from university. I'm [00:02:23] **Michelle Oravitz:** Oh my God. That is crazy. Cause you look so young. [00:02:27] **Gabriela Rosa:** Oh, thank you. It must be all those herbs and nutrients, you know, but, it's funny because like, that's exactly last two years ago, I had this experience of like seeing, literally seeing one of my babies graduating from university and thinking, Oh my God, where did the time go? [00:02:44] You know, like, that's just crazy, but, but it's, it's been wonderful. It's been a wonderful journey. don't know that I have. In a way, I think that, you know, we, as, Steve Jobs says, you can't, or said, you can't join the [00:03:00] dots in advance. You know, sometimes you can only join the dots in retrospect. And as I look back, I think, you know, I don't know that I planned to be where I am, but in a way I plan to be exactly where I am, if you know what I mean. [00:03:14] It's a very strange kind of [00:03:17] **Michelle Oravitz:** It found you. [00:03:19] **Gabriela Rosa:** certainly found me, that's for sure. and it was really through my experiences with patients that That it shaped the specific area that we focus on because we really only treat couples who typically have been experiencing infertility, miscarriage, failed treatments, and really have, you know, have tried everything and nothing has worked like that's who we treat. [00:03:41] And it certainly didn't start out that way. My, passion when I first started doing what I do was that I wanted to make sure We had a contribution to making the world a better place, one healthier baby at a time. And I really had in my young mind that I wanted to help as many people who wanted to have a baby to [00:04:00] prepare, to do preconception preparation, to be the healthiest version of themselves because we know epigenetics matters. [00:04:06] We know that the way in which, you know, prospective parents go into a conception attempt and certainly conception in general will. either increase or improve the health of a child or, decrease it, you know, there is no zero net some kind of effect. There's only ever always positive or negative effects. [00:04:26] Neutral effects are generally kind of weighed down to negative effects. So for me, and I'll talk more about that if you want to, but, you know, for me, it was that whole idea that I wanted to ensure That we were making that contribution. And it was interesting because although some people were really interested in being the healthiest that they could be, most people were not, most people are like, Oh, this is just too much work. [00:04:50] Let's just start trying. And if we have a problem, then we can do something about it. And that was never really my attitude towards it because the way that I see certainly the [00:05:00] work that we do. There is another layer to it, which is not so much about the physical and the functional. Although, of course, we address that our program has a 78. [00:05:09] 8 percent success rate for people who previously, you know, were infertile, lots of failed treatments and all of those things. And we validated those results through my masters in public health at Harvard. So we know that, you know, what we're doing certainly makes a difference. But. It really, for me, the undercurrent and the underlayer of why I wanted to do this work was actually for self actualization of the patients who came to us, you know, it was for really being able to reach one's full potential in terms of health and how that impacted other areas their life. [00:05:43] And that's how I wanted to work. And the people who were coming in for preparation really were not into that kind of work. And so I started to see that the people who are more in alignment with the work that I wanted to do and the legacy that I wanted to leave in the world were the people who [00:06:00] were having difficulty. [00:06:01] And so I started to kind of focus more and gravitate more towards, you know, those, challenging experiences and how to help people overcome them and, Transition and almost kind of transmute what they were going through. And about five or six years into it all, I had a patient who really changed the trajectory of my whole career. [00:06:25] And she had been referred to me by a friend who thought that she should have a conversation with me. She had been infertile for 10 years. She had done multiple failed IVF cycles at the time. And even though now I talk about that case and it's kind of like, Every day in the office for me at the time, it was the first time that I was seeing that. [00:06:44] And so I was like, Ooh, I don't know that we can help that kind of sit or that I can help that kind of situation. You know, I don't know that there's much that I can do, but she was really insistent and quite adamant. I actually talked to her the other day and told her this story because she didn't even know. [00:06:57] Yeah. And she was like, Oh my God, that's so [00:07:00] amazing to know. But you know, it's, what I ended up happening was that because she was so insistent at doing something, she said to me, she said, look, it's going to be my last try. I'm not going to do any more treatment after this. You know, I'm getting older. I don't want to continue this. [00:07:15] It's been long enough. So I said, look, that's fine. Let's do what we need to do and we'll see what kind of result we get. And Three months later, after years of nothing working, she was actually, it was about four months later, she was pregnant and I was like, Oh, okay. So there's, there's something here, you know, but then at the same time, I thought, Oh, that's, that's strange. [00:07:33] I actually doubted my own, my own results, you know, I was like, Ooh, I don't know, I don't really know if this is just one of those. Luke situations, you know, one of those kind of like random occurrences. But then there was another patient who came to me not long after her, who was infertile for 19 years and yeah, and then I was really like going, [00:07:54] **Michelle Oravitz:** Wow. [00:07:55] **Gabriela Rosa:** I really don't think that I can do anything for you. [00:07:57] She was 44 by the time she came to me. I [00:08:00] had a conversation with her. I said, look, it's not usually, obviously what walks through my door is not 19 years of infertility, but just recently I had a lady who had been trying for 10 years. We can give it a go and see what happens. And we did that. About five or six months later, she was pregnant. [00:08:15] And so I was like, okay, now to, you know, randomness can occur, but to is a bit like a lot. and so I started to, after we had that, success, so I had that kind of experience. I started to then really decide that, okay, you know what, I'm only going to treat people who have been. Trying for more than two years and nothing has worked. [00:08:37] And I did that for many, many years. And when I finally went to do our study for the for the fertility breakthrough program and its results when I was doing my masters at Harvard, we realized that Yes, we had a 78. 8 percent live birth rate for people who had been infertile for almost four years on average, plus or minus almost [00:09:00] three years. [00:09:00] So it really helped me to realize that, okay, this definitely makes it, you know, what we do and the methodology that we use, and that obviously I've developed over the years. really does make a difference to address these really difficult, complex cases of couples who, and individuals as well, you know, sometimes we do get solo reproduction patients who come to us who have been experiencing FALD, or egg cycle, or IVF cycle, but mostly couples who know that there is more that they kind of intrinsically know there's more they can do, but they don't know what. [00:09:34] And they also are very unclear typically about why it's not working. You know, they have these unexplained diagnosis of either infertility or failed treatment or miscarriage, and they keep being told, Oh, everything is normal. Just keep trying. And we know that clearly, What is normal is that you have sex, you get pregnant, you hold your baby, that's normal. [00:09:59] A [00:10:00] deviation from that tells me that, okay, there's more that we need to ask in terms of what's going on here and certainly more that we need to answer if we're going to get somewhere. So that's how it all started. And I guess that's how it's going, you know, [00:10:13] **Michelle Oravitz:** That's awesome. I mean, those stories are pretty amazing. I mean, really, really like shockingly amazing. And a couple of things came to mind as you were talking about it. And I love the fact that you were saying about really approaching a person that To make them more vital, like to really improve their overall wellbeing. [00:10:33] And rather than just focusing on disease, you're really focusing on their health and seeing them in almost a positive light. And it is actually, we don't really notice this, but it is actually a perspective. of many healthcare professionals or like older types of healthcare, like not older, I guess more like conventional. [00:10:53] Sometimes they'll focus more on the symptoms and we always say like root cause versus symptoms rather than just [00:11:00] focusing on treating disease. It's like treating health and really kind of a more positive way to approach the journey. [00:11:08] **Gabriela Rosa:** You know, what's interesting is that we see these days that fertility, and I say fertility rather than infertility. Fertility is highly medicalized, right? So it's, it's about finding the problem and treating a problem as if The ovaries and the testicles, i. e. the egg and the sperm, were the only parts that make this process happen. [00:11:36] And we know that it's not. And, you know, what's interesting about it, and I think that, you know, to speak to what you're talking about, the issues here are so much greater than where we find ourselves, because it's a, it's a healthcare system problem. The reality of it is that when it comes to prevention, typically public health is focused on [00:12:00] prevention and the healthcare system is focused on the treatment of disease. [00:12:03] And we see that when it comes to fertility a lot and what ends up happening as a result of it is that It really is just focusing on like, it's almost like, you know, you've got a sore finger. Okay, let's chop that off and fix that problem. Hopefully you don't get to chop it off, but you know, that's typically how it, how it's approached. [00:12:24] And so what ends up happening is that the entire context of the human being that is meant to produce the result of, which really fertility is a, is an outcome. But it's also a retrospective outcome. You know that it's you're holding a baby once you are, like whatever happens before that moment happens is essentially a part of what is going to lead to whatever outcome you have. [00:12:51] And so I always talk about it from this perspective. If you are experiencing Challenges in terms of getting pregnant, keeping a healthy pregnancy to term, [00:13:00] these are end results of many biochemical chain reactions that start all the way, you know, way before the result is meant to occur. What IVF tries to do is immediately work from like the immediate part that you can see, i. [00:13:15] e. egg and sperm. But the reality of it is that there's only so much leverage when it's not very much that you can get from only trying to address those cells, as opposed to all of the biochemical pathways that are leading to the creation of the cells in the way that they are. And that's part of why IVF its own, often fails, because one, it's not looking and addressing What are the reasons as to why we need IVF to begin with? [00:13:41] And what is it that we need to do to improve the chances of conception occurring, whether it's via natural conception or via IVF? I also want to really kind of underline and highlight the point that whether we're talking about any kind of reproductive challenge, whether we're talking about [00:14:00] infertility or miscarriage or failed IVF treatments, It's almost like those are clues. [00:14:05] They're not results. They're not the outcome because the outcome of reproduction is a baby. So if we're having failures in that process that are leading us to not hold our baby, it tells us that, okay, the clues that we have are the symptoms that we're experiencing. Infertility, miscarriage, failed treatments. [00:14:26] Those are symptoms. Right, really to a large extent. And what that means is that we need to treat them as such, because if we don't address the red flags that are infertility on its own, miscarriages on its own, and failed treatments on its own, because failed treatments is relevant here, because the that you have an egg and a sperm together, you have an embryo. You have a baby right in that moment. You have a baby when you transfer an embryo for treatment, [00:15:00] you are pregnant at the time of transfer. No matter what you are pregnant. So if you don't see a positive pregnancy test. That tells us that implantation has failed and that tells us that, okay, there's something there that we need to address. [00:15:14] Why is it failing? Most doctors, most providers don't care about it. They literally just say, oh, you know, it's a like, it's a numbers game. It's the luck of the draw. Just keep trying. Everything is normal. Just keep trying. When I hear that, literally, this is why I have so much gray hair. Because when [00:15:30] **Michelle Oravitz:** But you have beautiful skin. [00:15:34] **Gabriela Rosa:** when I hear that, I just go, Oh my God, like, how can we keep believing this lie that everything is normal, just keep trying whilst we're having very clear symptoms, infertility, miscarriage, failed treatment, that things aren't quite right. [00:15:49] What we also know about these symptoms, and I like to call them symptoms because really, That is what they are. They're telling us that there is some imbalance within the system that [00:16:00] often left unaddressed will lead. It's not may lead. It is will lead to other health conditions being developed in the long term. [00:16:09] And we know that being studies about this that show that. For people who have an infertility diagnosis and just bypass it with any other kind of treatment rather than addressing IVF etc, rather than addressing the issue, what happens is that the risk and the rate of all cause mortality in the future is higher. [00:16:35] So people who are diagnosed with infertility who don't treat it. actually die from all other causes, cancer, cardiovascular disease, diabetes, at a higher rate than people who actually address their problems. And this was demonstrated to happen and be true for females and for males. So literally, if you're not addressing infertility as a symptom, [00:17:00] you are digging yourself a hole sooner and at a younger age than you otherwise would want to. [00:17:07] Now, I know that this is unpopular and most people are going to feel very confronted by hearing something like this, but the reality is that, sure, you can go and bypass infertility and the symptoms of infertility and go into IVF and get a baby. But are you going to have the quality of life and the ability to be here to raise that child in the long term? [00:17:29] That's a very important question that people need to ask themselves before they simply just jump onto, you know, overcoming the issue with a band aid and just fixing it as opposed to actually truly addressing the root cause of the problem and finding what is the problem. You know, because there are things, for example, if you have antiphospholipid syndrome, which increases the risk of miscarriage, that's also a marker for cardiovascular disease in the long term. [00:17:59] So you're [00:18:00] literally like, if you are ignoring it for, and just take heparin, take whatever to be able to actually take home a baby and not really addressing the underlying concerns that your body is telling you than a present. Well, You are certainly increasing your risk of cardiovascular disease in the future. [00:18:18] And like that, there are many other examples. I'll give you an example of insulin resistance. You know, like I was diagnosed with PCOS when I was 18, I had to really understand how to take care of my body in the best possible way to have regular cycles, despite being told by a medical doctor that. I probably would never have Children. [00:18:37] I was able to conceive two babies twice, literally one and two kind of attempts later by understanding what it is that I needed to do in a holistic way for my body. Now, had I not done that and just jump bypassed the problem with taking metformin, not that I'm saying it can't be a part of the solution, but it can't be the whole solution, right? [00:18:57] I would have probably at this stage in my life right [00:19:00] now. Have pre-diabetes or have already have diabetes because we know that insulin resistance leads to pre-diabetes, which leads to the development of diabetes and that women with PCOS have and are at highest risk. Now by me ignoring my insulin resistance, yes, I'm increasing the risk of implantation failure. [00:19:21] infertility and diabetes in the long term. And like I said, if I don't address that at the, at the point in the time that it matters to overcome fertility concerns and fertility challenges, I am choosing diabetes in the long term. So, and we know that one of the biggest killers in the world these days is diabetes, cardiovascular disease, and cancer. [00:19:43] And there are many cancers that are associated with the insulin resistance condition, resistance conditions and pre diabetes. So again, you know, I already have a family history of cardiovascular disease, diabetes, and cancer. Do I want to add to that? No, thank you. [00:19:59] **Michelle Oravitz:** [00:20:00] Yeah. I mean, wow. You know, this is such an important topic that you're bringing up and it's something that I don't even think has really been brought up to this level on my podcast and I've been doing this since 2018. I mean, yes, I've talked about how, like I've had people on and say almost like going through the fertility journey saved my life. [00:20:19] I mean, so yes, people have acknowledged it, but to this detail that you're mentioning, I think it's just so important for people to hear. And I think it is important. It's one of those painful truths. And I think it's important for people to face it and acknowledge it because ultimately you can ignore it, but it's going to come back. [00:20:38] It's not like ignoring it makes it go away. [00:20:41] **Gabriela Rosa:** exactly. And I think that that is, you know, if, people take nothing else out of this conversation today, I think what's important is to understand that you cannot bypass infertility and still be healthy in the longterm. You have to work with your body to understand why is it giving you these symptoms? [00:20:58] What is it that you can do about it? [00:21:00] Not just hearing a doctor say, Oh, everything is normal. Just keep trying. And yet having completely either it. Out of range or out of optimal range test results and continue to think that, well, IVF must be the next solution because it is not. IVF can be part of a solution and it's a wonderful part of the solution for couples who really, truly need it. [00:21:23] And truly, it was developed for women. with tubal factor infertility. So people who had blocked fallopian tubes for some reason, it wasn't developed for the variety of fertility concerns or issues and, causes that we have today. So we can't just expect that we are going to bypass the problem and are going to have absolutely no negative effect in the long term. [00:21:48] And I think that that's a really important thing for people to understand is that. Yes, you might use it as a way to support a process, but not without [00:22:00] addressing, and certainly not by ignoring what's causing it to be needed to begin with. I think that one of the biggest things, and for me this is, you know, something that I'm exceptionally passionate about, is helping people get answers. [00:22:15] you know, we even have a full free program that we give to people. That is a four week program. It's called the fertility challenge. It's completely free. It's literally worth thousands of dollars. And what it does is it helps people to understand, okay, let's understand the diagnosis. For you. Let's understand what are the things that are not working in the way that it needs to and change that. [00:22:38] You know, the objective really is to get answers, get clarity, to be able to personalize the implementation of whatever it is that you need to do so you can conceive however it is that you're going to conceive and finally hold the baby. Not continuing to go out and around in circles until you run out of time completely, because that is sadly what [00:23:00] happens to so many women, so many couples, they try, and I talk to them all the time, and it's heartbreaking, you know, people who have been trying for 10 years to have a baby and feel like, gosh, I'm at the end of my rope, I need to figure out how else I can do this, or I'm really come to terms with never having a baby, you know, like this is the decision and the place that so many of the patients who come to Mirat and I so hope and wish that people can actually have this clarity, have these epiphanies way before they are at that stage. [00:23:32] stage where they literally have their back in a corner and there's nowhere else to move. So those are important things for me. I think that it's, you know, getting clarity and getting answers is the number one thing that's actually going to enable you to implement the right strategy in terms of treatment because you can line up. [00:23:54] 10 men with poor sperm morphology. And you can have 10 [00:24:00] reasons as to why that sperm morphology is problematic in all of those different men. Right? So it's not one size fits all. Exactly. I didn't know for somebody, let's say that they have heavy exposures to like, I've had farmers in my program, you know, heavy exposures to heavy metals and, and heat and, you know, all sorts of things. [00:24:20] And then I've got doctors, heavy exposure to radiation and so on. So, you know, it's, it's one of those things that you really have to understand the context specific need for the patient to be able to properly and effectively address it. Otherwise you're literally just trialing and erroring until. [00:24:38] Unfortunately, many people run out of time altogether.  [00:24:42] **Michelle Oravitz:** I think that the biggest problem is that people just don't even know what they don't know. So they go to doctors and then, I mean, I was one of them and people know this, you know, my listeners know this. I've been on the birth control pill and that was like my solution to irregular periods and it was just like, [00:25:00] take this. [00:25:00] And this is the only thing you can do. And apart from this, there's nothing you can do. And that's, um, you know, such a straight statement and such a definitive statement. Statement that I don't know better. So I just believe it. And then until years later, I find different modality and realize, Oh no, there is something I can do. [00:25:17] So like  [00:25:18] **Gabriela Rosa:** There's lots.  [00:25:19] **Michelle Oravitz:** I didn't know. I did not know what I didn't know until I knew. And so this is why I love having people like you on here, bringing light to this because people need to hear this. Cause I think it's going to start to like light up something in their minds. It's like, Oh, wow, this is something that I can really. [00:25:36] Look into that's number one is people don't know what they don't know. But also number two is that they don't even know they can do anything about it. Then there's a lot of things that you could do about it. And you know, there's so many people say like, Oh, there's nothing you can do. There's no cure. And a cure is kind of like a, you know, very definitive word, but treatment. [00:25:56] I mean, there's things that you can do that actually [00:26:00] can impact it. It's just that that is not something that is in the conventional world. [00:26:06] **Gabriela Rosa:** Yeah. And you know what else is interesting, and I think that this is important for people to understand as well, because it's, it's a bugmare of mine, which is when people go to their doctor and the doctor runs some tests and then they go back for results and they literally are told, Oh, we've done all the tests. [00:26:22] And everything is normal. Now, let's peel this back and let's explain what all the tests actually means because all the tests does not mean all of the tests, okay? And everything is normal definitely doesn't mean that if you're still not holding a baby. And let me explain what that, what I mean by that. [00:26:39] When it comes to the fertility guidelines around the world, which is what doctors will most of the time will be following guidelines because they don't want to be seen as being stupid amongst their peers. Okay, so what happens with this? doctor will typically refuse to prescribe or request a test result unless they [00:27:00] feel validated in doing so. [00:27:02] Okay. And the reason for that, and I've had this conversation with doctors, my own providers, as well as colleagues who tell me this, they say, I can't ask for this test because it's not going to be either approved by insurance, or I'm going to be criticized for requesting this test to which I reply. Well. [00:27:22] What is currently in the guidelines when it comes to fertility diagnosis is that you check for patency in the fallopian tubes, so are the fallopian tubes clear, and usually that's tested these days, it used to be an HSG, these days it's by Hycose, ultrasound with fluid in the tubes and, you know, dye spilling through if the tubes are clear. [00:27:45] The other test that is done is typically your kind of general FSH, LH, estrogen, progesterone. Progesterone typically recommended on day 21 of the cycle, which also is not necessarily the right thing because some women have irregular cycles and [00:28:00] lengthened cycles and irregular ovulation. So really progesterone should be occurring seven days post ovulation and not at day 21 of the cycle, particularly if a woman has lengthened cycles or shortened. [00:28:13] cycles. It doesn't mean that a woman is not ovulating in those two instances. It just means that pinpointing ovulation becomes more difficult. And that is pretty much, and then of course, sperm parameters. Most people that come to me, believe it or not, despite years of infertility, have not had a semen analysis done. [00:28:30] or don't have a recent semen analysis that really understands what's going on with sperm right now because sperm changes literally every four months. And so you can have the flu and end up with zero sperm. It actually can happen. And you know, that doesn't mean that that person is azoospermic forever and always, it just means that they've had a severe infection that has wiped out their for a sperm cycle or for a period of time. [00:28:57] So Understanding that the major [00:29:00] things, and some doctors are more thorough and some will prescribe or refer, recommend further tests, but as a bare minimum, they're looking for hormonal balance, looking for ovulation and looking for tubal patiency and sperm parameters. So those are four things. [00:29:15] Out of literally thousands of tests that could be done and that needs to be looked at. And of course, needs to be personalized because testing is also expensive and you don't want to be wasting time doing tests for no reason. So, you know, there is a balance to that. But it's not enough to have four tests and not really exactly know what it is that's being tested. [00:29:37] And your doctor tell you, Oh, you know, we've done all the tests and everything is normal because very little is going to be picked up unless there is some serious major issue. Very little is going to be picked up by those four, you know, four things being tested or four areas being tested. What's going to happen is that you may end up with some clues about what else needs to be tested, but [00:30:00] Typically, it's going to be insufficient to gain a proper diagnosis. [00:30:05] to which what happens from there is that people get diagnosed with unexplained infertility. And hence why unexplained infertility is the major, the biggest category of infertility diagnosis, because more tests have not been done. Now, typically, and this is when [00:30:23] we're  [00:30:23] **Michelle Oravitz:** I mean, that is such a good statement. Keep going. Sorry. [00:30:28] **Gabriela Rosa:** the thing about it is that that's what we're talking about conception and conception attempt failures, which IE infertility is what, how it's labeled. [00:30:38] But when we're talking about miscarriages or implantation failure, it's even worse. Because, guess what? The healthcare system expects that a woman has to have at least three miscarriages before testing is done. Now, really? I mean, I don't know, for anybody who has ever had one miscarriage, it's traumatizing enough. [00:30:58] Waiting to have three [00:31:00] before you actually do any further testing, to me, is pretty extreme. That's why, you know. It's unacceptable. It's, as a woman, I think it's just like, it's ridiculous, right? Now, the other thing then that happens is failed IVF You end up with an embryo. Most people who go into IVF, and it's not everyone, but most people will end up with at least one embryo, and there will be a decision to transfer said embryo. [00:31:23] If it doesn't work, and of course, if the cycle gets cancelled for any other reason before we get to that stage, or even then. after getting an embryo, i. e. embryo doesn't develop, doesn't, you know, there's no blastocysts to transfer, whatever it is. Every single one of those points of failure, so to speak, needs to be questioned and needs to be specifically tested and addressed because otherwise, again, you can end up with the same problem. [00:31:51] Now, In the case of IVF, it's more problematic because it's also extremely costly. In the United States, an average IVF [00:32:00] cycle costs about 17, 000 U. S. dollars. And around the world, you know, the price varies. But let's just go with the United States data. And we look at an average cost of 17, 000. That is whether you get to transfer or not. [00:32:13] you are paying that money. [00:32:15] **Michelle Oravitz:** Yeah. [00:32:16] **Gabriela Rosa:** you have an embryo or not, [00:32:18] you are paying that money. So the thing about it that I questioned is like, okay, and there are published studies that show that in order to have a close to 80 percent live birth rate, cumulative rate for IVF, i. e. having a baby, close to 80 percent cumulative rate of chance of having a baby, you have to have eight IVF cycles. [00:32:39] That's the average. Now imagine, imagine eight times seventeen thousand dollars, I mean for some people that's a house. [00:32:48] **Michelle Oravitz:** Yeah. [00:32:49] **Gabriela Rosa:** Right. So no wonder people can't afford to go and do IVF. No wonder there are so many challenges. But even if you can afford it, would you rather do something else first to [00:33:00] understand what is the cause and address that before going and doing another cycle? [00:33:04] You know, we have so many patients who come to us after failed cycles and go, look, I want to prepare to have another better cycle. Typically, those people end up conceiving naturally. They didn't even need IVF to begin with. And when they do, they end up having one or two maximum cycles afterwards, once you understand what the problem is. [00:33:23] So again, hence the critical importance of understanding what is the problem you are dealing with, rather than just expecting that you are going to be okay with some unexplained diagnosis. for your expertise. [00:33:37] **Michelle Oravitz:** So walk us through, like, if you have certain cases, like the ones that you were mentioning, that are really, really complex and many, many years of dealing with. really being on this journey, what are some of the steps you would take? You had mentioned doing testing and functional testing also just for people listening, if you don't know about it, is a lot more in depth and [00:34:00] detailed than what you'll typically get when you go to the doctor's office. [00:34:03] **Gabriela Rosa:** Yeah, no, I agree with that. And look, the testing piece, it's almost, it's a science and an art, right? Because it's almost like you need to balance. various things when requesting a test, you have to balance what is the return on the knowledge that you're going to gain? What's the time spent? What is the money spent? [00:34:22] What are the things that are actually going to give you a lot to be able to do about it versus not very much for a very expensive test? So there's, so for me personally, and certainly, you know, in the first time method, what we use in the pro in our programs, really, what we're looking at is we kind of go back to the drawing board, we collect all the data. [00:34:42] We really look at everything that the patient brings from their lived experience, whether it's test results, other things that they've done, whatever it is, we collect and analyze all of that information to really first understand, okay, what has been done? Where are the gaps? Where are the places of opportunity? [00:34:58] What are the things [00:35:00] that. we need action that is absolutely urgent. And one of the things that we don't actually need to address because there will be addressed as part of addressing the, you know, some of the basic major root issues, root causes. So it's understanding that nuance that actually ends up being able to direct a path, particularly in those cases that we treat that are very difficult and complex because you can do a thousand tests. [00:35:28] You know, there's thousands of tests that you can actually do. Will you do them? No, no. So then we have to really be able to identify, okay, what are the red flags that if we were to understand more about them? Or where the gaps that if we don't know is going to change the direction of our, say, of our choices, then we're starting to look at those things, you know, in cost effectiveness, cost effectiveness analysis, which is a big [00:36:00] field of science, really, the idea is this, if you are going to treat anyway, don't test. [00:36:07] Right. So for example, and there are pros and cons to this, but you know, there are certain things that you're going to treat anyway. So is there a need to test it? Sometimes there is. But sometimes there really isn't and that's the thing that we really need to kind of balance in the whole scheme of things is the things that are going to be absolutely essential and the things that are not really going to be that important. [00:36:34] **Michelle Oravitz:** And what were some of the protocols or what are the types of ways that you treat people or. What is included in the protocols? [00:36:44] **Gabriela Rosa:** It's depends because it's very personalized, you know, so we will use a blend of medical. treatments and even medical diagnostics, of course. And we then are going to utilize the best of all of the worlds that we have access to, whether it's [00:37:00] naturopathic medicine, integrative medicine, traditional Chinese medicine, lifestyle medicine. [00:37:04] So we then are putting together a very personalized process. That is going to help that individual that is part of that couple. Because like I said, you know, you have 10 different men, you have 10 different reasons. Therefore, we need to understand what is the reason here and what do we then make as recommendations. [00:37:24] My biggest focus always is minimum effective dose. I want to do the least possible to get the biggest resolved. Right. That is my focus. So I'm always assessing and addressing the case from that lens of like, okay, what do I need to touch? What do I have to leave alone? Because there are certain things that, you know, for example, I'll give you an example of heavy metal toxicity. [00:37:46] Heavy metal toxicity is a really tricky one. In some cases, it will increase the risk of miscarriage. Like, hugely. I had patient once who basically had 40 times the, elevated rate of what's kind of acceptable in a [00:38:00] human. And essentially had had 8 miscarriages a result, was coming to me to figure out, okay, why am I having miscarriage after miscarriage, even though I'm getting pregnant, she was only 30. [00:38:10] So we went on to identify that she had really high level of mercury toxicity, which was causing these miscarriages. And there were other factors too. So we addressed all of it and we had to make a decision in her situation to actually go for medical chelation therapy. Because what ended up happening for her with that high level is that she was going to continue miscarrying. [00:38:32] And we also knew that chelation therapy would take a long time because it doesn't work quickly. It took us 12 months of treating her, doing chelation, doing retesting, more chelation, more retesting to actually get to a point where she could start trying to conceive again. So it's not everybody has that kind of time, which means that we might find high heavy metals in a person and have to leave it alone because literally we have two years until this [00:39:00] is all over, right? [00:39:01] So it just depends on the situation and we have to make those critical clinical decisions that are going to really help the outcome that we are looking for. So it's highly personalized. So it's not. I don't have, we have a framework that we make sure that we don't leave things to chance, that we really are, you know, checking off every box, but we don't have a, this is the only way that we do this because we have to ask and answer questions and address and adapt accordingly. [00:39:29] **Michelle Oravitz:** So I guess, my question wasn't specifically like a protocol that's customized, like for all, cause I get it. We do the same thing, but do you use, what kind of tools do you use [00:39:39] **Gabriela Rosa:** Oh, we use all sorts of things from, yeah, from drug therapy to herbal medicines, to nutritional supplementation, to exercise, to sleep, to diet, like, All of the things, you know, so in terms of what it is that we're going to use, we're going to use whatever it is that we need to use. You know, sometimes we find infections that we're not going to waste time [00:40:00] trying to use. [00:40:00] I was just going to go straight to antibiotics. You know, because that's just the thing that's [00:40:04] going to give us the result the fastest. So, again, even the treatment part is going to be very, I guess, personalized to whatever it is that that person needs, because at the end of the day, I want speed.  [00:40:18] **Michelle Oravitz:** Yeah,  [00:40:19] **Gabriela Rosa:** speed and I want effectiveness. [00:40:21] So it's, it's balancing all of those worlds. [00:40:24] **Michelle Oravitz:** definitely have a unique perspective though, in a sense that you use tools that are conventional and, a little bit more alternative and holistic. So it is a really great combination because you can get amazing results with both. Yeah. [00:40:41] **Gabriela Rosa:** way that I see it is like, we really do want to blend the best of both worlds. We don't want to say, Oh no, this is not something that we use. I'm not. Look, honestly, I am not, I'm not a purist. I'm not a purist, you know, like, I don't think that there's only one way to do things. [00:40:57] I think I always am looking for what is the best [00:41:00] way to do something, you know, what's going to get us the outcome that we're looking for, balancing all of the constraints and challenges and situations that we have in front of us. So, but how? And I always say to my patients, I'm completely impartial as to how you get pregnant. [00:41:15] I don't care if we have to use IUI, IVF, you know, like I don't care donor egg. That's not the thing. The thing is, if my patient comes to me and says, look, I'm, I want a baby no matter what. we are going to explore every, every opportunity to be able to do that. Then I also have some patients who come to me and say, I will only try natural conception. [00:41:36] I'm like, okay, cool. Let's explore and make sure that we maximize that opportunity. You know, what are the things that we need to do? But it's, values and preferences of the patient that will determine where we go and what recommendations we will make. [00:41:52] **Michelle Oravitz:** Yeah. I love that. I mean, I think that that ultimately just shows that you're present with your patient because that is [00:42:00] ultimately what it is. It's not a one size fits all because then it's something that you pre craft and just give out. But when you're present with a patient, you're able to really assess what you have in front of you specifically. [00:42:11] One topic that I did want to actually ask you about, you know, to get your thoughts, A lot of times people will come in with like, What they say, quote unquote, low AMH, which as we know, sometimes fluctuates in itself, but people get really hung up on it in response to how their doctors get really hung up on it, and I've seen this my, in my own office is that it really doesn't make as much of. [00:42:38] I guess the challenge is people think it does. I've seen people with very low numbers that were told that they needed egg donor conceive naturally like multiple times after that. So I just wanted to get your thoughts on that. [00:42:50] **Gabriela Rosa:** Yeah, absolutely. It's a great question. And look, you know, what happens is that AMH levels, which measures the ovarian reserve, it's measuring the hormones that are excreted by [00:43:00] the eggs themselves, right? And so the more of AMH you have, the more eggs you're likely to have, the less AMH, the less eggs you're likely to have. [00:43:08] Yeah. Does it mean that if you have low AMH that you can't conceive naturally and what is the best way to conceive? Well, actually, all the science shows that if you have low AMH, typically the best option for conception is actually natural conception or IUI. As opposed to IVF. Most, and this is why most women with lower MH go to their doctors and they refuse to do IVF cycles if they are good doctors. [00:43:35] If they just want to take their money, they might not be that kind of doctor. Right? And so the reality of it is that Low MH in itself does not preclude a woman from conceiving with her own eggs naturally. I see the same thing in my clinic. In fact, our study, our Harvard study shows that even in the very low MH category, the less than one, the one to four is low, less than one is very low. [00:43:59] [00:44:00] We had the majority of patients conceive by natural conception in that category group. So very possible, very doable. However, it's not as easy as it used to be. Thank you. Right. When a woman had higher AMH, and this is also part of the reason why you need to make sure that you're addressing the full context of the patient, because a woman's ovarian reserve is just going to, it's going to decline at the time, no matter what. [00:44:26] And if you're treating the wrong problem, i. e. let's say, for example, we have very poor sperm quantity, quality, you know, all of those things. And you are continually treating the woman because she has low ovarian reserve. Well, you're actually leaving a lot on the table because she probably with a better sperm partner would actually have already conceived. [00:44:50] And so it's about understanding, again, this is where I always say fertility is a team sport. And I say that for a reason. You can't expect that a woman [00:45:00] with lower age is going to conceive with crappy sperm. If you have a lower age, what you need is superhero sperm, right? And so it's, and men's sperm quality decreases over time as women's fertility decreases over time. [00:45:14] So it's a, it's a matter of understanding. What it means, like, for example, if you have just low AMH and your FSH is normal on day two, then you have a much better chance of conceiving and taking home a healthy baby, whether it's naturally or any other way, than a woman who has low AMH and high FSH. [00:45:34] Because then, if you're having high FSH, it's telling you that already on day two, your ovaries are already struggling to release the eggs that are remaining. So that tells me that, again, IVF is definitely not the best option, and you need to figure out, okay, what else is there that you can, what are the levers that you can pull, because probably egg quality is [00:46:00] not going to be enough. [00:46:01] Right? And so then you have to address and adjust treatment accordingly. But just as a full answer to your question, just as a, as a very big summary, Lower MH does not mean that you can't conceive. It does signal the onset of perimenopause. Typically ovarian reserve lowers quite significantly five to ten years before menopause, and particularly for women who smoke, that happens even five years before women who don't smoke. [00:46:30] So it's certainly if you, if you are trying to get pregnant and you smoke, well, you better stop. Right now, because you are definitely almost kind of poisoning your chances of taking a healthy pregnancy to term at any point, like you're literally certainly decreasing your chances by at least five years compared to non smoking counterparts. [00:46:54] And if your partner smokes secondary, you know, kind of smoke is also going to be a problem. [00:47:00] So, and of course, that's going to be a problem for sperm. So there's all of those, those contexts as well that we have to take into account. But yeah, it's, it doesn't necessarily translate that low AMH means no baby or low AMH means that it must be donor egg situation. [00:47:15] We had patients, and again, this is in our analysis, the majority of patients who had low AMH were told that they needed to have donor egg. We, in the entire sample of 544 patients, we only had 5. 6%. actually need donor egg. So, and the majority were consuming naturally. So, you know, I take that with a very large grain of salt. [00:47:38] **Michelle Oravitz:** Yeah. And this is why you have to get many multiple opinions and really do your research and find the right practitioner. Maybe a couple of different practitioners. but I love your approach and I think that a lot of what you're saying, first of all, it makes a lot of sense, but it's also, is research based and empowering for people listening. [00:47:59] [00:48:00] And so for people listening who are interested or want to learn more about your work, what are the things that you offer online, like [00:48:08] **Gabriela Rosa:** Yeah. So [00:48:09] **Michelle Oravitz:** far away, [00:48:10] **Gabriela Rosa:** they can go to my website, which is fertilitybreakthrough. com and they can also search my name, which is Gabriella Rosa, G A B R I E L A R O S A. they will find, I have my book, Fertility Breakthrough, Overcoming Infertility and Recurrent Miscarriage When Other Treatments Have Failed free on YouTube and Spotify. [00:48:29] So they'll be able to get the audio version there. It's also available on Amazon and every other bookseller. And of course, as I mentioned earlier, you know, we have the free fertility challenge program that is designed for couples who want to overcome infertility and miscarriage, and most importantly, want to find answers, you know, and want to know what it is that they need to do and how to personalize their journey so that they can hold their baby sooner, [00:48:53] **Michelle Oravitz:** amazing, and you work one on one as well, right? [00:48:56] **Gabriela Rosa:** our team does absolutely. So, yes. [00:48:59] **Michelle Oravitz:** [00:49:00] amazing, Gabriella, this is an amazing conversation. I've seen you around before. I've looked at your information before we spoke and I was very impressed and this exceeded my expectations. So thank you so much for coming on. [00:49:14] **Gabriela Rosa:** Thank you. Thank you for having me. It's a real pleasure. [00:50:00]       

Download Your Free Guide - 3 Things You Need to Know About Cancer:  https://www.katiedeming.com/cancer-101/Ever wondered why birth control is prescribed as a universal solution for women's health issues? Dr. Katie Deming welcomes Dr. Monique Ruberu, a holistic gynecologist who left conventional medicine to help women find natural solutions for hormone health. After years of prescribing birth control as the default solution, Dr. Ruberu discovered there was a better way to address women's health concerns by understanding the root causes.Learn how your menstrual cycle is a window into your overall health. Dr. Ruberu shares practical ways to identify hormone imbalances through simple observations, and explains why conventional hormone testing often misses crucial information. Chapters:03:58 - Truth about hormonal imbalances  14:26 - Unexplained infertility26:00 - Signs your estrogen is out of control  39:00 - Struggling with menopause? 48:40 - How cycle tracking strengthens relationshipsFrom thyroid function to gut health to adrenal support, discover how these systems work together to influence your hormones. Dr. Ruberu offers accessible, natural approaches to common women's health concerns that go beyond just masking symptoms. Listen and learn why supporting your body's natural processes, rather than suppressing them.Connect with Dr. Monique Ruberu: https://www.naturalwomenshealth.com/Send us a text with your question (include your phone number)Watch & Listen to Born to Heal on Youtube: Click Here Transform your hydration with the system that delivers filtered, mineralized, and structured water all in one. Spring Aqua System: https://springaqua.info/drkatie Don't Face Cancer Alone"The 6 Pillars of Healing Cancer" workshop series provides you valuable insights and strategies to support your healing journey - Click Here to Enroll MORE FROM KATIE DEMING M.D. Free Guide - 3 Things You Need to Know About Cancer: https://www.katiedeming.com/cancer-101/6 Pillars of Healing Cancer Workshop Series - Click Here to EnrollWork with Dr. Katie: www.katiedeming.comFollow Dr. Katie Deming on Instagram: The.Conscious.Oncologist Take a Deeper Dive into Your Healing Journey: Dr. Katie Deming's Linkedin Here Please Support the Show Share this episode with a friend or family member Give a Review on Spotify Give a Review on Apple Podcast DISCLAIMER:The Born to Heal Podcast is intended for informational purposes only and is not a substitute for seeking professional medical advice, diagnosis, or treatment. Individual medical histories are unique; therefore, this episode should not be used to diagnose, treat, cure, or prevent any disease without consulting your healthcare provider.

Hey sister! In today's episode, we're chatting with Ann, a sweet and inspiring member of the Fertility Framework community. Ann opens up about her journey through the ups and downs of unexplained infertility, her frustrations with traditional fertility clinics, and the incredible growth she experienced after joining the program. This conversation is full of encouragement, practical insights, and faith-filled inspiration for anyone navigating fertility challenges. Episode Highlights:  Ann's struggle with unexplained infertility and her experience with fertility clinics. The “lightbulb moments” that came from charting her cycle and learning about her body. How scripture and stories of women in the Bible brought new hope to her fertility journey. Practical changes Ann made to support her hormones and overall health. The power of faith, support, and knowledge in transforming her perspective. Even in the hardest moments, God's design for your body and His plans for your future are good. Ann's story is a testament to the power of faith, science, and community working together to create hope and change. Feeling inspired by Ann's story? Learn how you can join the Fertility Framework and take the first step toward understanding your body and supporting your fertility naturally. Visit bekahyawn.com/course to learn more! In Him,  Bekah   >>Learn more about the Fertility Framework Course: https://bekahyawn.com/course   >>Not sure if the program is right for you? Send me a video, text, or audio question here: https://www.videoask.com/f9ivtsy56 >>Join our free online community here: https://www.facebook.com/groups/802419477419221   >>Take The Hormone Imbalance Quiz: www.bekahyawn.com/quiz  

Have you been diagnosed with unexplained infertility? That frustrating diagnosis where, on paper, everything seems fine. Your test results are normal, your scans are normal, your cycle is normal - everything seems NORMAL. But for some reason, getting pregnant just isn't happening.On today's episode we chat to Dr Aumatma Simmons who is going to answer the question - is unexplained infertility really a thing? And what can you do if this is your diagnosis?Dr Aumatma is a double board-certified Naturopathic Doctor & Endocrinologist & has been in practice for over 15 years. She specializes in fertility and is the best-selling author of two books, as well as being the host of the Egg Meets Sperm podcast.So on today's episode, we talk about what you should do instead.By the time you finish listening, you'll find out: How you can delve deeper if you've been told your fertility issues are unexplainedWhat tests to ask for and where to turn for helpDr Aumatma's 4-step program for uncovering underlying health issuesThe In Your Element Fertility Yoga Program is officially OPEN FOR ENROLMENT!Don't miss your chance to be a part of the most comprehensive mind-body fertility program available.For all the details and to register CLICK HERE!!When you finish listening, I'd love to hear your biggest takeaway from today's episode. Take a screenshot of you listening on your device, share it to your Instagram stories and tag me, @jen.elementpilatesyoga The doors to the In Your Element Fertility Yoga Program are now OPEN!! Secure your spot now inside the most comprehensive mind-body fertility program. It's here that I'll guide you through the best practices to: Regulate your nervous system Support your fertility Sync with your cycle & synchronise your hormones This is the exact process I have taken 100s of women through along their journeys to motherhood and beyond. And I can't wait to show you how.The program costs $39 usd per month - so you can try it today & see if it's right for you.Spaces are limited so jump in now to secure your spot for 2025!Visit https://www.elementpilatesyoga.com/in-your-element-membership for all the details & to register!

On today's episode of The Wholesome Fertility Podcast, Sarah, a woman I worked with, shares her deeply personal fertility journey that was close to four years. She shares her struggles, the various treatments she explored, and the spiritual practices that helped her find hope and healing. She emphasizes the importance of perseverance, the role of alternative therapies like acupuncture, and the significance of finding the right medical support. Sarah's story is one of resilience, faith, and the power of belief in oneself and a higher purpose.   Takeaways   Sarah struggled with unexplained infertility for three and a half years before seeking treatment. She explored various treatments, including acupuncture and IVF. Visualization and spiritual practices played a crucial role in her journey. Finding the right medical support made a significant difference. Sarah emphasizes the importance of not giving up on the journey. She believes in the power of intuition and listening to one's body. Connecting with nature helped her find peace and clarity. Nutrition and blood flow are essential for fertility. Sarah's experience highlights the importance of sharing stories for hope. She encourages others to start their journey sooner rather than later.       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) I'm so excited to have you on today, Sarah, to share your story. Thank you so much for being willing to open up and inspire others with your journey. I'd love for you to introduce yourself and share a bit about your experience.   Sarah (00:20) Thanks for inviting me, Michelle. My name is Sarah, and I struggled with unexplained infertility for three and a half years. I had multiple tests and examinations, visited several doctors, and went through all the standard procedures, but no one could pinpoint the issue.   During my research, I discovered that acupuncture could be helpful for infertility, as it promotes relaxation and balance. Along with acupuncture, I learned about the importance of the right supplements. That's when I found you, Michelle, through your amazing reviews online. I reached out, explained my situation, and shared how I'd been following everything the doctors recommended, eating healthy, but still had no success. What struck me immediately when I met you was your energy and positivity. You weren't just an acupuncturist; you were like a life coach, guiding me step by step. During our first visit, you assessed my needs, recommended supplements, and started a treatment plan. After just one session, I felt significantly more relaxed. I also started practicing the visualization techniques you suggested, spending time at the beach, watching the sunrise, and focusing on restoring my energy.   After five treatments, I was able to get pregnant naturally. It was an incredible moment, and I can't thank you enough for your guidance and support. Michelle (03:17) I appreciate your kind words, Sarah, but I want to highlight the effort you put into this journey. You took initiative, embraced the practices, and made significant changes—that's a big deal.   Sarah (03:28) Thank you. It was a challenging road, but your support made all the difference. To give some context, I had tried naturally for three and a half years. Then, I underwent four IUIs, but none were successful. During one of those cycles, I worked with another acupuncturist, but it didn't help. Eventually, I decided to move on to IVF. My first IVF attempt wasn't successful. The clinic retrieved a few eggs, but only two made it to embryos, and the fresh embryo transfer didn't work. That experience was emotionally draining. The clinic's lack of support left me feeling alone and uncertain. That's when I turned to you. We started acupuncture and supplements, and your guidance helped me approach the process differently. I switched to a new clinic, which was much more supportive. They recommended combining acupuncture with IVF, and this time, everything felt more aligned.   Michelle (06:01) It's amazing how much the right environment and support can make a difference.   Sarah (06:22) Absolutely. The second clinic was so thorough and caring. They retrieved more mature eggs, and six of them made it to embryos. We planned a frozen embryo transfer but decided to wait a few months to let my body recover. Meanwhile, I continued with acupuncture and the protocol you recommended.   Then, something unexpected happened. Before the transfer, I got pregnant naturally. It was a complete surprise. I couldn't believe it after everything I had been through. Michelle (08:27) That's incredible! Your story is so inspiring because you had every reason to feel defeated, yet you never gave up. What kept you going? Sarah (10:00) I'd say it was a combination of faith and determination. I also had a dream after my first failed IVF that really stuck with me. In the dream, a man in brown clothing with a beard stood over me and placed his hands out, giving me energy. It felt like a message not to give up.   Michelle (12:14) That's so powerful. Dreams can be deeply meaningful, especially during such emotional journeys.   Sarah (13:32) It was. That dream, combined with my spiritual practices, gave me strength. I started focusing on connecting with God and nature, walking barefoot in the sand, and appreciating the present moment. I also began meditating and visualizing my body healing and preparing for pregnancy. Those practices made a huge difference. Michelle (17:22) It's amazing how those connections to faith and nature can create such profound shifts. And I remember when you first came in, your hands were very cold, which indicated poor blood flow. Improving circulation was a key part of the treatment. Sarah (18:45) Exactly. My hands aren't cold anymore, and I feel so much healthier overall. The blood flow improvements and supplements were game-changers.   Michelle (19:58) Blood flow is essential for nourishing the body and supporting fertility. In Chinese medicine, when the blood isn't circulating well, it can cause stress and other issues. Supporting the body holistically allows it to do what it's meant to do naturally. Sarah (22:33) I agree. Another big takeaway for me was learning that not all clinics or protocols are the same. Switching to a more supportive clinic and waiting for my body to recover before the frozen embryo transfer were critical steps. Patience and intuition played huge roles.   Michelle (23:44) Your intuition and persistence were key. And I'll admit, when I first met you, I had a feeling you'd be successful. But I always try to stay neutral because I never want to give false hope. It's about supporting the process and trusting your body.   Sarah (24:26) Thank you for believing in me. That belief made such a difference, along with everything I learned about visualization and spirituality. I've come to realize how powerful those tools are.   Michelle (29:23) It's true. Visualization and faith are incredibly powerful. Thank you so much for sharing your story, Sarah. Your journey will inspire so many others who are navigating similar challenges.   Sarah (30:02) Thank you for having me, Michelle. I'm so grateful for the opportunity to share my story and hopefully give hope to others. Never give up—the results are worth it.   Michelle (30:30) Absolutely. Thank you again for opening your heart and inspiring others.

Visit https://elle-sera.com/ for 10% off your first order!Follow Alexandria:▶︎ LinkedIn▶︎ WebChapters: 00:00 Introduction00:39 Factors Affecting Fertility01:48 Unexplained Infertility and Common Conditions02:45 Personal Stories and Struggles03:40 Understanding PCOS and Its Impact05:23 Diet and Lifestyle Tips for PCOS06:35 Endometriosis and Fertility Challenges07:59 The Impact of Birth Control on Fertility10:33 Tracking Fertility and Understanding Your Cycle11:57 Age and Fertility: Myths and Realities15:07 Nutrition and Fertility: What to Eat17:55 Endocrine Disruptors and Their Effects20:27 Exercise and Lifestyle Recommendations22:49 Plastics and Their Impact on Health24:40 The Role of Sugar in Fertility26:20 Choosing the Right Foods to Overcome Cravings26:39 Building the Perfect Plate for Health27:40 Addressing Male Infertility30:54 Impact of Lifestyle on Fertility35:43 Importance of Sleep and Stress Management37:16 Unexplained Fertility and Miscarriages42:42 Support and Success Stories49:07 Conclusion and Contact Information Listen to the podcast on:▶︎ Apple Podcasts▶︎ Spotify Follow Elle-Sera for more:▶︎ Facebook ▶︎ Instagram▶︎ LinkedInAbout Elle-SeraHormones aren't JUST anything. They make you who you are and control everything – your energy, mood, weight, confidence, hunger, motivation, outlook, libido the list goes on. The impact of hormone imbalance on our psychology and behaviour has been dismissed – until now. Let's stop diminishing the way we feel because of our hormones, by uttering those three little words: “I'm just hormonal”, and start embracing the power you can have over them. Elle Sera supports thousands of women to reclaim their hormones, including myself. Our golden pill is packed with five potent ingredients, carefully chosen to rebalance hormones in one essential daily dose.Recorded and Produced by Liverpool Podcast Studios▶︎ Web ▶︎ Instagram▶︎ ...

On today's episode, we share in the journey of my wonderful friend, Jennifer.  I met Jen when she was in the trenches of a very long & difficult fertility path. She had been through years of struggles - multiple rounds of treatment, IVF cycles, miscarriage...And all without ever knowing why. She never received a diagnosis.Jen also shares how she got to the point where she knew she needed more than just medical assistance - she needed to find a way to come back to herself. This conversation explains exactly how she did this...and how it led her to her baby.By the time you finish listening, you'll find out: How Jennifer coped with her struggles through miscarriage + IVFWhen she knew it was time to seek help beyond medical interventionWhat she eventually did differently to bring her baby homeThe In Your Element Fertility Yoga Program is officially OPEN FOR ENROLMENT!Don't miss your chance to be a part of the most comprehensive mind-body fertility program available.For all the details and to register CLICK HERE!!When you finish listening, I'd love to hear your biggest takeaway from today's episode. Take a screenshot of you listening on your device, share it to your Instagram stories and tag me, @jen.elementpilatesyoga The doors to the In Your Element Fertility Yoga Program are now OPEN!! Secure your spot now inside the most comprehensive mind-body fertility program. It's here that I'll guide you through the best practices to: Regulate your nervous system Support your fertility Sync with your cycle & synchronise your hormones This is the exact process I have taken 100s of women through along their journeys to motherhood and beyond. And I can't wait to show you how.The program costs $39 usd per month - so you can try it today & see if it's right for you.Spaces are limited so jump in now to secure your spot for 2025!Visit https://www.elementpilatesyoga.com/in-your-element-membership for all the details & to register!

It's an Infertile AF Minisode! On today's episode, Ali chats with Dr. Jennifer Hintzsche, Ph.D., a scientist and the founder of PherDal Fertility Science, Inc. Jenn shares her 16-month journey with unexplained infertility and how her frustration with the diagnosis led her to take matters into her own hands. Using her scientific expertise and her husband's engineering skills, Jenn invented a sterile, at-home insemination device that ultimately helped her conceive. Tune in to hear Jenn's story and learn more about the innovation born from her personal experience.For more information, visit www.pherdal.com.TOPICS COVERED IN THIS EPISODE: Infertility; unexplained infertility; TTC; at-home insemination; pregnancy after infertilityEPISODE SPONSORS: WORK OF ARTAli's Children's Book about IVF and Assisted Reproductive Technologyhttps://www.infertileafgroup.com/booksDo not miss Ali's children's book about IVF! It's been getting rave reviews. “Work of ART” is the story of an IVF kiddo the day he learns he is a “work of ART” (born via IVF and ART). For young readers 4-8. Hardcover. Written by Ali Prato; Illustrated by Federico Bonifacini. Personalized and non-personalized versions are available. Order yours now at https://www.infertileafgroup.com/booksFor bulk orders of 10 or more books at 20% off, go to https://www.infertileafgroup.com/bulk-order-requestFERTILITY RALLYIG: @fertilityrallywww.fertilityrally.comNo one should go through infertility alone. Join the Worst Club with the Best Members at fertilityrally.com. We offer 5 to 6 support groups per week, three private Facebook groups, tons of curated IRL and virtual events, and an entire community of more than 500 women available to support you, no matter where you are in your journey.Join today at link in bio on IG @fertilityrally or at www.fertilityrally.com/membershipSAVE $40 on an annual membership with code RALLY2024EMBRYO SOLUTIONIf you're navigating infertility, have you ever thought about embryo donation as a family building solution? Embryo donation is when one family that has gone through IVF donates their embryos to support the family-building efforts of another family. Embryo Solution is an agency with an important mission: to fill the gap between infertility and excess embryos by connecting all parties involved. Whether you're looking to build your family or you've gone through IVF and you have embryos in storage that you're not sure what to do with, Embryo Solution can help. To find out more go to embryosolution.com Support this podcast at — https://redcircle.com/infertile-af/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

I couldn't be more excited to join Jennifer Edmonds on her Your Journey to Fertility podcast to tackle one of the most frustrating myths in fertility: “unexplained infertility.”Let's get real—there's no such thing as “unexplained.” If you've been told this before, it just means no one has found the root cause yet. And that's exactly what we dive into in this episode!

 In this episode of Fertility Docs Uncensored, your hosts Dr. Carrie Bedient from the Fertility Center of Las Vegas, Dr. Abby Eblen from Nashville Fertility Center, and Dr. Susan Hudson from Texas Fertility Center dive into the complex world of unexplained infertility, which affects about 15% of couples.In this episode, we'll explore the critical factors that can impact fertility, including age and its significant influence on egg quality. We'll discuss the importance of testing for egg and sperm quality and quantity, as well as how lifestyle factors can shape fertility outcomes. Our experts will also explain how IUI cycles and IVF can offer deeper insights into cases of unexplained infertility and how genetic testing might uncover hidden issues.Tune in for a thorough discussion filled with expert advice and valuable information to help you better understand the complexities of unexplained infertility. Let's dive in!Have questions about infertility?  Visit FertilityDocsUncensored.com to ask our docs. Selected questions will be answered anonymously in future episodes.Today's episode is brought to you by Theralogix

"Your baby is watching over you. Start living your life in the energy of joy, peace, and love." Topics Discussed The surprising ways diet can harm your fertility journey. Why keto and paleo might not be the right diets for you. The dangers of over-supplementing and its impact on detoxification. How back-to-back fertility treatments like IVF and IUI may hinder success. The Type A trap: why overdoing it harms your fertility journey. The power of patience and listening to your body's needs. "We type-A our way into infertility, thinking checklists and overdoing will save us—it won't."   Hello beautiful, Monica here! Let me just start by saying, if you're one of those amazing, determined women who think they can bulldoze their way through fertility challenges with sheer willpower and an endless checklist… buckle up, because I'm about to burst that bubble with love and honesty. This episode dives into the oh-so-common traps we all fall into on the fertility journey. From the "health" foods that might be your worst enemy (hello, tomatoes!) to the supplement aisle looking like a fertility gold mine but actually being a liver's worst nightmare—we're calling it all out. And let's not forget the emotional and physical toll of IVF and IUI. Yep, we're going there, because someone has to say it: more treatments don't always equal more chances. I also share a bit about my own Type A tendencies and how they didn't just slow me down—they made my body rebel. If you've ever thought, “I'll just outwork this infertility thing,” let me save you some time: stop. Tune in for some real talk, a little tough love, and a whole lot of practical tips to help you step back, slow down, and get on the right path to becoming the conscious mama your baby knows you can be. "Most people going through fertility treatments don't actually need IVF—they need to heal first." Timestamps 00:00: Visualization exercise—align your energy with your dream family. 00:28: The six vital steps to fertility success: diet, rest, energetics, and more. 00:56: Welcome to Finding Fertility: Why infertility isn't always about your lady bits. 01:50: The harms of social media black holes—and the lessons from TikTok. 02:48: Diet mistakes: Why keto and paleo might not work for you. 04:00: Over-supplementation and the strain it puts on your liver. 04:50: The hidden costs of repeated IVF cycles and fertility drugs. 06:10: The importance of health improvements between fertility treatments. 07:08: Type A tendencies: How overdoing and stress derail fertility. "Stop over-supplementing—it's not a quick fix, and your liver isn't a superhero." Let's Do This Together

In this episode Cassie comes on the podcast to share her pregnancy and birth journey! Cassie tried to get pregnant for over 2 years and shares her long journey through unexplained infertility. She also shares her birth story which turned into a planned cesarean that she remembers still as the best day ever. ____________________ If you enjoyed this episode please subscribe and share with your mama friends! wanna be on the podcast? https://www.whatthebumpclt.com/podcast  connect with me on Instagram: https://www.instagram.com/whatthebumpclt  our website / blog: www.whatthebumpclt.com  Cassie on instagram: https://www.instagram.com/crazycass37?igsh=cGpxdXN1dzVsYW0= therapist mentioned: https://mindspacecounseling.com --- Support this podcast: https://podcasters.spotify.com/pod/show/what-the-bump/support

Who doesn’t love supporting products that are based on a heart-based purpose and mission? This is why I invited Caryn Johnson, Founder and CEO of BOND on to the podcast. Having lived her own fertility journey, Caryn, former CMO of Vital Proteins is passionate about helping women support their health by balancing their hormones and […] The post A Fearlessly Fertile Special: Unexplained Infertility Isn’t A Diagnosis: Getting to the Root Cause of Fertility Issues and Recurrent Miscarriage, A Conversation with Caryn Johnson, CEO of BOND appeared first on Rosanne Austin.

Ever felt like your path to motherhood is a never-ending uphill battle?If you've been struggling with infertility, failed treatments, or unexpected challenges along the way, you're not alone. But here's the thing -- You're not meant to face it in silence.In this emotional episode, you'll hear a conversation I had with Claire Johnston. She opens up about her journey through infertility, IVF, and the unexpected hurdles she faced. From surviving pediatric liver cancer at just 15 months old to battling the heartache of failed IUIs and the trauma of an ectopic pregnancy, Claire's story is a testament to resilience, hope, and the importance of support.BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER:● The importance of advocating for yourself through medical challenges.● Why mental health support is vital on your fertility journey.● How a supportive community can make all the difference.● What Claire learned about strength, hope, and never giving up.If you're struggling, this episode is a must-listen for anyone who needs a reminder that their story matters, and they are never truly alone.CONNECT with Lisa & get IVF COACHING SUPPORTDOWNLOAD: FREE GUIDE: 11 SUCCESS STORIESBOOK a complimentary DISCOVERY CALL BOOK: ‘HOLD ON, BABY! A Soulful Guide to Navigating the Ups & Downs of Infertility & IVF.'INSTAGRAMWATCH on YOUTUBELISTEN to the PODCAST on Apple and Spotify:**Please Rate the show & Subscribe! THANK YOU so much for your Reviews of the podcast!Music Credit (Closing Song) by Sam Costigan. Follow her on Spotify and IG

LOCAL EDITION EPISODE! - struggled with unexplained infertility for 16 years ( actively trying) - foster to adopt through Washoe county - adoption placement 6/2021 ( long tedious battle ) - 11/4/22 final adoption day and forever ours - with this adoption journey it took me out of the medical field ( supervisor of medical assistants ) and then home for almost 2 years, starting back part time with WCSD to have a flexible schedule, then moving to full time and now wanting to work for my own ( mobile notary ) so I can have the flexibility for when she starts kindergarten! My parents have been a tremendous backbone in raising her bc they have helped us when daycare is closed or shut down due to minimal staffing etc. they have been our lifesavers!!! And our Ava adores them, as they do as well

Send us a textInfertility is often seen as a female issue, but the truth is men are half the equation. In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols shifts the spotlight to male fertility and the critical role of the semen analysis in evaluating reproductive health. A semen analysis isn't just a basic test—it's a window into the “medical health” of male fertility, providing insights into parameters like volume, sperm count, motility, and morphology. Dr. Amols explains what these parameters mean, how they're assessed, and why they matter in the journey toward parenthood.But what happens when a semen analysis looks normal, yet infertility persists? Dr. Amols delves into advanced tests that take male fertility evaluation to the next level. Learn about DNA fragmentation testing, which assesses the integrity of a sperm's genetic material—crucial for successful fertilization and healthy embryo development. Discover SpermQT, a cutting-edge diagnostic test that evaluates sperm functionality, energy production, and molecular markers, offering a more comprehensive fertility profile.Dr. Amols also discusses the scenarios where these advanced tests are most useful, such as unexplained infertility or repeated IVF failures. He shares actionable advice on lifestyle changes, antioxidant therapies, and advanced sperm selection techniques that can help improve sperm health and optimize fertility outcomes.Whether you're starting your fertility journey or supporting a partner through theirs, this episode will empower you with knowledge about the often-overlooked role of male fertility. Join us as we uncover how these tools can provide a deeper understanding of sperm health and help unlock the full picture of fertility.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.

Alexandria DeVito, MS, CNS is the author of 9 Months Is Not Enough and founder & CEO of Poplin, the first pre-pregnancy wellness company.After years as a functional nutritionist, Alexandria founded Poplin to help couples prepare for conception. Previously, Alexandria spent a decade in healthcare consulting at McKinsey and tech investment banking at Merrill (now BoA). She holds dual Master's degrees and certifications in wellness, nutrition, and personal development.The discussion covers the limitations of traditional fertility treatments like IVF, the importance of whole-body health for successful conception, and how lifestyle factors play a critical role in fertility. Alexandria introduces her comprehensive approach to fertility that extends beyond reproductive organs to encompass overall health. She discusses the innovative work of her company, Poplin, and her book "9 Months Is Not Enough," which offers actionable steps for pre-pregnancy wellness.—------------------------------------Join the Your Infinite Health Community! www.skool.com/your-infinite-health—------------------------------------Takeaways1. Preconception health isn't just about you—it's about future generations.2. Fertility is a shared journey.3. Stress management and reducing reproductive anxiety are crucialConnect with Alexandria DeVito:Website | Instagram | Facebook | Tiktok | LinkedIn: https://www.linkedin.com/in/alexandria-devito-3381553/LinkedIn: https://www.linkedin.com/company/getpoplin/ConnectDr. Trip Goolsby & LeNae Goolsby are the co-founders of the Infinite Health Integrative Medicine Center, and are also the co-authors of the book “Think and Live Longer”.

We're fangirling because our idol Dr. Jolene Brighten, board certified in naturopathic endocrinology and a certified sex counselor is on the podcast! Dr. Brighten is the author of Beyond The Pill and Is This Normal, a nonjudgemental guide to creating hormone balance, eliminating unwanted symptoms, and building the sexual desire you crave. A fierce patient advocate and completely dedicated to uncovering the root cause of hormonal imbalances, Dr. Brighten empowers women worldwide to take control of their health and their hormones through her website and social media channels. This episode is all about reclaiming control over your fertility, demystifying hormone health, and standing up to the gatekeepers in women's health. Dr. Brighten doesn't hold back on why the healthcare system often fails women and what you can do to advocate for yourself. From learning about ovulatory disorders to recognizing why more women are being diagnosed with infertility, Dr. Brighten shares her wisdom with a no-nonsense approach and a whole lot of empathy. Whether you're trying to conceive, navigate the challenges of birth control, or just want to understand your body better, this episode has you covered. TOPICS COVERED →Challenges of coming off hormonal birth control and regaining hormonal balance →Different types of ovulatory disorders and their impact on fertility →Premature ovarian insufficiency and functional hypothalamic amenorrhea →Why smoking and lifestyle choices play a huge role in fertility (for both men and women) →The importance of reproductive endocrinologists for those struggling with infertility →Supporting women after miscarriage: vitamins, nutrients, and emotional care →The impact of environmental toxins on reproductive health →Using red light therapy and mitochondrial support for improving egg quality →Labs you should look to test if you're TTC →The importance of using FAM methods for TTC because timing is everything →How it took 27 years to get diagnosed with Endometriosis (And to ask for gel MRI) →Breaking the stigma around advocating for your health and doing your own research EPISODE RESOURCES ➡ FREE PMS Workshop *register here https://event.webinarjam.com/register/2/8m6kmfy ➡ Beyond the Pill by Dr. Jolene Brighten https://shorturl.at/2tQVc ➡ Is This Normal? by Dr. Jolene Brighten https://shorturl.at/bIq90 ➡ Best time to test your hormone levels during your cycle https://shorturl.at/vXjrj ➡ https://drbrighten.com/ - Tons of articles about women's health, including infertility, perimenopause, and hormone balance. ➡ Prenatal Plus by Dr. Brighten Essentials: Prenatal vitamins with tested raw ingredients https://shorturl.at/vWNHJ ➡Cannabis and Female Reproductive Health https://shorturl.at/EBnLY THANK YOU TO TODAY'S EPISODE SPONSORS ➡ Get up to $325 OFF Kale Diagnostics code BALANCEDBEYARS plus ALL your FAQS answered here: https://www.balancedbeyars.com/blog/working-with-kale-diagnostics-faqs ➡ Get FREE WeNatal fish oil ($30 value) with purchase of WeNatal subscription  Wenatal.com/justaphase  ABOUT US We're Carly, Alaina and Julie Beyar- Three sisters, certified in Fertility Awareness and Hormone Health, helping women transform their menstrual health, fertility, and mindset. Naturally. Holistically. Sustainably. And with a healthy dose of humor. From fertility to postpartum, and everything in between, join us every Wednesday for candid conversations, empowering insights, and the occasional dose of laughter. SUBSCRIBE NOW for a journey through the phases, where we keep it real, relatable, and always entertaining...and don't forget to RATE US & REVIEW ⭐ We appreciate YOU! LET'S CONNECT ➡ Instagram https://www.instagram.com/balancedbeyars/ ➡ Join our weekly newsletter https://www.balancedbeyars.com/subscribe-now ➡ Website https://www.balancedbeyars.com/ https://www.instagram.com/kourtneysimmangnutrition/

In this week's episode I'm sharing an inspiring client success story that highlights the complexity of Unexplained Infertility and the need for a care team to dig deeper with you. We chat about the importance of comprehensive testing, support on your fertility journey, and our signature Whole Couple Approach. Listen on to hear how this client got pregnant in just 3 months after trying for 2 years with no success and being told IVF was her next option.   Topics Covered: Unexplained Infertility Hashimoto's Hypothyroid and Fertility Whole Couple Approach Comprehensive Fertility Testing How Nutrition and Lifestyle Play a Role in Fertility Care Fertility Support   Enjoy 20% off your first order of Needed products with the code DRKELSEY over at thisisneeded.com Curious what a full fertility lab list looks like? Grab Fertility Labs 101 for our complete work up, explinations, and optimal lab values for both you and your partner over at ttc.kelseyduncan.com/fertility-labs

Rachele Macera - Mom to 2 and expecting her 3rd this month is a Birth & Postpartum Doula - Founder of Safe Haven Doula and childbirth educator. Rachele's birth experience impacted her so strongly that she decided to get into birth work and to support moms women through pregnancy, birth, postpartum and with breastfeeding. She also experienced some unexplained infertility and in her story she explains how she worked through those issues and have 3 children. Go to: https://www.safehavendoula.com/ Free monthly postpartum support group the first Wednesday of every month. Rachele's Virtual childbirth education course out now! https://www.safehavendoula.com/new-page Instagram: Brittany Olson @becomingamotherpodcast Rachele Macera @safehaven.doula

In this week's episode I'm sharing with you 2 studies that came across my desk recently showcasing the importance of ruling out endometriosis if you've been told you have unexplained infertility. We go through this process with many of our Fertility Confidence Method clients, and advocating for testing when it comes to endometriosis has always been incredibly challenging. Today I'm sharing with you why this is important for those of you who have been struggling with unexplained infertility, recurrent implantation failure, or recurrent miscarriage and other ways we can potentially get answers when it comes to endometriosis that doesn't involve exploratory surgery.   Topics Covered: Statistical rate of endometriosis in unexplained infertility Gold standard endometriosis diagnosis BCL-6 use in endometriosis diagnosis for unexplained infertility   Study One: https://pubmed.ncbi.nlm.nih.gov/38943813/ Study Two: https://pubmed.ncbi.nlm.nih.gov/35642436/   Grab 20% off your first order of Needed supplements over at thisisneeded.com using the code DRKELSEY Fertility Confidence Bootcamp kicked off on Oct 7th, and there's still time to join us! Come build out your fertility care plan with me this week by registering at ttc.kelseyduncan.com/bootcamp

You've been diagnosed with unexplained infertility or have been trying to get pregnant without success and you're wondering what to do next. In today's episode, I share my top 5 recommendations on the best next steps for how to help you get pregnant, even when you've been told you can't. Then you'll hear from my client Kira, who at 35 years old, was diagnosed with unexplained infertility after 1.5 years of trying without success. She shares her journey of struggling with infertility, but then uses it as a catalyst to put the power back into her hands and take control of her body and reproductive health where she ultimately ended up getting pregnant naturally.  Episode Highlights: How to identify if you are in a sub-fertile state Top 5 things to do when you're not getting pregnant Kira's history as an active, health-conscious athlete who struggled with irregular periods and hormonal imbalances after going on birth control  How her performance as an athlete was impacted by her menstrual cycle, and how birth control masked underlying hormonal issues The process of getting her IUD removed and working to restore her natural cycle and hormone balance through supplements, herbs, acupuncture, and gut health support  Kira and her husband's experience with being diagnosed with unexplained infertility How the DUTCH test helped identify Kira's estrogen dominance and aromatization issues, and the protocol they used to address it  Kira's natural pregnancy after working with functional health practitioners  Related Links: Sign up for Private Fertility Coaching with Nora here For full show notes and related links: https://www.naturallynora.ca/blog/118   Please Note: The contents of this podcast are for educational and informational purposes only. The information is not to be interpreted as, or mistaken for, clinical advice. Please consult a medical professional or healthcare provider for medical advice, diagnoses, or treatment.  

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

I love to help people avoid fertility challenges by sharing my fertility advice, especially when it comes to busting the myths that I hear all day from patients. I also love to help people avoid fertility challenges by sharing my fertility advice, especially when it comes to busting the myths that I hear all day from patients. So I'm devoted this episode to the nine myths about fertility that you should stop believing. If you hear these myths at social gatherings, now you can be a fertility myth buster too! Here are the 9 myths I'm busting in this episode: 1. Birth Control Pills Have Ruined My Fertility 2. Previous Paternity Equals Current Fertility 3. Baby Number Two Will be Just As Easy As Baby Number One 4. You Can Control the Gender of Your Baby 5. Unexplained Infertility is Real 6. Getting Pregnant Should Be Easy 7. Your Fertility is a Carbon Copy of Your Mom's Fertility 8. Egg Freezing is an Insurance Policy 9. You Can't Have a Healthy Pregnancy without a Regular Menstrual Cycle Read the full show notes on Dr. Aimee's website Do you have questions about IVF?Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, October 21, 2024 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom.   Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org. Other ways to connect with Dr. Aimee and The Egg Whisperer Show: Subscribe to my YouTube channel for more fertility tips!Subscribe to the newsletter to get updates

Rebecca Garner is 34 years and is from the suburbs of Chicago. She is a mom of two with a 5 year old daughter and 1 year old son. Rebecca had two C-sections and went through a period of unexplained infertility when trying for her second. She got back into writing during this time to help cope. She reflects on the importance of self-care and maintaining personal identity alongside motherhood. She shares her innermost thoughts regarding becoming a mother to each of her children and how each experience was different for her. In addition to being a mom she is a teacher and a published author. Her debut young adult fiction novel is called “Why won't my boobs grow…and other Annoyances”. The sequel in the series is being released on October 8th 2024 and is titled “Dear Boyfriend… and Other High School Dilemmas.” Preorder the Ebook at https://www.amazon.com/dp/B0DC6WHCKT Go to https://www.rebeccagarnerauthor.com/ for more information Instagram: @Becomingamotherpodcast Brittany Olson @b_pepeolson Rebecca Garner @rebeccagarner_author

In this episode, Professor Chapman discusses the options for treating unexplained infertility, focusing on the differences between IUI and IVF. He explores the pros and cons of each treatment, including success rates, costs, and invasiveness, helping listeners make informed decisions about their fertility journey. Explore the 'Prof. Michael Chapman - The IVF Journey' Facebook Page, your reliable destination for cutting-edge insights and guidance within the realm of In Vitro Fertilization (IVF). Don't miss out on the IVF Journey podcast; stay informed with the latest episode updates. Tune in for expert discussions and valuable information on navigating the intricate path of IVF.

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

Do you think you have unexplained infertility but have not been given an official diagnosis? Maybe there are tests that no has thought about doing yet? If so this episode is for you. Join Dr. Carrie Bedient from The Fertility Center of Las Vegas, Dr. Abby Eblen from Nashville Fertility Center and Dr. Susan Hudson from Texas Fertility Center for an episode about explaining unexplained infertility. We talk about the tests you need – and the ones you really don't need.   We explore testing on the uterus, tubes, and ovaries .  Your male partner may need both a semen analysis and a Spert QT to look at sperm amount and function. We discuss the role of laparoscopy and who may benefit from a surgical evaluation. What role do other medical conditions play in the diagnosis? Finally, treatment options are discussed including the cost to success ratio and the timing of each. Tune in I bet you will get some helpful tips.Today's episode is brought to you by Path Fertility 

EVEN MORE about this episode!Unlock the secrets to a balanced, fulfilling life in our conversation with Saskia Röell, a former professor turned mind-body-spirit fertility expert. Learn how aligning your mind, body, and spirit impacts fertility and overall health. Saskia reveals how overcoming mental and emotional blocks, often overlooked in traditional medicine, can lead to successful pregnancies after years of struggle.Discover the profound connection between the mind and body during pregnancy and childbirth through personal stories and real-life examples. Explore the emotional and physical challenges women face and the power of mental preparedness in shaping positive outcomes. Saskia shares practical techniques for shifting mindsets and tackling underlying fears, illustrating how mental states influence physical experiences and well-being.Finally, delve into healing techniques that address trauma and energy imbalances to enhance fertility. Saskia discusses methods like past life regression and color therapy, sharing stories of clients who have overcome significant fertility issues through these holistic approaches. Gain insights into how emotional health, stress, and environmental factors play a crucial role in fertility, and learn how visualization and mindset shifts can break through even the toughest fertility blocks. Don't miss this enlightening episode offering a holistic approach to transforming your fertility and health.Guest Biography:Saskia Röell is a world-renowned Specialized Mind-Body Fertility Coach, Soul Purpose Coach, and Bestselling Author of "The Naked Truth of Unexplained Infertility." She is a mother of four sons and one daughter and cares for three dogs and four cats. Her mission is to help women achieve their dream of motherhood.For over 20 years, Saskia has helped women worldwide overcome challenges like unexplained infertility, miscarriage, and emotional trauma to achieve pregnancy. Her clients range from A-list celebrities to everyday neighbors, all sharing the goal of becoming mothers.Her journey began while teaching at the Rijksuniversiteit of Groningen in The Netherlands, where she explored how unhealed emotions, trauma, and distorted beliefs affect the body and mind's ability to conceive and birth children.Episode Chapters:(0:00:01) - Fertility and Pregnancy With Saskia Röell(0:16:18) - The Power of Rewiring Your Mind(0:23:16) - Emotional Health's Impact on Fertility(0:33:19) - Healing Generational Trauma and Fertility(0:44:25) - Healing Fertility Blocks Through Color TherapyPlease join Julie next week with your question.Thursdays at 8pm ET, 7pm CT, 5pm PT.https://askjulieryanshow.comAnd, please leave a five-star review and subscribe so you can hear all the new episodes.Sponsors & RecommendationsDisclaimer: This show is for informational purposes only. It is not intended to be medical, psychological, financial or legal advice. Please contact a licensed professional. The Ask Julie Ryan show, Julie Ryan, and all parties involved in producing, recording and distributing it assume no responsibility for listener's actions based on any information heard on this or any Ask Julie Ryan shows or podcasts.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In today's episode, I'll be sharing some stats on the prevalence of miscarriage as a woman moves through her reproductive years, along with common causes of recurrent pregnancy loss and then I will focus on different tests you can do to help mitigate your risk for miscarriage before you even start trying or testing options that you can do after experiencing a miscarriage or recurrent pregnancy loss. My goal is not only to provide you with knowledge through the information I'm sharing today, but also to offer support and a sense of hope to those who might feel defeated and frustrated with their medical providers. Whether you're personally affected, know someone who is, or simply want to understand more about this important topic, this episode is for you. Episode Highlights: The risk of loss as a woman moves from her 20's to her 40's Hormone dysfunction and its contribution to miscarriage The leading cause of pregnancy loss and how to test for it Anatomical and uterine obstruction tests to help identify risk for miscarriage How the gut and vaginal microbiome contribute to loss Identifying microbial pathogens and how to properly treat them The antibody test Poor sperm parameters and how they correlate to pregnancy loss Related Links: Check out my 1:1 Private Coaching package options here For full show notes and related links: https://www.naturallynora.ca/blog/110 Please Note: The contents of this podcast are for educational and informational purposes only. The information is not to be interpreted as, or mistaken for, clinical advice. Please consult a medical professional or healthcare provider for medical advice, diagnoses, or treatment.  

Overcoming Unexplained Infertility: Gut Health, Autoimmunity & Positivity

Vicki was diagnosed with unexplained infertility after losing 5 babies, through miscarriage, ectopic pregnancy, and twin loss. She also has two living children. Vicki helps women with womb cleansing and healing in order to help them unblock and heal their body.   --- Support this podcast: https://podcasters.spotify.com/pod/show/findinghopeafterloss/support

Today, Ali has a true sports icon on the show: Former pro soccer star Carli Lloyd, who won two World Cups and two Olympic Gold medals during her incredible career. Carli is currently pregnant -- and in the second trimester -- with her first baby, but it's been a long and difficult infertility journey to get here. Carli tells Ali all the details, starting from when she and her high school sweetheart-turned-husband, Brian, started to try for a baby, and what happened when it wasn't working. She talks about traveling the world playing professional soccer, why she didn't want to have kids while she was playing, and how, when she retired at 39, she found out, "It's a lot harder to get pregnant than people think." She explains being told they should do IVF, going through the retrieval process, and how her first transfer didn't work. She also talks about why they needed to take a mental break, what it felt like to do their next retrieval, and how she felt when she found out she was finally pregnant. "This journey was a humbling experience," she says. "For someone who's achieved greatness in the soccer world to have to struggle through this, it was really, really difficult. I was almost broken to a point I've never felt before."  For more, follow IG @carlilloyd TOPICS COVERED IN THIS EPISODE: Unexplained infertility; IVF; egg retrievals; embryo testing; embryo transfers; zero healthy embryos; mental health; pregnancy after infertility EPISODE SPONSORS: WORK OF ART Children's Book about IVF https://www.infertileafgroup.com/books Do not miss Ali's children's book about IVF! It's been getting rave reviews. “Work of ART” is the story of an IVF kiddo the day he learns he is a “work of ART” (born via IVF and Assisted Reproductive Technology). For young readers 4-8. Hardcover. Written by Ali Prato; Illustrated by Federico Bonifacini. Personalized and non-personalized versions are available. Order yours now at https://www.infertileafgroup.com/books For bulk orders of 10 or more books, go to https://www.infertileafgroup.com/bulk-order-request FERTILITY RALLY @fertilityrally www.fertilityrally.com No one should go through infertility alone. Join the Worst Club with the Best Members at fertilityrally.com. We offer 5 to 6 support groups per week, three private Facebook groups, tons of curated IRL and virtual events, and an entire community of more than 500 women available to support you, no matter where you are in your journey. Join today at link in bio on IG @fertilityrally or at www.fertilityrally.com/membership SAVE $40 on an annual membership with code RALLY2024 NATALIST www.natalist.com  Natalist is on a mission to improve your fertility journey with evidence-backed essentials to support your needs, from vegan prenatal packets to easy-to-use, plastic-neutral ovulation tests and fertility-friendly lube. Natalist is offering my community 25% off your first order at Natalist.com with promo code INFERTILEAF.  RECEPTIVA DX https://receptivadx.com/ ReceptivaDx is the singular test capable of identifying endometriosis,progesterone resistance, and endometritis in one comprehensive analysis. These conditions are often the hidden culprits behind unexplained infertility, directly impacting the success rates of IVF treatments. Ask for the Receptvia DX test today, and use code INFERTILEAF24 for $75 off. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Send us a Text Message.Welcome to another insightful episode of Taco Bout Fertility Tuesday with Dr. Mark Amols. This week, we're exploring the '3 Strikes and You're Out' strategy in fertility treatments. Why do doctors suggest transitioning to IVF after three IUI cycles? Dr. Amols breaks down the data behind this recommendation and discusses various scenarios where IUI might be beneficial or when it might be best to skip straight to IVF.Dr. Amols explains how mild endometriosis, younger patients with a shorter duration of infertility, and unexplained infertility can be reasons to consider IUI initially. He also covers why moderate to severe endometriosis, advanced maternal age, and long-term infertility might lead to opting for IVF right away. The episode dives into the success rates of IUI, highlighting the diminishing returns after three cycles, and the importance of individualized treatment plans based on unique patient circumstances.Listeners will learn about the factors influencing the decision to stop IUI and move on to IVF, including poor sperm quality, poor ovarian response, and the emotional and financial toll of multiple IUI cycles. Dr. Amols emphasizes the importance of consulting with a fertility specialist to tailor the treatment plan to each patient's specific needs.Whether you're just starting your fertility journey or considering your next steps after several IUI attempts, this episode is packed with valuable information to guide you. Join us for a deep dive into making the right choice for your fertility treatment plan, understanding the reasoning behind the '3 Strikes and You're Out' rule, and exploring the options available to you.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.

Today's episode highlights the emotional toll that infertility can take on individuals and couples. Our guest speaks candidly on how her fertility journey affected her mental health, marriage, and perspective towards friends who found easy success with pregnancy.   Hana Peters and her husband started trying to have a baby and soon realized they needed to seek additional support. In this episode, Hana shares her journey. She speaks on the unsolicited advice she received along the way and how this impacted her relationships, her initial reaction to a diagnosis of unexplained infertility, and how she was able to pursue parenthood with a dedicated doctor and through her employer-sponsored benefit, Progyny. For mental health support and resources, check out:  Progyny Article: Coping with stress during fertility care  This is Infertility Podcast episode: Bonus Episode 10: Prioritizing Your Mental Health During Your Fertility Journey  Employer guide: How to support employees with infertility mental health guide  Guest: Hana Peters, Progyny Member at Salesforce  Host: Dan Bulger, Progyny   For more information, visit Progyny's Podcast page and Progyny's Education page for more resources. Be sure to follow us on Instagram, @ThisisInfertilityPodcast and use the #ThisisInfertility. Have a question, comment, or want to share your story? Email us at thisisinfertility@progyny.com.   This episode is also a video! Watch it here: https://youtu.be/o_-IvppWYK0  

Abbe Feder is the founder of InCircle Fertility and host of the Fertility Chic.  In this episode, Abbe shares her own six-year journey through unexplained infertility, including her initial reluctance to turn to assisted reproductive technology. Ultimately, Abbe and her husband tried IUI and then IVF with multiple failed transfers and loss. After a traumatic birth experience and emergency hysterectomy, Abbe is the proud mom of twins.  Abbe leans on her experience and a deep well of empathy and tools to guide hopeful parents through the infertility experience. InCircle Fertility is not just a service; it's a guiding light for anyone navigating the complex path to parenthood.   Abbe's belief in coaching clients through this challenging process is unwavering; she holds their hearts and hands as they navigate the emotional and physical hurdles of family building. If you or someone you know resonates with this journey, join us for an insightful conversation."    IN THIS EPISODE:  [2:49] Abbe discusses why she created her company, Circle Fertility  [4:00] Abbe reflects on her 6-year journey to becoming a parent  [10:43] Abbe decides to go to a fertility doctor for IUI treatments  [14:59] Abbe admits she believed that when starting IVF treatments, you would immediately get pregnant. She explains how she dealt with the disappointment  [20:47] How do you protect your mental health through disappointments? Abbe discusses details of the IUI and IVF journey  [31:20] Abbe advises on how to navigate the complex decisions of the process, and she discusses the expense versus self-care  [38:42] When should a person seek coaching, and how does Abbe define family    KEY TAKEAWAYS:  It is unfair that a woman who did not take care of her body can quickly get pregnant, and a woman who took excellent care of her health and body can't conceive.   It is difficult to make life decisions when going through IVF. Your hormones are raging, you are taking more, the stakes are high, and you are exhausted. That is the time when you need to be able to lean into someone you trust.   Taking IUI or IVF treatments is no guarantee that you will become pregnant.     RESOURCE LINKS:  Stork'd - Facebook  Stork'd - Instagram   Stork'd - YouTube   InCircle Fertility - Website  InCircle Fertility - Instagram  InCircle Fertility - LinkedIn    BIOGRAPHY: Abbe Feder   Abbe Feder founded InCircle Fertility after emerging on the other side of her all-consuming struggles with infertility and pregnancy loss. These experiences were life-altering and when the dust settled, it quickly became evident that the only possible next step was supporting others as they navigate this turbulent terrain. Combining professional expertise, industry know-how, and an abundance of empathy and compassion, InCircle Fertility is here to meet you wherever you are in the world and wherever you are in your journey to parenthood to provide the support and guidance needed to find your resolution. 

Hey friend! Unexplained infertility can be a real....well..you know! I'm sorry if you've struggled with a lack of answers and a way to move forward. Today I'm sharing 4 things that I think are the real cause of infertility in couples. I hope you know if you are struggling with unexplained infertility that you aren't alone, you aren't broken, and you aren't doing anything wrong! I hope you'll take this 4 things, brainstorm about how you can pivot and move forward. Come to the Facebook group with all your questions if you need help!   Grab the Free Checklist: Fertility Checklist and Guide   Join us in the free Facebook group: Fertility Foundations and TTC Support   Let's connect on Instagram: @simplywomanandwomb    Set Up a Coaching Call: Coaching Call

Roxy went through fertility struggles, including being diagnosed with unexplained infertility. She had 2 failed IUIs and went through IVF. Roxy had a chemical pregnancy and the 8 week miscarriage of her daughter, Luna, who was conceived through IVF. --- Support this podcast: https://podcasters.spotify.com/pod/show/findinghopeafterloss/support

Today Ali is talking to Modern Mom Probs founder Tara Clark about her unexplained infertility journey. Tara talks about growing up in Catholic school and the "fear-based" sex education she got; her three devastating miscarriages; being diagnosed with fibroids and having a procedure to remove them, and why she and her husband needed to take a mental health break after their losses. She also talks about trying again, doing three IUIs; getting pregnant on her third IUI; and the anxiety after loss she experienced when she was pregnant with her now-11 year old son, Jack.  TOPICS COVERED IN THIS EPISODE: Unexplained infertility; sex education; miscarriage; mental health; infertility; IUI; failed IUIs; IUI success; pregnancy after loss; the anxiety of pregnancy after infertility  EPISODE SPONSORS: WORK OF ART Children's Book about IVF https://www.infertileafgroup.com/books Ali wrote her first children's book, and it's available now! “Work of ART” is the story of an IVF kiddo the day he learns he is a “work of ART” (born via IVF and Assisted Reproductive Technology). For young readers 4-8. Hardcover. Written by Ali Prato; Illustrated by Federico Bonifacini. Personalized and non-personalized versions are available. Order yours now at https://www.infertileafgroup.com/books For bulk orders of 10 or more books, go to https://www.infertileafgroup.com/bulk-order-request FERTILITY RALLY @fertilityrally www.fertilityrally.com No one should go through infertility alone. Join the Worst Club with the Best Members at fertilityrally.com. We offer 5 to 6 support groups per week, three private Facebook groups, tons of curated IRL and virtual events, and an entire community of more than 500 women available to support you, no matter where you are in your journey. Join today at link in bio on IG @fertilityrally or at www.fertilityrally.com/membership SAVE $40 on an annual membership with code RALLY2024 RECEPTIVA DX ReceptivaDx is the singular test capable of identifying endometriosis, progesterone resistance, and endometritis in one comprehensive analysis. These conditions are often the hidden culprits behind unexplained infertility, directly impacting the success rates of IVF treatments. Ask for the Receptvia DX test today, and use code INFERTILEAF24 for $75 off. Learn more about your ad choices. Visit podcastchoices.com/adchoices Learn more about your ad choices. Visit podcastchoices.com/adchoices

In this episode, Ellora La Shier, graduate of the EBB Childbirth Class, shares about her struggle with six years of unexplained infertility and how it impacted her eventual birth story. Listen in as Ellora describes the frustration of unexplained infertility, suffering through years of increasingly painful periods, and the relief of finally receiving a diagnosis of endometriosis. Despite facing numerous challenges and undergoing various treatments, including intrauterine insemination (IUI), Ellora remained determined and resilient.   Finally, after years, Ellora underwent surgery to remove the abnormal tissue caused by endometriosis. Following surgery, she and her husband were overjoyed to discover that they quickly became pregnant. Although this pregnancy marked the end of a long and challenging infertility journey, Ellora still had to process the many years of healthcare dismissal and her complicated relationship with pain, and how this would impact her eventual unmedicated birth. Ellora's story highlights the importance of perseverance, self-advocacy, and finding supportive healthcare providers in navigating the complexities of infertility and reproductive health.   Resources Find evidence-based information about infertility here.   EBB Resources: Watch the video of this podcast episode on the EBB YouTube channel here!  Join the EBB Pro Membership and get access to contact hours, a doula mentorship, live trainings, and a PDF Library with exclusive handouts (including a 2-page handout on breech) by joining here. Learn advocacy techniques through the EBB Childbirth Class.   Follow Evidence Based Birth: Facebook Instagram X

On today's episode of The Wholesome Fertility Podcast, Dr. Briguglio, a fertility health expert, shares her passion for empowering patients and addressing the challenges of unexplained infertility and overreliance on IVF. She emphasizes the importance of comprehensive testing and addressing root causes to improve fertility health. Dr. Briguglio also discusses the interconnectedness of physical and mental health and the significance of individualized testing in the initial consultation. Additionally, she highlights the importance of iron and ferritin levels and addresses the challenges of vegan diets and cholesterol.   In this conversation, Dr. Samantha Briguglio discusses the role of cholesterol and inflammation in health. She emphasizes that cholesterol is not the villain it is often portrayed to be and that it is needed for hormone production. Dr. Briguglio advocates for a balanced approach to diet and lifestyle, focusing on sleep, diet, and movement. She encourages individuals to find their own natural path to healing and emphasizes the importance of empowering people with information.   Takeaways Comprehensive testing and addressing root causes are crucial for improving fertility health. The physical and mental aspects of health are interconnected, and addressing both is important for fertility. Individualized testing and a holistic approach are key in the initial consultation. Iron and ferritin levels play a significant role in fertility health, and vegan diets may present challenges in obtaining necessary nutrients. Cholesterol is not the villain it is often portrayed to be and is needed for hormone production. Nourishing the liver and eating enough fiber can support healthy cholesterol levels. A balanced approach to diet and lifestyle, focusing on sleep, diet, and movement, is crucial for overall health. Empowering individuals with information allows them to make informed choices about their health.     Dr. Samantha Briguglio is a licensed Naturopathic Medical Doctor and the founder of Walk the Natural Path Hormone Health and Fertility Care.   Dr. Briguglio has a passion for helping women achieve their wellness and/or fertility goals, and she treats – and teaches – her patients from a mindset of natural healing that treats the root cause of their symptoms.   Website: www.walkthenaturalpath.com   Instagram @walkthenaturalpath   Facebook: www.facebook.com/walkthenaturalpath   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:   Chapters   00:00 Introduction and Passion for Fertility Health 04:09 Passion for Empowering Patients 07:07 Challenges with Unexplained Infertility and Overreliance on IVF 11:03 Importance of Comprehensive Testing and Addressing Root Causes 16:35 Interconnectedness of Physical and Mental Health 24:06 Importance of Iron and Ferritin Levels 25:56 Challenges with Vegan Diets and Cholesterol 26:52 The Role of Cholesterol and Inflammation 30:05 Nourishing the Liver and Eating Fiber 35:03 The Importance of Sleep, Diet, and Movement 37:34 Finding Balance in Diet and Lifestyle 43:20 Empowering People with Information 45:30 The Inspiration Behind Walk the Natural Path   Michelle (00:00) Welcome to the podcast, Dr. Brigulio, right? Brigulio is how you pronounce it, or Sammy, right? Awesome. Dr. B, awesome. So first of all, I love your Instagram. I'm going to say that. You guys got to check out her Instagram. It's going to be in the episode notes. I kind of want to lead with that because she has fabulous content, really rich with information and tips.   Samantha Briguglio (00:05) Yes, you did that nicely. Or Dr. Bean. It's easier.   Michelle (00:25) for fertility care and health. And before we get started, I would introduce yourself and also share how you got so passionate in specifically fertility health.   Samantha Briguglio (00:39) Yeah, well, thank you so much. It's really fun to have a platform like Instagram to share all this stuff with and help educate people. But hi, I'm Dr. B. Virgulio, Samantha Virgulio. I actually just got married. So legally, my name, I just changed my name. Thank you so much. It's been really, really fun. But I am keeping Dr. B for business purposes. So you can always remind me, remember that.   Michelle (00:54) Congratulations.   Samantha Briguglio (01:09) I'm Dr. B, so you don't have to worry about any changes. But how I got infertility, I feel like it's kind of a long story, but I'll try to keep it as short as possible because this also has to do with how I got into natural medicine, which actually stemmed from when I was a child. I was pretty sick as a kid. And I was pretty sick.   Long story short, my mom really fought for me and found natural medicine. And I went from being on like oxygen treatments like two to three times a day. Yeah, it was pretty crazy to being a total normal kid who played a bunch of sports and just loved running around and just basically natural medicine changed the trajectory of my life. And so I became super passionate about it. Went to college, was kind of like, eh, I don't wanna go to med school. That looks really hard.   Michelle (01:38) Oh wow.   Samantha Briguglio (02:00) trying to find other avenues, but I always got brought back to natural medicine. I was like, this is just where I'm supposed to be. Actually wanted to go into pediatrics originally and ended up not doing that because I wasn't able to get enough training, like hands on, like one-on-one with kiddos. And I just felt like that was really irresponsible. It's like all of a sudden started a practice where I was working with kids and I didn't feel like ready or trained enough to do that. And...   In my last year of school, I actually found a fertility course. It was like an extra like, I don't know, $600 on top of all the other loans I was taking out. So I was like, oh, this looks fun and interesting. I fell in love. Like I just fell in love. I actually, the person who wrote the course is Dr. Jacqueline Chassie at the time. She just changed her last name. I guess it's a few years now. Seamonton, I think it is. If anyone wants to find her, her courses are great.   Michelle (02:44) Wow.   Samantha Briguglio (02:56) but Hello Fertility is her Instagram actually. But she is an amazing teacher and I went on to join her year-long mentorship in fertility after I graduated, which obviously kind of like changed the course of my life and career. And I just felt so in love with it. Part, I was actually really good at it, right? Like sometimes like you're just good at something or not. And I was like, I don't want to be a jack of all trades anymore. And I just felt like I...   Michelle (03:01) Mm-hmm.   Samantha Briguglio (03:25) my intuition just went very hand in hand with the fertility practices, treatment, and just diving into that and learning more. I loved it, I enjoyed it. And then later on, I'm talking to my mother and my grandmother, and I'm telling them how I'm so drawn to this, and I find out my mom went through her own journey with miscarriages and loss, and then my grandmother, took her 10 years to conceive, I'm like, no wonder I'm drawn to this. I'm supposed to help all these people. My family had this struggle, so like.   Michelle (03:51) Wow.   Samantha Briguglio (03:55) Now I get to help and get back. So kind of a long story. I try to give the most important pieces, but there it is.   Michelle (03:59) That's incredible.   Amazing. No, it's interesting because my mom had secondary infertility with me. tried for a while.   So she had a really hard time. She also thought she was going to lose me at different times, like lost a ton of weight. So it's kind of interesting that you say that. And it's pretty wild because it does kind of hit home.   I don't know, I do believe that subconsciously we can almost feel something in ourselves. There's just certain things that call to us and we just feel like this is it. This is what we're supposed to do. And I totally understand what you're saying. It really, really resonates with me. So that's cool.   Samantha Briguglio (04:38) Yeah, right, you just keep getting pushed down a path where eventually you're like, okay, I'm surrendering, this is what I'm supposed to do. Like that's basically what happened to me.   Michelle (04:48) Amazing. Well, you're so good at it and I can feel the passion. I really can. That's one of the things that I love Instagram. I have to say, I mean, with social media, it's like a blessing and a curse, right? But there's so many amazing things about social media because you're able to connect with people in a different way and get to know people. And people are able to share stories and information. You can get tons of information on Instagram, especially it's really big in the fertility world.   So I feel like there's just so much content, but you can really feel a person's passion and also just drive to learn and provide quality information. And I find that with your account, it's actually one of my favorite accounts, I'll be honest, because it teaches me and this is where I love it. I'm like, when I feel like I'm getting, as a practitioner, I'm learning so much, I'm like, I got to have them on the podcast. I got to pick their brain.   Samantha Briguglio (05:42) You're so sweet. Thank you. I feel like, yeah, no one's ever told me I run short on passion, that's for sure.   Michelle (05:42) For my guests and for me.   Well, it works for you and it works amazing. And so we were talking actually in the pre-talk about certain things that we feel really passionate about. And as practitioner, I find, and I know that you're great because we talked about it, that usually your passion, it's like the P, right? The P, because P for passion and P for pissed off. It's very fine line between the two because   Samantha Briguglio (06:15) R-heh!   Michelle (06:19) The things that we're passionate about, we've also been pissed off about. Meaning, for me, it's like I'm being told that you can't do something. I've always had that even in my life. I'm like, no, screw you. I can do it. Don't tell me I can't. I feel that passion with my patients. When people tell them they can't, and then I see that they can, and I'm like, I can't   why are you telling them they cannot do it? I don't like that. It pisses me off, but I feel very passionate about empowering. So you feel like that too. We talked about a couple of things. So I'll let you have the mic.   Samantha Briguglio (06:57) Yeah, yeah, we talked about two main things, right? I think the first one was the unexplained infertility. That diagnosis drives me nuts. Because I probably said a couple bold things about it on Instagram before, and one of them that I felt like it was lazy medicine. And I feel like that seems harsh, but it's kind of the reality of it, right? Because I'm like, you're being lazy. You're not doing any more tests, you're not trying to figure out like what could be this underlying cause, you're just saying like, oh, the things that are obvious are all good. So we don't know there's it's unexplained. And so that drives me nuts.   Michelle (07:35) It feels like you're putting it back on the patient. That's what it feels like. It feels like, oh, well, we don't know. So here you go.   Samantha Briguglio (07:41) Yeah, 100%. And then, you know, leading to the other thing that we kind of talked about is that then it's like, okay, well, we don't know, so IVF is your only answer. That drives me nuts. I think IVF is amazing. I think it has a time and a place. I think it has helped a lot of families, especially with, you know, certain diagnosis, especially anatomical ones, but like to be like you have unexplained, let's do IVF, or, you know, we haven't even pulled your progesterone yet, but we don't know what else is wrong. So like, let's just go to IVF. Like it just...   Yeah, talk about getting heated and passionate, which just drives me insane, because I feel like it's unfair and you're not doing your duty to your patients and it's at the end of the day, kind of lazy. Yeah.   Michelle (08:22) Yeah. And I'll tell you, um, I feel like there's this common misconception. I feel like that it's almost, I almost want to say it's due to marketing because we have been conditioned to believe that if we pay an arm and a leg for something, it's a guarantee that we're going to get the best of the best. And I think that that's what it is. People think that it's a guarantee to go through the IVF process. And I've actually found, and again, same as you, I completely agree.   Samantha Briguglio (08:39) Yeah.   Michelle (08:52) that IVF's incredible. It's an amazing thing to have. It's amazing. The technology's beyond. I remember going and doing acupuncture for a transfer, and every time I go, I'm beside myself on the incredible opportunity that so many couples have. So 100%, yes, for that. However, in some cases, I've actually found that my patients have had many failed IVFs.   retrievals and transfers. And then they went on and did better getting pregnant naturally at an older age in their forties. So like that kind of, it challenges that whole idea or mindset that it's a guarantee and it's like the only option for some people. So I'd love to get your thoughts on that.   Samantha Briguglio (09:40) Oh yeah, I've had many patients that have tried multiple IVF things like three to four even, and come back and get pregnant naturally. IUI same thing, a lot of IUIs and then they'll get pregnant naturally. And they're like, I don't really get it. I'm like, it's because we had to treat the root cause. Like one of them that really stands out in my mind is that they had actually got health issues and everyone was like, their hormones looked actually pretty decent. Even their A quality wasn't bad, but their gut was like not okay. Like   not okay at all. Like diarrhea episodes daily, which is that's, that's not a healthy gut. And I was like, Oh my gosh, what? And so we treated and we treated for a little bit and they started to heal and started to feel better. And then all of a sudden, like a couple months later, like boom, pregnant and healthy pregnancy. And I just tell, like, it's just a testament to like, the reproductive system can be fine. But if something like your thyroid or your   Michelle (10:10) Mm-hmm.   Oh wow.   Samantha Briguglio (10:40) your other systems that we have that make our whole body, right, is impacted. That can cause issues. Your body sometimes doesn't want to, you know, carry another life if everything isn't okay.   Michelle (10:54) Yeah, totally. And so you mentioned actually a really important one, gut health. Western medicine is amazing in what they're amazing. You know, everybody has their own toolbox and like things or specialties. And so that's not something that's typically looked at or like, you know, tested. They'll do like, they'll look at like ultrasound, they'll look at like   Samantha Briguglio (11:09) Mm-hmm.   Michelle (11:14) the tubes, they'll look at like the anatomical, they'll do the blood work, the hormones.   And obviously, when they come to you, it's a whole other detail of testing. So let's talk about some of the things that are often missed in conventional medicine that you look at that they may not know about.   Samantha Briguglio (11:36) Yeah, I'll definitely talk to that. I do also wanna say like some things are also best in combination. So I love natural medicine and I think it can do amazing things, but a lot of times also like a combination of like conventional and natural is also really amazing. I've won, like for example, endometriosis patient that it's been really beneficial for them to have both, right? They have like the laparoscopic surgery done and now we're working on inflammation and reducing all these other things, but.   Michelle (12:02) Right.   Samantha Briguglio (12:05) they're feeling so much better. So like I said, I can get heated about some things, but I also am very appreciative of all forms of medicine. It's just like, we all, we just have to stay in our lane and also know that it's okay if there's, if someone's taking from all different types. If anything, that's good, right?   Michelle (12:14) Yeah.   Yes. I always say like a team, a well-rounded team with all their different strengths.   Samantha Briguglio (12:32) Exactly. So I just wanted to say that too. But when it comes to things that I look at that are going to be different, I mean, who I feel like the list can be kind of long, actually. I mean, I asked from everything like, what are your bowel habits or your bowel movements to your, you know, what's your gum health like, do your gums bleed a lot to, you know, do you have headaches, musculoskeletal pain, we focus a ton on stress. And it's not like the type where it's like, oh, you're stressed, like, just don't stress, right? No, we like figure out like,   root cause of that stress. And if that root cause needs to be explored more, it's like, okay, do we bring another person onto this team? Obviously we focus on a ton of diet and lifestyle habits. I just ask about them. And then we talk about what we can improve versus what we don't need to improve. Thyroid health, like I said, the list can kind of go on and on, but it can be from anywhere from like your daily habits to environmental exposure, you know, a job at the workplace. I actually see a lot of blue collar men.   Michelle (13:14) Yeah.   Samantha Briguglio (13:32) I find that to be very common, either blue collar or very like high stress jobs are a lot of men that I see for like sperm count and quality. And you know, like I said, I feel like the list could go on and on. There's always kind of something and I kind of say there's like the most obvious things, which to me are like diet and lifestyle, gut health, like thyroid health. And then there's like the small things like anti sperm antibodies and you know, like an immune flare or   Michelle (13:48) Yeah.   Samantha Briguglio (14:00) you know, skin conditions or, you know, maybe some of the things that seem a little less obvious, like reproductive microbiome. Uh, and there's kind of almost tests for all of this now. It's just also, it can't be really expensive. So like I said, I like to start with like the really big layering things, make sure those are good before I move on to the smaller things.   Michelle (14:12) Mm-hmm.   Yeah, I mean, there's so many things that I definitely want to talk about with what you just said. Like one of the things, you know, it's interesting how people are saying, oh, just stop being stressed. Sometimes you're stressed because your body's stressed. Like if your body or your gut's off, it's going to impact your mind. Well, in Chinese medicine, we learn about how everything's so interconnected. So like how your body feels if your body's not getting the nutrients it needs, it's going to feel stressed. I mean, have you ever felt hangry? You know that like impacts.   Samantha Briguglio (14:41) Yeah.   Michelle (14:50) immediately or if you're not getting enough sleep, if you're not getting good sleep, that's going to impact your stress levels. So it's so intricately connected. And when you have that calm, or even your gut health is better, your mind starts to feel better as well.   Samantha Briguglio (15:06) Yeah, I love that analogy of have you ever felt a hangry? I think that's so perfect. I haven't heard it, but that's so good. Like, yeah. Like sometimes if you're not, no, you don't even know sometimes you're not even not feeling good, but it could be manifesting as an emotional response or something. I know I was feeling a little extra stressed out and I myself did a gut health test on myself and I was like, whoa. Like honestly, I would expect more physical symptoms, but I think mine were manifesting a little bit different. And I'm like, wow.   Michelle (15:14) It's like perfect example, right?   Right. Well, that is such a good point that you bring up because I think that, like for example, my patients who are sensitive to gluten, they end up feeling really well after removing gluten, but not for the reasons they think. Like they say, if I eat bread, I'm fine. I don't feel bloated or anything like that. But with food sensitivities, it doesn't necessarily have to show up as digestive discomfort.   Samantha Briguglio (15:49) Yeah.   100%.   Michelle (16:01) And I think that that's like, you know, so that's like one example of how things can impact you, you don't even realize that you could have something and that has nothing to, like, you're not going to feel it directly as that. It could show up as headaches or low energy. It could be so many things.   Samantha Briguglio (16:17) Yeah, brain fog, anxiety, joint pain. Joint pain's a big one that everyone just brushes off as like musculoskeletal issue. And I'm like, no, that's like an inflammation issue, right? Like, why are you? Like, so yeah, no, I, for sure.   Michelle (16:24) Right.   Oh yeah. Yeah, for sure. So how do you figure out like where you start with the testing? Like when you first see people, I mean, I'm sure it has to do with a lot of what they'll tell you.   Samantha Briguglio (16:42) Yeah, so, you know, initially, depending if I have like a single visit or I see a fertility for two. So I see, you know, people individually, but I see the couple together, which also I think super important. I feel like one person always seems to get ignored. Like there's never like, let's treat both. It's like, oh, there's a abnormal semen analysis. Let's treat the guy. And then like the female side's forgotten. Or, oh, so this person has endometriosis. Let's make sure we focus on that. And then to see the male sides.   Michelle (16:53) Yeah, that is.   Samantha Briguglio (17:10) forgotten. So it's like, I really like the fact that fertility for two. Honestly, it's mostly for affordability that I do the fertility for one just because if we can try to do something, but I always think, you know, treating both is the best. But when it goes, sorry, back to your question. So when I see people as either 60 or 90 minute visit, depending if it's one or two, and we ask   I mean, I ask a lot of questions. First, I just kind of give them the floor. I'm like, share your story with me. Like, tell me, right? I think intuition's so important. And a lot of times, like couples end up telling me what I need to hear in that first part, because they're just, they don't even know it's like this most important thing, but I'm like, whoa, like that was huge. Like, okay, writing that down. Then I ask a lot of questions that like, will branch off of what they share with me. And then we dive into, you know, family history, their own history.   Michelle (17:53) Yeah.   Samantha Briguglio (18:05) you know, general review of systems, which basically means checking in with every, from like head to toe, every single system of the body. And we have them answer questions like, are you bloated? Yes or no, right? On the female side of things, definitely diving into the menstrual cycle, like a full dive in. Usually it takes us like, sometimes 15 to 20 minutes just to talk about the cycle, which probably seems like a lot, but like, no, I ask a lot. I ask like questions from like, what size are your clots to   Michelle (18:27) Yeah.   Samantha Briguglio (18:34) how many tampons do you fill to tell me about all of your symptoms and like the timeline that you have them within your cycle. So we really take a deep dive into that. Um, and then, you know, from there I kind of compile, like all their symptoms, come up with the ideas for the labs that I want to draw. And then based off symptoms and labs, we form a treatment plan. Um, based off all of that.   Michelle (19:00) Are there some common labs that you usually, almost for everybody use, or one test that you typically feel like everybody should take? I know it's kind of like a one-size-fits-all, but...   Samantha Briguglio (19:12) Yeah, you know, no, for sure. Right? Yeah. Like, I know what you're trying to say. You're like, I know it's individualized, but what are labs that are for everyone? Yeah. So yes, and I tell a lot of people that right, because I'm like, you can go get all these basic labs, but I might be asking for you to get other labs based off what you tell me. So just be prepared to go twice. So a lot of time, they just have people wait to come get labs. So they're not going back and forth. Because that takes time. And I'm like, I'm like the person that like, I just want to do all at once.   Michelle (19:18) Yes.   Yeah.   Samantha Briguglio (19:41) Um, but there's going to be the classic, the day three of your cycle. So third day of bleeding and then seven days after a predicted ovulation labs, the day three ones are going to be like the estradiol, the FSH, the LH, the seven days after ovulation would be progesterone. Um, usually with like the day three lab, I also order, um, like a CBC, a CMP. So that's like your, your blood counts looking at red blood cells, white blood cells, the CMP is kind of looking at kidney, kidney liver.   Michelle (19:41) Yeah.   Samantha Briguglio (20:09) and then like lipid panel looking at like cholesterol. So just like those basics are always really nice. I do, I used to wait to order insulin, but now I'm just starting to do it more for everyone just because there's just been, like it's really hard to guesstimate who's gonna be having elevated insulin because I've ordered it on some people that I'm like, I just feel like I need to order it. And then it comes back super high. I'm like, okay, they are not a typical candidate for insulin.   Michelle (20:21) Mm-hmm.   Mm-hmm.   Samantha Briguglio (20:36) But like I ordered it and they have like an insulin of 24, which is like way over my range of what I like to see it in, right? So I kind of started doing that one a lot. Obviously a thyroid focusing on like the TSH, free T4, free T3, thyroid antibodies. And then another one I actually also really like, vitamin D, cause that can be in relation to like miscarriage and loss. So just making sure that's elevated in general.   Michelle (20:37) Bye.   Yes.   Samantha Briguglio (21:06) I do an AMH if they haven't gotten one done. That one, obviously I wouldn't get for guides too, but so far all the other ones that I've listed can also be for men. And then another one that I think I would do for a lot of people would also be ferritin. So ferritin is a lot lower in a lot of people now. It's the storage form of iron. It's something that...   Michelle (21:24) Mm-hmm.   Mm-hmm.   Samantha Briguglio (21:32) the more research I've done, the more I'm seeing that, they always talk about iron being too low and can cause like a bunch of issues in pregnancy and then also to try to conceive, but people forget that ferritin is a storage form and if it's lower, usually that means that we are actually low, we're giving all our storage to like the active form. And so we wanna make sure that's elevated enough and there's a lot that can go into that, but that's been another one that I've been   Michelle (21:56) Mm-hmm.   Samantha Briguglio (22:01) doing a lot of research on lately and most people, it comes back super low. So it's just kind of where I just started doing it. I used to only do it. Yeah, they ignore all the time. And it's something that I would only do for those who had like a heavy menstrual cycle or history of endometriosis or like a gut health issue where they had problems of absorption. But now I'm just like starting to do it more often for everyone because.   Michelle (22:06) Oh, interesting. It's actually something that a lot of people ignore. They like totally overlook.   Samantha Briguglio (22:24) Again, it's like most, a lot of people are having it super low. So I'm like, okay. And with ferritin though, then you have to go into, sorry, I'm like totally like going on a rant here, but I'm like, I have to finish it out. Yeah. Well, but I'm like with ferritin it's nice too, because first you can treat it with like iron and like vitamin C, right? Like see if that's, that's the culprit. And then you test it and if it's gone up, usually that is the issue, but it can also be due to like   Michelle (22:34) Oh no, I do the same thing. That's how I always think. I go everywhere.   Samantha Briguglio (22:52) Like low ferritin can be due to chronic inflammation or an underlying like disease or like virus or bacteria in your system that you need to figure out to treat. And so sometimes I'll just do the iron first and then we can go to the other piece if we, if it's not working, cause that means that there's definitely something else going on.   Michelle (22:57) Mm-hmm.   Yeah, I mean, interesting, you know, talking about iron. What I find interesting about it, and I remember like listening to a podcast and they talked about how it's better to have things like beef liver, like through foods, because it has a well-rounded combination of nutrients that helps iron absorb better versus when you're just taking iron and sometimes the body doesn't know what to do with it. And it just kind of, it almost gets toxic, the amount of iron because it's not.   Samantha Briguglio (23:40) Yes, yes, it's totally can.   Michelle (23:42) Yeah, so let's talk about that because I think it's really important to talk about because people might be like, oh, you know, if that's what it is, let me just take iron. But like, that's not always the solution.   Samantha Briguglio (23:53) No, you're totally right. I mean, obviously like a beef liver on eating more meat cooking with a cast iron pan There's the good old fat. There's the good old fashion iron fish like there's so many different things you can do um some people Usually I give iron to people who have a hard time incorporating like meat or have a hard time cooking like it's very individualized Right, like it's you kind of have to meet the patient where they're at um, but things that I will recommend for iron and   Michelle (24:00) Right, yeah.   Yeah.   Samantha Briguglio (24:20) Just clarification, this is not medical advice. This is just things I like to do in my practice. But I like to do actually, there's a lot of studies on dosing iron every other day actually is helpful for absorption, pairing it with vitamin C. So that either means like eating an orange or getting a supplement that has vitamin C in it or taking vitamin C with the iron. That's gonna, and those things make a big difference, right? So they sound little.   Michelle (24:24) Yeah, yes.   Samantha Briguglio (24:49) A lot of people worry about constipation with iron and that's where they're like, oh, that can be an issue too. So if you just eat it, it'll be better. Eating it's always gonna be better. I'll never take away from that. But just cause we're also on the side of supplementation, there's different forms of iron. And I like an iron bisglycinate form that's actually absorbed a little bit easier and usually doesn't cause constipation. I say usually because I had to get a constipation one time. I was shocked, but it did.   Michelle (25:14) Mm hmm.   Okay. Yeah.   Samantha Briguglio (25:17) And so that's where I'm like, let's just really focus on like cooking with the cast iron and iron fish and like the, let's have, let's eat meat, right? Like, let's try, I mean, the leafy greens, people talk about that all the time. They can be helpful, but they're not digested. They're just, they don't, they're not in our body. Yeah. It's not the same.   Michelle (25:26) Yeah.   It's not the same.   And then on the other hand too, like, I mean, I have like one patient that...   Her doctor said, stay away from eggs, stay away from red meat, because your cholesterol is high. So I wanted to talk to you about that, because I know that there's like this school of thought that just avoid all the things that have cholesterol and you'll be good. Or why is the cholesterol in there in the first place? Could it be covering up an underlying inflammation? Because in Ayurvedic medicine, they talk about like, vata pitta kafa, I don't know if you're familiar with like the different elements.   Samantha Briguglio (26:04) Oh yeah, oh yeah.   Michelle (26:06) Yeah, yeah. So when something gets really inflamed, they say kafa, which is a little bit more of that moist, heavy substance, comes over to protect. So the same thing with amyloid, with Alzheimer's possibly. Is it because, does it come in to protect something? It's like this coating, same thing with cholesterol. So does that come in to coat the walls because there's inflammation?   Samantha Briguglio (26:33) So I feel like I have to answer a couple other things before I answer that question. One of the things is I don't think cholesterol is the villain that it used to be. So there's a lot of studies that say like, more cholesterol is better than not enough cholesterol. And cholesterol is needed to build, it's a building block for our hormones and things like that.   Michelle (26:47) Mmm.   Samantha Briguglio (26:52) cholesterol is needed. People villainize it so much, but even the bad versus the good, the HDL is the good, the LDL is the bad, we still need LDL cholesterol. These things our body needs. One of the theories, and it's a more recent one, but it's still a few years old now, is that it's not actually the amount of cholesterol that's an issue. It's more related to if there is inflammation or not.   If you're saying, on one end you're like, is the cholesterol being there as like a protective thing for inflammation? Or is cholesterol being that elevated not as terrible as we think it is, but we need to make sure that like the inflammation is monitored and reduced? That's always like a big question. And then another one is like looking at ratios. Like cholesterol ratios are actually the most important thing, right? So,   Okay, we could have elevated, you know, LDL or total cholesterol and triglycerides. But what if we have like an HDL that's like in the eighties or 85 or something? That's to me, if we have a cholesterol that's even like, you know, it seems to be extremely over the limit, but we have this really strong HDL, like maybe it's not as big of an issue as we think it is. Right.   Michelle (28:10) Mm-hmm.   Samantha Briguglio (28:16) Also a lot of times instead of eating things that have less cholesterol, I usually just encourage eating more fiber. So fiber actually binds with cholesterol and then we just poop it out. So like instead of like limiting all these things, I'm like maybe you're just not eating enough fiber. Maybe it's the other thing. Maybe it's not that you're eating too much of something. Maybe it's a lot. Maybe it could be either a combo or maybe it's you're not eating enough fiber, which most people don't. Right? Because fibers and like veggies and things like that.   Michelle (28:23) Mm-hmm.   Mm-hmm.   Mm-hmm.   Samantha Briguglio (28:44) So it's like maybe we just need more fiber, nourish the liver a little bit more, and then our cholesterol issue goes away. So sometimes it's kind of a combo. Sometimes yes, it might be accompanied by the inflammation. Maybe is it the chicken or the egg, right? Is it the inflammation that's causing cholesterol or is it cholesterol that's causing more inflammation? At the end of the day, I feel like we truly don't know that answer 100% yet, because different studies keep coming out on it, but.   Michelle (28:44) Right.   Bye.   Bye.   Samantha Briguglio (29:10) Overall, I would say my biggest thing and my biggest recommendations to treating cholesterol are actually by nourishing the liver and eating enough fiber. Obviously, if they have a really bad, high fatty diet with like really bad fats, like unsaturated fats, then that's an earth saturated fat. I'm like, wait a minute. What I said was wrong.   Michelle (29:19) Yeah.   Saturated fence, yeah. You know what it is? We talk too much about this all the time and it's just our brain's like, uh?   Samantha Briguglio (29:39) Yeah, I totally my brain was like, whoopsies, at least I caught it quickly. Whew. Um, you know, basically we do want to limit that limit that, right? But like eliminating the good fats, like avocado and eggs and stuff. Like that's, that's not what we want to do. That was a big rant, but there we go.   Michelle (29:43) You did.   Yeah.   No, I mean, I will say like, you know, when people say I can't have eggs, I can't have the yellow of eggs. I'm such a great food. But then of course, I'm always afraid to say, don't do what your doctor said. Like I will never say that. It's just, you know, so I wanted to get your opinion on it because you hear just so many different opinions on everything that it gets very confusing. And then sometimes the mainstream opinion isn't updated.   Samantha Briguglio (30:09) Right.   Right. No, they say it takes 10 years in medicine from an article coming out to making actual changes. And then by the time that happens, there's a new article that comes out.   Michelle (30:24) I'm finding that like, yeah.   Yes. then of course, you don't want to, again, step on other people's toes and you're like, well, I kind of remember hearing a study that says the opposite of this, you know, and I'm not talking about this specifically, I'm just saying in general. So sometimes, you just get so many different perspectives. But then of course, as a practitioner, you have to be very careful as to what you're   Samantha Briguglio (30:45) Yeah.   Michelle (30:54) suggesting and you don't want to go cross basically somebody's other treatment plan with their practitioner, that kind of thing. So I'm sure you know exactly what I'm talking about.   Samantha Briguglio (31:06) Totally. Yeah. And you know, I also just give patients options. I'm like, we can try this and let's monitor. Let's like do this way for a couple of months and then get your labs drawn and then do this way for a couple of months and get your labs. Like we can, you know, if their cholesterol isn't like in scary high levels, then I'm like, it's like we have room here. There's room. I'm like, how long do you think your cholesterol has been like this? Like we don't have to like change things tomorrow. Like we can just start slowly working on it. Like I said, if it's not in a dangerous place, but   Michelle (31:12) Yes.   Mm-hmm.   Yeah.   Samantha Briguglio (31:35) Usually it's not. And so I think the fiber thing is honestly the most underrated thing there is. And then, yeah, and then eliminating the bad fats versus and keeping the good fats. Because the good fats are what keep your HDL high and they're helpful for that really good ratio. So we don't wanna eliminate the good stuff, we wanna eliminate the bad stuff.   Michelle (31:37) Yeah.   That's a good point, yeah.   Right. So the good stuff meaning avocados, salmon, you know, like good. Yeah.   Samantha Briguglio (32:06) eggs, nuts, you know. Yeah, that's, yeah, exactly.   Michelle (32:12) very important information. So, foods, I think that that's a huge thing because a lot of, we just don't, we're not conditioned to eat healthy. I just feel like there's a, you know, this quick fix and a lot of processed foods and people don't have the time or the energy to cook.   But that's one thing that I've at least seen that has been a little bit more difficult is really implementing a new way of living because it's so intricately connected to our behavior and it impacts inflammation, it impacts fertility like in so many ways. And then also like certain food additives that can impact gut microbiome, like thickeners,   Samantha Briguglio (32:48) Yeah.   I know and now there's like this thing that where it's like natural and holistic medicine is like kind of trending Like let's just like call it what it is, right? Which is cool because when I first started I would tell people what I do and they have no idea Like no one knew what I was gonna do Yes, it's more mainstream, which is awesome   Michelle (33:02) Mm-hmm.   Yes, we're becoming mainstream.   Yeah.   Samantha Briguglio (33:16) But now it's like also been taken to the extreme. So I'm like, oh goodness, now we're like flying on this other side where it's like, oh God, like everyone's eliminating everything and like, it's just been crazy. And so now people come to me and they think I'm like chill. They're like, that's it? I'm like, yeah. And I'm gonna.   Michelle (33:33) Wait, so tell me, tell me, what do you say typically? What are your big things that people should pay attention to and what kind of things should they be a little more lax on?   Samantha Briguglio (33:44) Yeah, so like the thing I'm most strict about is sleep. I will always be like sleep over everything, sleep rules. Sleep is like, you will not, if you wake up early to sleep, your workout, your workout's not gonna be as effective than it would have been if you just like slept a little bit longer and then maybe try to get like a shorter workout in, right? Like it's, things like that, I will always stand by sleep first, always, always. Second, honestly, diet and movement.   Michelle (33:50) Yeah.   Samantha Briguglio (34:15) They're kind of linked for me now. It always used to be diet first, then movement, but now there's just so many, like there's so many people going through a lot of like stress and like mental health struggles that, yes, I can help with, but I feel like movement just helps set the tone for so many people's day where it like allows them, they move, it like allows them to like follow up with more healthy habits. So it's like this weird, you know what I'm saying?   Michelle (34:39) Oh, yeah, it's somatic. I mean, yes, because we were talking about how your emotions are very much tied to your body. That's why somatic therapy is so powerful. Probably another step over talk therapy, which is why things like yoga really impact the mind because when you're moving, you're sort of processing emotions and emotional states.   Samantha Briguglio (34:50) Mm-hmm.   Yeah.   Michelle (35:07) in a different way. And it also helps you cognitively. I mean, there's just, so movements like very underrated.   Samantha Briguglio (35:13) Yeah, well, and they, cause they only, people, I feel like we're only looking at it from like a, what does movement do to your body versus what diet does do to your body, right? And, but we're forgetting like the, oh, if I move and I feel good and I'm happier throughout the day, I'm more likely to like pick the healthier choices and eat the healthier foods than, and get restful sleep and all these other things. So honestly, they're kind of tied for me. Sometimes movement ranges up. I don't know, you know.   Michelle (35:33) True.   Yeah. But I also say if you're getting good sleep, you're going to be less likely to grab that sugary snack. Yeah.   Samantha Briguglio (35:50) That's exactly so this is where it's kind of like all of it matters a lot, but that's why sleep is like number one for me um But sleep so like obviously the diet and the movement piece But when it comes to diet, I feel like a lot of people are really strict now There are so many bad foods. Yes, there are so many seed oils and all of that But I feel like now people are going on the other side of getting really stressed out about what they're eating how much they're eating   Michelle (35:56) Yeah.   Samantha Briguglio (36:15) you know, making sure they're getting all their nutrients in. Now I'm like, oh God, we've like over-corrected for a lot of people now that are in this wellness space. I'm like, okay, we need to like chill out a little bit. Like not everyone needs to eliminate gluten and dairy. If it bothers you, eliminate it. If you have an issue with it, eliminate it. If you're allergic to it, eliminate it. But like, if you eat it and you feel fine, like let's just not cut out another food, right? You know.   Michelle (36:15) Mm-hmm.   Mm-hmm.   Samantha Briguglio (36:42) A lot of practitioners believe that like no one should eat that and dairy is super inflammatory. And I'm like, well, yeah, but like quality matters always. If you're getting a good organic dairy, that would be helpful for some people.   Michelle (36:49) It's true. Yeah. Same thing with organic weed because it's not sprayed with glyphosate. I think that that's a big thing too. I mean, I'll be honest, I mean, it's just the world we're living in right now. It's a little bit of an uphill battle, but I agree with you that it can almost manifest, and I've talked about this before, it can almost manifest very similar to an eating disorder.   Samantha Briguglio (37:02) Okay.   Yes.   Michelle (37:15) I mean, because people get so upset and it really impacts them how they're eating. So it's a fine line of having a balanced perspective on food.   Samantha Briguglio (37:27) Yeah, yeah, it's orthorexia that it's literally actually has a technical name now and that means you're so stressed about eating healthy You either like just won't eat at all Which is actually not good for women. They'll say like for men It's actually better to fast than eat the unhealthy thing But for a lot of women it's better to like actually eat the unhealthy thing than to fast for too long fasting still. Okay but that's sorry, that's a whole nother conversation, but um Yeah, so I go from the approach of 80-20 rule   Michelle (37:33) Mm-hmm.   Yes.   Yes.   Samantha Briguglio (37:57) and making it sustainable. So I'll tell my patients like all the time, I'm like, you're not a perfect person. You can't be perfect all the time. And if you're gonna stress about being perfect all the time, that's a whole nother thing we have to deal with. So instead, let's give you freedom to live your life. I go out, I go out and eat french fries, like all the time, I love french fries. Like I guarantee those are not always fried in like olive oil or whatever. They're definitely fried in probably like a seed oil or canola, like I know that, but I love them.   Michelle (38:17) Me too. It's good. Yeah.   Mm-hmm. Yeah.   Samantha Briguglio (38:26) But the rest of the time, you know, I get my movement in, I'm drinking tons of water, I'm sleeping like nightly, like I take care of my mental and emotional health, like I'm doing all these other things that, so when I eat the French fries, it's not that big of a deal. I'm like, yeah. And so that's where I want people to feel free now.   Michelle (38:37) Mm-hmm.   Right, I get, no, I get what you're saying.   Samantha Briguglio (38:50) They can be as careful as they want as long as it doesn't cause like chronic stress. Like if avoiding all of that stuff actually helps you and relieve stress, great. But for majority of people I've seen, it really causes a lot more stress. So I become very picky about a couple of things and then I kind of just say, I'll help you with the other stuff, right? Like eliminating sugar, that's a big one. That one to me is a bigger deal than like the dairy and the gluten, right? So for me, I'll be like, okay, let's eliminate   Michelle (39:12) Mm-hmm.   Samantha Briguglio (39:19) Let's reduce sugar, but I'll give them ways to reduce it. How do we make our own healthy Reese's cup at home? That's not gonna be bad. You can have a couple Reese's cup, honestly a day if you're making them out of organic dark chocolate and organic peanut butter that has only, the only thing is in it is peanuts. I'm not always worried about that then. And they'll be like, oh, okay, I'll make those. I love to cook or I love to bake, great.   Michelle (39:27) Mm-hmm.   Samantha Briguglio (39:49) I'm like, awesome. So like, boom, like that's already helping their sugar habits, right? Talking about pairing foods, like instead of taking away, taking away, taking away, more like add in, right? Like if they really like their smoothie in the morning that has all this stuff in it, they say smoothie is not that great and it's not good on the stomach and all of these things. I know in Chinese medicine, it's actually probably not good at all because they say you wanna start with like warm, right? Like they're like, let's, we want.   Michelle (40:14) But you know, it's funny that you say that because I do tell people the 80-20 rule as well, but I do that with raw. So like if they love their smoothie, fine, but just make it like 20% and that's your 20%. You know, or if you're like, if you're having smoothies and then a ton of salads and then all this raw stuff, fine, then that starts to add up. But I say the same thing.   leave it out for a little bit so that it's not freezing like frozen. Just kind of like let's do this balanced.   Samantha Briguglio (40:44) Yeah, and sometimes I'll be like make it a little bit thicker. So like let's maybe add some oats or some chia seeds or some more veggies to it to add some fiber and then like maybe eat it with a spoon instead. So that's getting those like chewing mechanisms going. We're really just starting our digestive system a little bit more than just drinking something. But you can compromise. Yeah, you can compromise and just add things in. You don't have to like completely take away everything. And I think a lot of people.   Michelle (41:03) Right. That's a good point. You want those enzymes.   Yeah.   Samantha Briguglio (41:13) or shocked by that, surprised by it, but they like also kind of love it because it's like, whoa, this is actually doable.   Michelle (41:19) It feels good. It feels safer, first of all. It doesn't feel as pressure filled. And it also is, like I know from a mindset, from a subconscious mind thing, because I studied hypnotherapy, I feel like behavior and like our, what is it that stops us from changing habits? You know, like we all have habits and we repeat,   Samantha Briguglio (41:23) Mm-hmm.   Michelle (41:44) And one of the biggest almost like laws is that you cannot create a vacuum. And that's why it never works to just stop anything. So you have to just substitute. So I love that you said that like intuitively you're almost like realizing that about the mind. If you're giving the mind a substitute or instead of this, then have that, but it's kind of similar and then it's much easier to start a new habit that way.   Samantha Briguglio (41:50) Mm-hmm.   Yep.   Yeah, and you just have to give people kind of a chance instead of saying like, do this, do that. You're just like, okay, let's add, or let's, yeah, like you said, substitute. So, very, I'm also very passionate about that, as you can see.   Michelle (42:22) Hmm. I love that.   Yes. Yeah. Well, I mean, you know, these things are important for people to Because once you have this information, you have a lot more empowerment. And I feel like people just don't have that information. everybody deserves to know that. I love this conversation. I mean, I can keep talking to you for hours, but obviously we have like a limit on time.   But I definitely love picking your brain on these things. And I think that you have a really nice balance on how you look at it. So for people who do want to work with you or like learn more about you, how can they find you?   Samantha Briguglio (42:52) Thanks.   Yeah, well, we kind of talked about Instagram earlier. That's a very easy way. Walk the natural path on Instagram. I do have a website. It's also walk the natural path. So anything with that, your odds are you're gonna find me somewhere. So you can reach out, yeah, in DMs. Sometimes I'm a little bit slower. So sometimes I recommend filling out like a new patient form or booking a consultation call with me so you can chat a little bit about like your case and then what I can do to help or if I feel like we're a good fit.   Michelle (43:16) I love it.   So you help people virtually too. I just want to mention that, not just locally. Awesome.   Samantha Briguglio (43:35) Yeah. Yep. Virtually too. Yes.   Michelle (43:40) Also, so what was the inspiration to walk the natural path? Because I see you actually walking many natural paths and hiking, and I think that's so cool because you do a lot of like nature walks.   Samantha Briguglio (43:52) Yes, oh my gosh, such a passion of mine. I honestly like I used to do like one a week for sure I need to get back to it. Since the wedding has been a little crazy. But walk the natural path actually came from the idea of creating an Instagram to help promote natural medicine before it kind of dove into this like mainstream thing, right? And   I don't know, the name just like came to me, which was actually pretty crazy because I feel like I'm not the most creative person. So for that to happen, I was like, oh, this is it. And then it just kind of took off. And then when I switched the Instagram over to my business, it just, I think it just stuck and it was close to my heart. And my name is Dr. Samantha Berguglia, which is very, very long. And I was like, a lot of people just go by like.   Like my bestie is like Dr. Sienna Miller. I'm like, that's so cute, that's short. And that's kind of like what her business is. And she has a different title now, but I just, I decided to go with it and it stuck. And like you said, it's part of who I am. I walked nature trails all the time.   Michelle (44:51) us.   Because I see you walking nature trails, which by the way, that's a whole other topic. But I think that doing that is also really good for our health.   Samantha Briguglio (45:05) Yeah, in our hearts and yes, but I guess really what it's about though is it's saying like I'm walking the natural path to like healing Like at the end of the day, it's like always walking This natural path and natural though can mean anything to anybody, right? So not to get on a whole nother convo, but just to wrap it up it can mean You know the like the actual natural medicine that everyone really thinks about but it's the natural path for you So that could also be like combining   Michelle (45:13) Yeah.   Yeah.   Samantha Briguglio (45:35) conventional IVF plus natural medicine. That can be your natural path. So it's what feels natural to you. It's kind of supposed to be interpreted, but yeah.   Michelle (45:47) I love it. Well, that's a great note to end with. And this is an awesome conversation. I'm so glad we finally met. I know we were like DMing each other back and forth on Instagram for a while and following each other. And then I was like, I got to get her on the podcast. I really like the stuff that she's putting out. So thank you so much for coming on here, Dr. B.   Samantha Briguglio (46:07) Aw, thanks for having me. This has been wonderful.