Latest / The Brilliant Fertility Podcast / Episode 063: Restorative Reproductive Medicine vs. IVF

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Episode 063: Restorative Reproductive Medicine vs. IVF · The Brilliant Fertility Podcast

• 0:05
  Speaker 1: Welcome to the Brilliant Fertility Podcast.
• 0:07
  Speaker 1: I'm your host, dr Katie Rose, and this podcast exists to help illuminate the path ahead of you.
• 0:13
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• 0:27
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• 0:33
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• 0:41
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• 0:47
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• 1:12
  Speaker 1: Welcome back to the Brilliant Fertility Podcast.
• 1:13
  Speaker 1: Today we're diving into something that I've noticed is getting pretty controversial, at least in what's being delivered to me in my social media feed, and that is this sort of ideological debate between restorative reproductive medicine and IVF.
• 1:30
  Speaker 1: So what is restorative reproductive medicine?
• 1:35
  Speaker 1: Because it has a nice ring to it right.
• 1:37
  Speaker 1: So from their website directly, this is what it says Restorative reproductive medicine.
• 1:44
  Speaker 1: Their website directly this is what it says Restorative reproductive medicine RRM is a specialized field of medicine that focuses on identifying the underlying health conditions that contribute to reproductive dysfunction and suboptimal reproductive health, treating them to restore the natural functions of the reproductive system.
• 2:01
  Speaker 1: So, unlike conventional approaches that use IVF, iui that may suppress normal physiology to deal with dysfunction, rrm seeks to work with the body, treating reproductive abnormalities not by bypassing the body's processes, but by diagnosing, understanding and addressing underlying health concerns.
• 2:18
  Speaker 1: This approach improves overall wellness and restores reproductive abilities such as fertility.
• 2:24
  Speaker 1: That's directly from the Institute of Restorative Reproductive Medicine's website and it sounds great Like it sounds very similar to naturopathic philosophy of treating the whole person, really understanding what's going on at its core.
• 2:41
  Speaker 1: You know the term root cause comes to mind and comes up within RRM frequently, but lately there's a discourse around RRM and you know, unfortunately, some of the people who are very strongly pushing the philosophy of RRM also being very anti-choice and really having a very negative spin on IVF and it's creating some drama in the fertility world.
• 3:20
  Speaker 1: That I'm noticing and I've had a couple of questions come up from patients and people in the community who aren't actively trying to conceive but are like what's this whole deal about RRM and IVF?
• 3:34
  Speaker 1: I've seen one person say this, I've seen another say that, so I am just like putting this all out there today, because we do need a conversation around it and, before I jump too far down this rabbit hole, I just want to remind everyone why I'm here, why I do what I do.
• 3:55
  Speaker 1: So my intention is to always treat the individual in front of me as the unique, magical unicorn that they are and help them to understand what's happening in their body, to investigate any underlying factors that would prevent them from getting pregnant and to ultimately give them the best chance of growing their family in the way that feels most aligned for them, of growing their family in the way that feels most aligned for them.
• 4:23
  Speaker 1: I have no ideological stance on IVF.
• 4:24
  Speaker 1: I believe it's a scientific miracle and it's just a tool.
• 4:29
  Speaker 1: It's a tool that does not have a 100% success rate.
• 4:33
  Speaker 1: Nothing does so.
• 4:35
  Speaker 1: If someone is leaning towards IVF, or if they've been encouraged to try IVF, or maybe even told IVF is your only option, I'm always going to simultaneously advise that we be setting some foundations in place first, to help them be more successful with IVF.
• 4:53
  Speaker 1: I do unfortunately see that sometimes people are counseled towards IVF without ever being counseled regarding nutrition, avoiding toxins, understanding their circadian rhythm, optimizing male factor.
• 5:06
  Speaker 1: There's just so much that we actually do have influence over that isn't being discussed in the vast majority of IVF clinics and that is doing a disservice to people.
• 5:19
  Speaker 1: So what I'm observing in on social media, what's coming through, and even like some of the email newsletters, is that we've got like the two sides right, that the we have some prominent doctors in the IVF space coming out and saying like RRM is is ideologically bad for women, bad for medicine, because it's pushing an agenda that is ultimately anti-choice, anti-ivf, not going to give people the best shot at having a child.
• 5:54
  Speaker 1: On the flip side, we have the RRM side saying like whoa, whoa, whoa, like we never said we're anti-IVF.
• 6:02
  Speaker 1: But there are some people who are pro-RRM and anti-IVF, who have prominent platforms and I'm just like, sitting in the middle, kind of grossed out by all of it, because somewhere along the line, the Make America Healthy Again movement sort of co-opted some of what us naturopathic doctors have utilized in our medicine for as long as it has existed of, you know, trying to get to the root cause and use natural means whenever possible.
• 6:45
  Speaker 1: But there is also this very like anti-choice, anti-ivf rhetoric that comes along with it.
• 6:52
  Speaker 1: That is certainly not where I stand, and just to reiterate this, like I stand with my patients in their ability to choose what is right for them and give them the best chance for success, and we have to pull from all of our available resources to make that happen.
• 7:16
  Speaker 1: Sometimes we have to pull from the evidence that we have on nutrition and inflammation and circadian rhythm, and supplements and acupuncture and herbs, as well as the opportunity to use tools like IUI and IVF to increase the chances of pregnancy and live birth.
• 7:36
  Speaker 1: There is no right or wrong here.
• 7:39
  Speaker 1: There is no right or wrong here.
• 7:54
  Speaker 1: And when we demonize one entire group of doctors, one entire modality of medicine, we're really that's what's doing a disservice.
• 7:59
  Speaker 1: Before you know, maybe people make assumptions about where I stand, because as a naturopathic doctor, I've certainly had people make assumptions about oh well, you're natural, so you must be anti-IVF, you must be anti-vaccine, you must be.
• 8:13
  Speaker 1: Whatever story they've made up about me is very interesting.
• 8:19
  Speaker 1: I think we just we tend to try to fill in our own blanks about people in situations as humans, but for me, when it comes to fertility, approach like I am, just for you, having all of the information available, the strategy to implement, the information that's appropriate for you and the empowerment to make the choice that is best for you, whether it's trying to conceive unassisted, whether it's through IUI, whether it's through IVF, whether it's through donor egg, whether it's through adoption.
• 8:57
  Speaker 1: However you choose to build your family is what is right for you, and I support you in that.
• 9:05
  Speaker 1: And sometimes it's not going to look the way we thought it is.
• 9:08
  Speaker 1: No one consciously chooses to struggle with fertility, no one consciously chooses to have a miscarriage, no one consciously chooses to need IVF, and so I think we just need to bring so much more compassion to this conversation and be really mindful of when there's this big division.
• 9:38
  Speaker 1: When there's, you know, the sides that are just pulling us further, apart from each other, apart from authentic connection and the ability to utilize all the tools.
• 9:50
  Speaker 1: So how?
• 9:52
  Speaker 1: How do I actually integrate this into practice?
• 9:57
  Speaker 1: How do I negotiate?
• 9:58
  Speaker 1: Some of this ethically is nuanced, of course, but restorative reproductive medicine, like some of the trainings that I have actually participated in, such as the mentorship I did with Dr Phil Boyle, have been so incredibly helpful when it comes to approaching really complex situations people with autoimmune disease, people with recurrent pregnancy losses, people with suspected endometriosis or people who've had confirmed endometriosis, who've gone on to have.
• 10:35
  Speaker 1: You know, ivf can't fix everything.
• 10:41
  Speaker 1: That is just a truth.
• 10:43
  Speaker 1: Ivf is absolutely the best tool if someone has blocked fallopian tubes, if there is significant male factor.
• 10:53
  Speaker 1: Are the two situations that, like, no amount of restorative reproductive medicine is going to overcome blocked or absent fallopian tubes or someone who has, like, a really significant male factor.
• 11:13
  Speaker 1: Or scenario where maybe someone's even had a vasectomy and they have to, you know, retrieve the sperm differently and use IVF to get the egg and the sperm together.
• 11:22
  Speaker 1: Like there are just certain situations when that is truly the only tool.
• 11:28
  Speaker 1: And then there's this huge, freaking gray area.
• 11:31
  Speaker 1: That will range from people who.
• 11:35
  Speaker 1: Everything looks pretty good on paper, you know, the uterus appears to be clear, the tubes appear to be open, they appear to be ovulating based on rudimentary workups, and there's adequate sperm, and then we have the whole realm of well, what about the root cause?
• 11:57
  Speaker 1: What about the root cause?
• 11:59
  Speaker 1: And, like, I kind of cringe when I hear the term now, because it's it that whole world of root cause has been kind of taken over by this, like wellness industry, and I feel like I need I need to find new terms for things.
• 12:16
  Speaker 1: Individualized medicine is maybe the best I can come up with, but we absolutely do need to understand does someone have an underlying luteal phase dysfunction?
• 12:27
  Speaker 1: Do they have a thyroid hormone situation where we've got some subclinical hypothyroidism, or even Hashimoto's, which would then put them in more of the autoimmune situation going on that would make their body hyper reactive to foreign DNA growing within them?
• 12:49
  Speaker 1: You know situations like lupus or Sjogren's or interstitial cystitis like they're.
• 12:57
  Speaker 1: We've got a whole battery of possible autoimmune situations that could interfere with implantation and pregnancy, and then we have nutrient deficiencies.
• 13:09
  Speaker 1: Ivf certainly cannot overcome those scenarios and unfortunately, you know, I do sometimes see people being encouraged or even told IVF is likely your best option when no one has looked into those buckets for them.
• 13:30
  Speaker 1: There are some exceptions to this rule.
• 13:32
  Speaker 1: There are some outliers to this that I'm so grateful for Reproductive endocrinologists like Dr Natalie Crawford she has a great podcast To Be a Woman, be a woman, dr Amy, aka the egg whisperer.
• 13:55
  Speaker 1: These are two truly more holistically minded reproductive endocrinologists who are utilizing the evidence that we have about underlying factors in their practices and speaking on them and educating the public about them.
• 14:04
  Speaker 1: But that's unfortunately not true for every IVF clinic, which is really hard because when we only have a few options available to us in every city, like, how do you know that you're seeing an IVF doctor who's really getting to the bottom of things?
• 14:20
  Speaker 1: Just as a resource, if you haven't already downloaded it in the show notes, I will add a link to the labs that I run for all of my fertility patients to understand better what their body needs on an individual level from a hormone, thyroid, nutrient, inflammation, blood sugar regulation standpoint super important to go beyond the very surface level hormone tests that a lot of IVF clinics are doing.
• 14:53
  Speaker 1: And also, you know, if you step into a clinic and you start asking questions about hey, like, what else can I be doing to optimize my outcomes?
• 15:05
  Speaker 1: If you're being told there's nothing you can do, like you, just you take your IVF meds, you show up for your monitoring scans and that's it.
• 15:15
  Speaker 1: There's nothing else we can do.
• 15:16
  Speaker 1: That's a red flag to me.
• 15:19
  Speaker 1: It's also a red flag to me if you're working with a health coach or a functional medicine provider.
• 15:26
  Speaker 1: I am worked up If you're working with someone who you know is more in the camp of root cause medicine, restorative reproductive medicine, and you start to ask like, hey, what are my best chances of getting pregnant, staying pregnant, what are what are my best chances if I want to have more than one child and say they're all written?
• 15:51
  Speaker 1: This person's already 40 years old.
• 15:53
  Speaker 1: And if you have someone who is ideologically opposed to IVF and therefore will not suggest it for you or makes you feel shame about wanting to pursue some sort of reproductive assistance, that is also a red flag.
• 16:14
  Speaker 1: Our you know, our political beliefs, our religious beliefs, like there is no room for that in medicine.
• 16:22
  Speaker 1: I had a mentor very early on in medical school who said something that just always felt so true for me that you know, when the doctor and the patient are in the room together, there is no room for your ego.
• 16:37
  Speaker 1: The ego should not be part of your treatment plan plan.
• 16:50
  Speaker 1: And I think the same is true for whatever your belief system is Like, that does not mean it needs to be projected onto the patient in front of you.
• 16:53
  Speaker 1: So if you, as the patient, are feeling like a provider is projecting their belief system onto you, that's a big red flag.
• 17:04
  Speaker 1: You, that's a big red flag.
• 17:09
  Speaker 1: Take a beat, take a pause, take some time for yourself and really sit with your own value system, your own priorities, your own desires, and allow that to lead your decision-making.
• 17:22
  Speaker 1: But at the end of the day, ivf has been such a phenomenal tool for many of my patients and BFP clients to grow their families and had we not had the good foundations in place to optimize their hormones and their nutrition status and their mindset and their intuition ahead of going into IVF, I don't know if the IVF outcomes would have been as supportive.
• 17:49
  Speaker 1: So we need middle ground, we need individualized medicine, we need providers who are open-minded enough to just say, hey, what is best for this human being sitting in front of me and the vision that they have in their soul for their family, and that's it.
• 18:11
  Speaker 1: There are so many amazing things that I have learned from this whole world of restorative reproductive medicine and there are amazing reproductive endocrinologists out there who are helping people grow their families with IVF, and there's room for all of it.
• 18:38
  Speaker 1: So please use your discernment in this crazy world that we have, where there's just so much information at your fingertips, there's so many opinions, there's AI that you know you can upload your videos, imaging reports and your lab results too, and that's rather terrifying because it's not always accurate.
• 19:03
  Speaker 1: That can be a whole nother episode.
• 19:06
  Speaker 1: I've got my whole episode idea bank, but I don't know if we'll ever get to.
• 19:12
  Speaker 1: There's so many things, but I hope this just gives you a more grounded approach to the conversation between, like it doesn't have to be black and white, it doesn't have to be this or that, and it certainly doesn't have to be, you know, one whole camps ideology that prevents you from having the family that you want, prevents you from having the family that you want.
• 19:44
  Speaker 1: I think I can breathe now.
• 19:45
  Speaker 1: I had to get that off my chest, I had to vent about that a bit, and if you've had an experience where you were shamed or steered away from any one treatment whether that be something more natural and holistic or wanting to go for ART, assisted reproductive technologies I hope that you can just release that now.
• 20:19
  Speaker 1: I hope that that can stay in the past, and if you feel like you are carrying any lingering emotions around that reach out.
• 20:32
  Speaker 1: You're not alone and you certainly don't have to continue on this journey alone.
• 20:40
  Speaker 1: So I'm here for you If that's something that you ever want to explore together.
• 20:45
  Speaker 1: Doing emotional processing work is one of my favorite things that we do in my weird holistic world of fertility support and maybe one of the most underutilized ways of supporting people on their fertility journey.
• 21:02
  Speaker 1: But if you are leaning towards one or the other of like, does it have to be natural?
• 21:11
  Speaker 1: Does it have to be IVF?
• 21:12
  Speaker 1: Like it doesn't have to be anything?
• 21:13
  Speaker 1: There's not real rules behind this.
• 21:18
  Speaker 1: But please, if you're leaning towards IVF, have a good support system in place.
• 21:23
  Speaker 1: Take a couple months ahead of time to lay the foundations for more successful outcomes and reach out if you need help.
• 21:31
  Speaker 1: You are not meant to do this alone.
• 21:33
  Speaker 1: I don't think any of us humans are meant to do hard things alone, even though we have so many beautifully type A, hyper-independent listeners who I know are just very gently working towards being able to ask for and receive help.
• 21:48
  Speaker 1: Please get the help that you deserve on this journey, whatever that looks like for you, and I'm sending you so, so much love as always on your journey.
• 22:04
  Speaker 1: I hope that this just gives you a little bit of space from the noise and that it's not adding more to the noise, but my mission is always to help you feel more empowered in your journey to make the choices that feel best for you.
• 22:23
  Speaker 1: All right, If you got something from this episode, shoot me a DM.
• 22:26
  Speaker 1: Let me know how this landed for you.
• 22:30
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• 22:35
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• 22:39
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• 22:42
  Speaker 1: This just helps the podcast get in front of more listeners who need to have a little more grounding in their experience as well.
• 22:49
  Speaker 1: Lots of love to you and I'll see you next time.