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Separating Fact from Fiction: Navigating The Rabbit Hole · Love and Science Fertility

• 0:30
  Speaker 1: Welcome back to the Love and Science podcast.
• 0:32
  Speaker 1: Today we will be talking about the rabbit hole.
• 0:36
  Speaker 1: I cannot tell you how many conversations I've had lately with my clients and my listeners about how very difficult it is when we have a particular question where there's something that's not going well in our fertility journey and we go to the internet the interwebs, as some people say and we type in Google does an ERA help my chances of success?
• 1:03
  Speaker 1: Or how are the chances of getting pregnant after this many UPlay transfers?
• 1:09
  Speaker 1: Or maybe I have a mosaic embryo?
• 1:13
  Speaker 1: What does that mean?
• 1:14
  Speaker 1: Like, whatever it is, whatever clinical question it is I mean, I've been guilty of this too, so I'm not there's no judgment here but my goal in life and at Love Science so that's how I make this happen in the world, you know professionally is that my clients feel empowered, and what I wanna call out is, whenever we go down the rabbit hole, that just feels very empty, it feels almost addictive and I would even argue it feels disempowering.
• 1:45
  Speaker 1: So how can we take back that power, figure out fact from fiction and really just have moments of calm in our lives when we don't feel like, if we don't Google something to death, that we will ultimately be responsible if our treatment doesn't work out, because I think that's at the end of the day.
• 2:06
  Speaker 1: It's like the stakes are high and we want to have a child or we want to grow our families, and it feels like if we don't find the right thing, then it's our fault if it doesn't work, and that is just so not true.
• 2:22
  Speaker 1: What I want to do today is share with you what I've learned about separating fact from fiction and how to navigate the fertility process in a way that does not steal our power and does not make us feel like at every moment we should be Googling all these things, because I think temporarily we do it because it gives us a false sense of control, but it really just steals our joy.
• 2:46
  Speaker 1: So, in terms of my first suggestion for how to get out of this sort of addictive habit, as I will call it again without judgment, but still Okay I think the first thing is really to look at the relationship you have with your reproductive endocrinologist and really ask is this relationship a quality relationship?
• 3:08
  Speaker 1: And I say that there are thousands of wonderful REIs out there and many of them are my close friends and family, and I just feel so honored that I get to be one, that I get to help people build their families in this way as well.
• 3:22
  Speaker 1: It is such an honor that I can do this and that I get to help people build their families in this way as well.
• 3:23
  Speaker 1: It is such an honor that I can do this and that I've helped so many people build their families.
• 3:28
  Speaker 1: At the same time, it's a little bit like dating.
• 3:30
  Speaker 1: Maybe we go on a date and something just feels off right.
• 3:36
  Speaker 1: It's like we can't really put our finger on it, but something in the interaction doesn't feel right.
• 3:43
  Speaker 1: It's a two-way street, right, like I feel this way sometimes.
• 3:45
  Speaker 1: You know, obviously I'll take care of any of my patients, but sometimes, like in the interaction there just feels like something just doesn't fit in a sense.
• 3:54
  Speaker 1: So I would think back and, just you know, conjure up the conversations you've had recently with your REI and say, like, how do I feel about this relationship?
• 4:03
  Speaker 1: Do I feel we've had trust from the very beginning?
• 4:06
  Speaker 1: Because I think the reason this matters is that your REI is your guide through thick and thin, through the good news, through the bad news, through all of it.
• 4:17
  Speaker 1: And so when we think about who's going to help us interpret the data right, because no two situations are the same.
• 4:25
  Speaker 1: Whatever your situation is, you come with your personal values, your personal goals, your previous past experiences, your hopes for the future.
• 4:34
  Speaker 1: Nobody else in the world is going to have that same exact match stories.
• 4:39
  Speaker 1: There may be people with similarities and there may be some studies that can help to guide care, but there's never like the right thing to do.
• 4:47
  Speaker 1: Next.
• 4:48
  Speaker 1: There's usually a few different options and then the question is helping to figure out what is the right thing for you personally so that you can achieve your goal of building a family.
• 4:58
  Speaker 1: So, again, the relationship with your REI is a super important one.
• 5:03
  Speaker 1: I'd say.
• 5:04
  Speaker 1: Most people I talk with have a strong relationship and they're getting exactly what they need.
• 5:11
  Speaker 1: I think there are some people who come and find me and they say I just feel like I'm not getting answers to my questions.
• 5:17
  Speaker 1: I feel like I'm another number, and in those situations I would empower you to get a second opinion.
• 5:22
  Speaker 1: See if somebody else out there does feel like I'm another number, and in those situations I would empower you to get a second opinion.
• 5:24
  Speaker 1: See if somebody else out there does feel like a better fit.
• 5:27
  Speaker 1: And sometimes I mean the news is the news.
• 5:30
  Speaker 1: We can't change what is going on with the fertility process, with the cycle, what's already happened.
• 5:35
  Speaker 1: But to have somebody who can sensitively deliver that news, to have somebody who can interpret that, who can project ahead and sort of give you a roadmap for the next foreseeable future, I think that can make all the difference.
• 5:52
  Speaker 1: I will tell you for my own patients.
• 5:54
  Speaker 1: I will often get to the point where I'm like you know what, we're in a data-free zone and I think there's biological plausibility to trying this thing, but I can't show you a study.
• 5:59
  Speaker 1: And I think there's biological plausibility to trying this thing, but I can't show you a study.
• 6:03
  Speaker 1: And I also will say look, if you were my sister, this is what I'd recommend, because I think sometimes if we think like as objectively as possible, that does our patients a disservice, but if we can actually make it very personal, I have somebody else in my universe the other day who said you know, this person said if I were your, if you were my daughter, this is what I would have you do.
• 6:27
  Speaker 1: And you know I don't mean to get too paternalistic here, but I think we've lost a little bit of that in terms of the doctor patient relationship.
• 6:31
  Speaker 1: I think you know we've lost that trust.
• 6:34
  Speaker 1: We've lost that.
• 6:34
  Speaker 1: I trust you with that recommendation, and so you know, I'm saying only to do this if you feel like you have a good relationship with your REI, which I hope you do.
• 6:43
  Speaker 1: But if that person says like if you were my sister, this is what I would do, if you were my daughter, this is what I would do, then I would say like, take that and heed that with a little bit more weight than you would if this were just like of the various options, this is a possibility.
• 6:58
  Speaker 1: This is a possibility.
• 7:00
  Speaker 1: So communication is really important.
• 7:01
  Speaker 1: Getting answers to your questions, you know that's really important.
• 7:04
  Speaker 1: I always say there's two different levels of questions.
• 7:06
  Speaker 1: There's a level of questions that are bread and butter and most people in the field can answer them very easily without even thinking about them very hard.
• 7:13
  Speaker 1: But then there's, you know, the questions that are kind of upper level questions.
• 7:16
  Speaker 1: There's questions that really are high level.
• 7:20
  Speaker 1: They require a lot of thought, a lot of experience.
• 7:23
  Speaker 1: They require really taking your personal consideration into the perspective in terms of helping you make that decision, and so those are really the questions that I would say like you know, is my REI helping me with this, like, how can I be as prepared as possible?
• 7:42
  Speaker 1: How can I create the space, maybe get another appointment?
• 7:46
  Speaker 1: Ask these questions just to understand what my next roadmap is and to help me really have the best chance at achieving my dreams.
• 7:56
  Speaker 1: So that's my first suggestion is start where you are and see how your REI can help you, and if that's not the best of relationships you know, get a second opinion and just see what your options are.
• 8:08
  Speaker 1: I will also, along with that, say think about how you ideally would want to feel in a relationship that is, a patient-doctor relationship, right?
• 8:18
  Speaker 1: So for me, when I'm a patient, I like to feel that there's trust, I like to feel cared for, I like to feel seen and understood, I like to feel compassion, I like to feel that somebody is treating me as they would a family member who's very important to them.
• 8:34
  Speaker 1: So I would just sort of conjure up how do I want to feel and is this how I'm feeling?
• 8:40
  Speaker 1: And if it is, fantastic, if it's not, you know, I give you full permission to just think about how you can get what you need.
• 8:48
  Speaker 1: The third consideration I would bring up is, you know, in terms of separating fact from fiction.
• 8:56
  Speaker 1: I think there's a lot of things in medicine where it's like, well, this will work for most people, right, and so say there's a study you know, say it's poor responders and like, okay, well, this is sort of you know what the data show for people in this category.
• 9:13
  Speaker 1: I hear from, like I said, the minority of my clients and patients that sometimes they don't feel like they themselves are considered, which is it's so sad to me when I hear this, but I also know that I felt this too as a patient.
• 9:26
  Speaker 1: Sometimes I felt like just another number, sometimes I felt like people were just getting through their day, and so I would really ask the question, especially if treatments haven't worked thus far and you're like, okay, are we moving in a forward direction?
• 9:39
  Speaker 1: Is somebody carefully considering your particular situation and your details and your history and your goals, or do you feel like it's more kind of one size fits all and that you're kind of just swimming along with the school of fish and that you're not really getting that personalized approach?
• 9:58
  Speaker 1: So I think that's really important.
• 10:00
  Speaker 1: Again, this is not to.
• 10:01
  Speaker 1: I'm very careful because I have patience too, and I'm not criticizing any of my colleagues, I'm just saying that sometimes it's not a great fit and sometimes, if you feel you're not getting what you need, there are ways to get what you need and I want to give you full permission to feel like that's a possibility, because it really is.
• 10:18
  Speaker 1: The fourth suggestion I have is to consider what resources exist, and I say this with caution, like I said before, because I think you know an REI or you know a coach with experience, like me.
• 10:29
  Speaker 1: I get to do both, which is fantastic, and I have the experience of both, which I love.
• 10:34
  Speaker 1: I think sometimes, without somebody who's interpreting the data for you in your situation, without even if you're like a cardiologist or a critical care doctor, like it can be really really hard to understand, like what resources are true and what are false.
• 10:49
  Speaker 1: Like I say, fact from fiction, and I think if we actually input anything into PubMed, we can come to any conclusion we want, because there's all sorts of studies out there in the world.
• 11:00
  Speaker 1: There are studies that are even run by people who are trying to sell the thing that they're testing, and I think any of us would argue that that cannot be an unbiased study because there's a conflict of interest there.
• 11:12
  Speaker 1: I understand it's hard to do good research these days, but I think that really looking with a keen eye of like, how am I going to learn what is real, what is tested, what is generalizable to me in my particular situation, all those things are important.
• 11:28
  Speaker 1: So social media has become a place where people find the vast majority of their information, even their news, which is a little frightening.
• 11:35
  Speaker 1: But I do think that sometimes some of the fertility groups online can be helpful, because you at least sort of get a sense of what other clinics are offering, what other patients are being offered.
• 11:48
  Speaker 1: You know for various situations, and so I think you know sometimes there are adjuncts to care that maybe don't have a ton of science behind them, but there are possibilities, and so just knowing what's out there sometimes can be helpful.
• 12:03
  Speaker 1: I say that again with caution, because I think there's a lot of what I call comparitis in these groups and it can be very triggering too to listen to somebody else's story, especially if they've gotten good news.
• 12:13
  Speaker 1: So be very careful on social media.
• 12:15
  Speaker 1: If I do it myself, I say okay, I literally set a limit, I say I'm doing it from this time to this time and then I'm stopping, I think, unless I set limits, like you know as soon as like 11 pm, and I'm still scrolling.
• 12:26
  Speaker 1: So give yourself a container for doing this if this is helpful to you.
• 12:30
  Speaker 1: But just you know, get support if those groups are supportive to you.
• 12:33
  Speaker 1: Get sort of a little bit broader view of all the things that are happening in various places, understanding that many of these are not evidence-based.
• 12:41
  Speaker 1: And you know, if you have a question for your REI like, hey, what do you think of this thing, do you think it would be helpful in my particular situation?
• 12:49
  Speaker 1: Why or why not?
• 12:50
  Speaker 1: I think sometimes that can just really up-level the conversations and empower you to really take an active role in your care.
• 12:59
  Speaker 1: So that's again with caution, that can be a little bit helpful.
• 13:04
  Speaker 1: The American Society of Repetitive Medicine is fantastic.
• 13:06
  Speaker 1: They are basically the REI's main society for advocacy, for studies, for coming together, for guidelines in the US.
• 13:18
  Speaker 1: So it really there's a journal that goes along with the ASRM, called the.
• 13:23
  Speaker 1: It's actually called Fertility and Sterility, which is kind of a funny name, but that's what it's been.
• 13:27
  Speaker 1: It's been called for years and there are a lot of interesting studies in that.
• 13:32
  Speaker 1: Again, you know, one study does not change practice but if you're actually looking for like, is this in like the journal of, like you know, wild animal zoo science.
• 13:43
  Speaker 1: I don't even know, I'm just making it up, but there's like sometimes I look at PubMed and I'm like I've never heard of that journal.
• 13:48
  Speaker 1: That's very interesting and this is my field, like if you're you know.
• 13:51
  Speaker 1: Obviously there's, like you know, journal scores and things that you can see in terms of the quality of the evidence in general.
• 13:57
  Speaker 1: But I do think, in general, the American Society of Repetitive Medicine is a good place to learn.
• 14:01
  Speaker 1: They have, when you go to their website, they have like a section for professionals and they have a section for patients.
• 14:08
  Speaker 1: I think both of those are very, very fruitful and they do review the data periodically and come up with guidelines for care.
• 14:15
  Speaker 1: They're not perfect Like any body of literature is never perfect which is why I think your REI and or me can help you interpret some of this data.
• 14:24
  Speaker 1: But that is one place that you can look where I do think it is helpful in terms of separating fact from fiction.
• 14:32
  Speaker 1: Resolve is also really helpful, as I record this.
• 14:34
  Speaker 1: Right now it's National Infertility Awareness Week.
• 14:36
  Speaker 1: They also have a lot of good resources about adoption as well and, you know, alternate family building.
• 14:43
  Speaker 1: So I really love Resolve.
• 14:44
  Speaker 1: I think they do a lot of good work and they also have a lot of good data.
• 14:48
  Speaker 1: And then you know, I would say use me as well.
• 14:52
  Speaker 1: You know I launched this podcast to reach people and to help people and give them support along their journeys.
• 14:57
  Speaker 1: We can certainly talk about evidence-based medicine, evidence-based topics that is one of my three pillars is evidence-based, along with compassion and empowerment.
• 15:07
  Speaker 1: So I really do feel strongly about helping to educate, helping to empower, to separate fact from fiction, helping to empower to separate fact from fiction.
• 15:18
  Speaker 1: I have my social media accounts Facebook and Instagram.
• 15:25
  Speaker 1: I have this podcast.
• 15:25
  Speaker 1: I have my love and science practice, which is my passion project.
• 15:27
  Speaker 1: I absolutely love the safe space that I've created for women professionals who are undergoing this journey.
• 15:31
  Speaker 1: We do one-on-one coaching.
• 15:32
  Speaker 1: We have group sessions every other Friday night.
• 15:34
  Speaker 1: It's really fantastic, and so I think, in terms of using me to help you separate fact from fiction, I think that can be really helpful.
• 15:42
  Speaker 1: And also when I do my discovery calls, when people book a call with me to see if working together would be a good fit, I try to make those as high value as possible.
• 15:49
  Speaker 1: So if people have questions about their care, again, there's an asterisk there because I wear my coaching hat, not my doctor hat, in terms of the perspective I offer.
• 15:59
  Speaker 1: But I also think that I have so much experience at this point and I'm so thankful for that.
• 16:03
  Speaker 1: I've worked really hard for it.
• 16:04
  Speaker 1: So I might as well spread the love, share the knowledge and help people out.
• 16:07
  Speaker 1: So I would say those are really good resources and just be careful, because you can find an answer to any question and the rabbit hole can feel like you're getting closer to that one thing.
• 16:19
  Speaker 1: That's going to make everything better, but in my experience it really takes the power away and can be really really tough.
• 16:25
  Speaker 1: All right.
• 16:26
  Speaker 1: So my fifth suggestion, when you are thinking about separating fact from fiction and this may be counterintuitive, but it's to tune into your gut, because what I will say is sometimes, when everything looks a certain way on paper, that may not be the best thing for you personally, and so you know.
• 16:44
  Speaker 1: This is why I call my practice love and science.
• 16:47
  Speaker 1: This is why I say that when I'm putting in an embryo, this is why I do think that there's the, they say, like the art and the science of medicine.
• 16:55
  Speaker 1: There's the heart aspect of medicine and the science, and I think if we make things too science-y, like, devoid of any humanity, devoid of any individuality, devoid of any thoughts, of somebody's personal feelings and goals and desires, I think then we are not gonna get the best outcome because we also shut off any inner wisdom.
• 17:19
  Speaker 1: I can tell you story after story after story of patients of mine where we had a strong plan A with the cycle and then I got an intuitive hit and thankfully, like I talked about before, I really tried to have very trusting relationships with my patients from the very beginning and sometimes that means a change in the strong plan A.
• 17:37
  Speaker 1: And I will tell you when my intuition comes on.
• 17:41
  Speaker 1: And maybe this is that I have a lot of experience and I kind of get this spidey sense when something isn't quite right.
• 17:47
  Speaker 1: I can't describe what my intuition is.
• 17:49
  Speaker 1: I know it's not fear, but it's like this intuitive knowing that sometimes the thing that would be suggested, based on only science or only reasoning, is not the right thing for that person.
• 18:02
  Speaker 1: And so I think you know, as you are tuning into, like I know everyone should set excuse me, I know everyone says I should do another IVF cycle, but I really feel like I need to do an IUI or I really feel like I need to take this month off, like I would listen to that.
• 18:17
  Speaker 1: I have people get pregnant in those cycles and so really saying this isn't all about the brain and the reasoning and the science, but I think that there is a role for tuning into our body's own inner wisdom, processing our feelings, thinking about our feelings, thinking about why we have the feelings that we do and when we do have an intuition, when we do have a suggestion that we are supposed to go in a certain direction, even if it doesn't make rational sense sometimes.
• 18:49
  Speaker 1: You know, sometimes that's the right thing to do, and I always say, you know, hey, if it's something that's like completely in left field and you know, maybe you want to bounce it off your REI, maybe you want to bounce it off of me.
• 18:59
  Speaker 1: You know, all those things are helpful sometimes, but I do really think some of the worst decisions I've ever made in my life were when things look good on paper, all my alarm bells were going off and I ignored those things.
• 19:12
  Speaker 1: And so I think it's that combination of, yes, of course, using our brains, but also dropping into our bodies and what feels right to us, given our particular experience and then moving in that direction.
• 19:25
  Speaker 1: So with that, I hope you have a little bit better tools to separate fact from fiction.
• 19:33
  Speaker 1: I think we've talked about how a trusting relationship with your REI is of utmost importance, especially as there's so many decisions to make, and maybe not necessarily the quote unquote right decision, but the next right thing for you.
• 19:44
  Speaker 1: How do you want to feel in the context of that relationship, just kind of as a filter?
• 19:49
  Speaker 1: For are you getting what you need?
• 19:50
  Speaker 1: And I hope you are.
• 19:51
  Speaker 1: If not, there are options.
• 19:53
  Speaker 1: Are you being considered individually and the details really do matter, thinking about resources that can objectively help you separate fact from fiction, because there's so many resources out there?
• 20:05
  Speaker 1: And I think that getting an unbiased view and something that is actually going to help you move forward and not just keep you stuck down the rabbit hole of these ruminations that is really my goal is to give you your power back and then also to really consider the role of our intuition, of our gut, because ultimately, I want your dreams to come true.
• 20:26
  Speaker 1: I want you to have everything that you need to make the next right decision for you, which will then lead to the next right decision, which will then lead to the next right decision along the path of helping you get pregnant, stay pregnant, build your family, whatever it is your goals are.
• 20:42
  Speaker 1: I want that to happen.
• 20:43
  Speaker 1: So, in empowerment and love and compassion, I'm signing off.
• 20:47
  Speaker 1: I can't wait to see you soon If you think that working together would be a good fit, if you think I can help you separate fact from fiction.
• 20:52
  Speaker 1: Do not be shy.
• 20:54
  Speaker 1: Book a call today.
• 20:54
  Speaker 1: I would absolutely love to talk to.