Season 1, Episode 11
Training for the Fertility Marathon with Dr. Beth Taylor
When it comes to the fertility journey, itâs more like a marathon than a sprint. And just like a marathon requires weeks and months of training to run a good race, creating healthy embryos requires preconception training, too. Our goal is not just for you to start the race but to cross the fertility finish line with a baby in your arms. With patience, testing, and the right treatments, you can greatly increase your chances of having a healthy baby.
In this episode, I get more technical with Dr. Beth Taylor from Olive Fertility Centre to talk about the different fertility tests and screenings IVF clinics can provide to assess the quality of your embryos as well as your uterine receptivity (any risk of implantation failure) in order to increase the chances of positive pregnancy and live birth.
IVF treatments have come a long way in the past couple of decades, and itâs important that we educate those on the fertility journey about everything we can offer to give them the best chance of a positive outcome.
We know you want the best for your family and to be made aware of the testing and treatments available to you, so please join us to learn about your options and why preimplantation genetic testing and uterine biopsies might be a choice for you to help grow your family. Â
Key Takeaways:
- Nourishing the âseed and the soilâ [2:55]
- Using PGT-A testing to increase implantation odds [9:56]
- The mosaic embryo dilemma [17:00]
- How self-correction in Chinese medicine applies to IVF [19:44]
- Creating healthy embryos is a marathon, not a sprint [22:48]
- Testing uterine receptivity [27:17]Â
- The importance of the uterine microbiome [37:31]
- Keeping your embryos safe during testing [50:01]
Dr. Taylor is an infertility specialist. She is a co-founder and co-director of Olive Fertility Centre in Vancouver BC where Acubalance Wellness Centre offers IVFacupuncture onsite.
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After completing her medical degree at Dalhousie University in 1998, Dr. Taylor MD, FRCSC moved to British Columbia to do her residency in Obstetrics and Gynecology at the University of British Columbia (UBC). She subsequently completed a fellowship in Reproductive Endocrinology and Infertility and then joined Genesis Fertility Centre. Dr. Taylor worked at Genesis Fertility Centre until 2013, when she helped establish the Olive Fertility Centre.
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She is a Clinical Associate Professor at UBC. She is also an active staff member at BC Womenâs Hospital and Vancouver General Hospital. Dr. Taylor has also published several papers in peer-reviewed journals and has written three book chapters.
Dr. Taylor loves the challenge and science of IVF for people struggling to conceive. She likes to try new ideas and new IVF protocols to get the best outcomes for Olive patients. She keeps up to date with the research literature and is open to trying novel procedures to try and solve even the most challenging fertility problems.
Where To Find Dr. Beth Taylor:
Instagram (@olivefertility)
To connect with Lorne Brown online and in person (Vancouver, BC), and to set IVF acupuncture appointments if you are going to Olive IVF clinic, visit:Â
Connect with Lorne and the podcast on Instagram:
https://www.instagram.com/acubalancewellnesscentre/
Watch the Episode
Episode Transcript
Lorne Brown:
By listening to the Conscious Fertility Podcast, you agree to not use this podcast as medical advice to treat any medical condition in either yourself or others. Consult your own physician or healthcare provider for any medical issues that you may be having. This entire disclaimer also applies to any guest or contributors to the podcast.
Welcome to Conscious Fertility, this show that listens to all of your fertility questions so that you can move from fear and suffering to peace of mind and joy. My name is Lorne Brown. Iâm a doctor of traditional Chinese medicine and a clinical hypnotherapist. Iâm on a mission to explore all the paths to peak fertility and joyful living. Itâs time to learn how to be and receive so that you can create life on purpose.
Today, on the Conscious Fertility Podcast we have Dr. Beth Taylor. She is one of the directors at Olive Fertility Center in Vancouver, British Columbia, Canada. She is a reproductive endocrinologist, and Iâve known Dr. Beth Taylor for many years. I think we met maybe you were a resident or fellow when you were at UBC? What were you doing when I met you back in the day?
Dr. Beth Taylor:
I think it was a fellowship back in 2005.
Lorne Brown:
Yeah, okay. So-
Dr. Beth Taylor:
Long time.
Lorne Brown:
So, Beth was already curious and into integration back then because she came to my clinic with some of her colleagues to get some acupuncture, and so even back in 2005, she was quite open-minded. Now, at Olive Fertility Center, theyâre offering the best of western reproductive medicine when it comes to the technology and the care, and theyâre truly integrative, evident by that us, Acubalance, go on site for their IVF acupuncture, embryo transfers, and we have lots of discussions on integrative care to help support the women and men during the fertility journey.
Today, I thought weâre not going to talk so much about the consciousness aspect of fertility, although I know with Dr. Taylor, with Beth here, that could come up. But, weâre going to talk about some of the things Iâm around testing for quality, and in particular, weâre going to talk about how do we know if we have a good embryo and how do we know if the lining is receptive? Can we get an implant? Because there is kind of a handshake that has to happen. You have to have a good embryo and the uterus has to receive that embryo in order to have an ongoing pregnancy.
So, since these embryos are so precious, I mean, theyâre all precious, but as women age, they become more precious to them, and if they donât have a lot of embryos in an IVF cycle, wow, now theyâre really precious because you only have so many, and so we really want to make sure weâre putting in an embryo that has the chance to become a baby, and I thought I would ask you about some of the testing that you guys do when it comes to knowing whether that embryo or not has a chance to turn into a live birth.
Dr. Beth Taylor:
Thanks, Lorne. Thereâs lots of new stuff happening in this area, so itâs kind of fun to talk to you about it, and Iâll use your model. Youâve always talked about the seed and the soil. Those are the two parts that make the plant grow or the baby grow, and if we talk about the seed, how do we make sure the seed is healthy? How do we make sure that the embryo is healthy? What that means then is a healthy embryo is more likely to stick in the first place and give you a positive pregnancy test. Itâs less likely to miscarry, more likely to make a healthy baby that you have in your arms nine or 10 months later. So, the health of this seed is so important, and thatâs predicted mostly by the womanâs age. More and more weâre realizing the male age matters too.
But, when we say healthy, what does that really mean? Well, it means a lot of things in an embryo, but the biggest thing that means is is it chromosomally normal? So, does it have the right number and structure of the chromosomes in the embryo? We can test to figure out if it does or not, and that testing is done before we put the embryo in. So, itâs preimplantation and itâs genetic testing, so itâs PGT, and when weâre looking for chromosomes, itâs got an A at the end because itâs for aneuploidy which just reflects the number of chromosomes, and weâre looking for abnormal numbers of chromosome, so itâs aneuploidy. So, PGT-A is what weâre talking about when weâre saying, âLetâs test that embryo, letâs test that seed to see its health status.â So, PGT-A is a test thatâs being used more and more often. Thereâs some controversy with it, like any tool we have in medicine, thereâs some controversy with it, which we can talk about as well. But, thatâs what the testing is called and it involves biopsying an embryo to see whether itâs normal or not.
Lorne Brown:
Well, letâs talk a little bit about that IVF process and getting to the biopsy because some of the listeners have gone through this, but there are some that may not even know that this is available or are about to embark on an IVF. So, in an IVF cycle, and this is going to be a short and sweet version of IVF, but you use drugs to stimulate several follicles in the ovary, and you go in and retrieve those follicles, go in to retrieve the eggs from those follicles, and in the lab you inseminate and these eggs get fertilized and they grow into embryos over a five day period. The biopsy that youâre doing then, these embryos, so you retrieve the eggs, theyâre fertilized with sperm, seminated, which in turn hopefully fertilized the egg, and theyâre going to grow. Youâre biopsying them on day five, ideally. Some of them though you do have to grow, Iâve noticed, longer. Some take up to day six or seven, right? For biopsying.
Dr. Beth Taylor:
Thatâs right. We biopsy day five, six or seven, which is five, six or seven days after weâve created the embryo through fertilization. Day five and six are about the same, similar chance that an embryo will be normal, the biopsy goes well, similar success rates with those embryos. Day seven we start to see a bit of a decline in success rate and even just the chance that itâs a healthy embryo.
Lorne Brown:
When youâre doing this biopsy, itâs at the blastocyst stage, and thereâs kind of like two stages to this blastocyst, you have these inner cells and then the cells that are going to become the placenta. A lot of patients are like, âI donât want you to take any cells from my baby.â Youâre not taking cells from the baby when you do this biopsy.
Dr. Beth Taylor:
No, thatâs right. So, thatâs why we wait five, six, seven days to do the biopsy, because at that point the baby has separated, differentiated away from the placenta, and so the baby is⊠When you look at these embryos, day five, six or seven, itâs very clear this is the baby, and then thereâs cells that are around the baby, and thatâs the future placenta. Itâs called the trophoblast, that trophoblast at that stage, and itâs the trophoblast we biopsy. We donât biopsy babies. Doesnât that sound horrible, even to say in one sentence?
Lorne Brown:
I know, but itâs important to-
Dr. Beth Taylor:
It is.
Lorne Brown:
⊠share that, right? Because when they say⊠I mean, we see the people that go through this, they want this to work so badly. Iâm always amazed, and weâll tie this into the conscious part right here as theyâre already in love with this baby before theyâve met this baby, before itâs even implanted. Itâs amazing how this is beyond space and time when you look at it from a conscious perspective. So, just the idea that youâre biopsying the embryo, Iâm sure you guys see a lot of the patients get quite concerned, quite worried that youâre going to take cells from that. How do you put them at rest that this is not damaging the placenta and obviously not the baby because youâre not taking cells from whatâs going to become the baby, but do you have ways and the science to share with them how this is okay?
Dr. Beth Taylor:
Well, firstly, as they say, the proof is in the pudding. We have tens and hundreds of thousands of babies born after PGT that are healthy, so we donât think weâre harming these children, thereâs no evidence of that. Healthy babies, just like any other IVF baby. There is a small chance of harm to an embryo if the biopsy is done. Too large a biopsy taken or thereâs an issue with how the cells are handled, there can be damage to an embryo, which is why we donât tell everyone to do this. But, the risk is really small. Perhaps 1%, perhaps 2% is what most studies show that thereâs a risk that you could damage an embryo just by handling it like that. But, really 98% chance that weâre not doing any harm at all. Weâre getting really valuable information, is the upside.
Lorne Brown:
At this stage of the development, when itâs called a blastocyst around day five and six, it seems like us humans are like salamanders, these things just correct and duplicate. So, itâs not like the placenta is going to be missing anything.
Dr. Beth Taylor:
Well, thatâs right, and remember the placenta at that stage might only be 300 cells and eventually itâs going to divide enough to become hundreds of thousands of cells, and then thatâs so early on in their lives, these cells are all we call pluripotent or totipotent, like they have potential to become many, many different things and many, many cell divisions to become much bigger and larger. So, really weâre not harming the future placenta, thereâs no evidence of that.
Lorne Brown:
Yeah, Iâm always amazed just how we have this innate ability to regrow things and fix things at such an early stage, which what you guys have now are⊠Weâve seen this in salamanders, but we see this in human beings, weâre like them, at the early stages, and youâve seen this in the science with the PGT that you guys do.
Dr. Beth Taylor:
Well, thatâs right, and wouldnât it be nice if we could keep that healing and proliferation that happens at the embryo level, and even as children that they can procreate. If youâre a child and you cut their arm, boy it heals amazingly, right? Weâre just able as humans when weâre young, weâre just able to regenerate that, and thatâs certainly happening to a manyfold in the embryo.
Lorne Brown:
So, I want to talk about the different types of genetic testing and why you would do this. So, letâs start off with just the most common one, and you talked about PGT aneuploidy, PGT-A, back in the day, thatâs what it was also called PGS and also CCS. Is that the same test?
Dr. Beth Taylor:
Exactly right.
Lorne Brown:
Okay. So, itâs the same test that weâre talking about here. When do you counsel patients to do this? Whatâs the upside of doing this test? Why would somebody want to do this test?
Dr. Beth Taylor:
We should be doing this test if weâre interested to know the chromosome status, and if you know the chromosome status of an embryo, you know if itâs healthy or not, a healthy embryo is more likely to stick, and itâs less likely to miscarry. So, someone who has had many miscarriages should really think about PGT-A, because the reason theyâre having many miscarriages, which everyone knows are traumatic, physically, mentally, emotionally, theyâre one of the hardest things a couple and a woman in particular will go through, is a miscarriage. So, avoiding a miscarriage is good enough reason in my mind to really contemplate PGT-A for everyone. Miscarriages are, besides the emotional side, physically hard on the uterus, they can leave women with scarring of the uterus and make it less fertile in the future. So, we really want to be cognizant of what it means to miscarry, not underplay that.
Because most of the big studies that look at the value of PGT-A have shown limited value in women under 35, if you donât consider miscarriage. Okay? But, in over 35 itâs shown value. The thinking there is that if you donât biopsy these embryos and you just put them in the woman, one after another, month after month, the outcome is the same whether you biopsied them or not, and that makes sense. If you had four embryos and you had a biopsy, you knew that one of them was normal and you put it in, that person will have a baby. She got that baby from one embryo transfer though. The other person who had four embryos and only one was normal, she might have had three embryo transfers and two miscarriages and a really big delay because that takes time to have transfers and miscarry. But, eventually, the end of that story is that she did have that normal embryo transfer and she had a baby from it.
So, the story at the end, a year later, 18 months later, was exactly the same, and thatâs the argument against PGT-A. That ultimately if you just used the embryos, you didnât need to do the biopsy. But, I think, the counter argument there is that three embryo transfers are really expensive, theyâre time consuming, theyâre emotional, and potentially putting you at risk of a miscarriage if youâre putting in an abnormal embryo. So, I think thereâs lots of reasons that donât show up in that final live birth rate data point, that suggests everyone should contemplate PGT-A.
Now, there are definitely exceptions to that, and if you look at our centerâs numbers, about 60 to 70% of our patients are doing PGT-A and the rest are not, for various reasons. For example, the woman under 35 who has one or two embryos, she might just opt to put them in, and the cost is probably the same, and sheâs not putting her embryo through a biopsy, even that one or 2% and the outcome has the same story whether she biopsied or not. So, thereâs definitely scenarios where we make the decision, even later on in their treatment, we start out thinking weâre going to do PGT-A and then change our mind as we go along. But, Iâll circle back.
So, thereâs some women it really, really makes sense for, and thereâs some women it really, really doesnât make sense for. But, for the vast majority of people, it generally makes sense nowadays to do PGT-A. When we think about it, what area of medicine are we not wanting to get more information from? What area of medicine where weâre going to blind yourself to information that we could have, that could potentially help us, in this case avoid miscarriage or just even more likely have a live birth.
Lorne Brown:
I want to summarize what you shared because itâs such a common conversation that we see with our patients that are going through IVF at your center. So, I like the math side of it because itâs coming down to odds, and as you put it so nicely, is thereâs that individualized aspect of whatâs going on for the patient, because not just the stats of live birth but the emotional toll, and the physical toll on the individual, and financial costs of unsuccessful transfers. So, what Iâm understanding from our conversation is, like you said, the live birth rate, if you took somebody and she has four embryos, and you donât test and only one is normal, but you didnât test, but we just know this because we know things, then thatâs the only one thatâs going to stick, and we donât know if youâre going to put that one in first or if thatâs going to be the fourth transfer thatâs going to work.
So, when you test, youâre saving that person time because now rather than wasting their time and money putting in the three abnormal embryos that wonât stick, or will and then miscarry, youâre able to go right to the embryo thatâs going to work. So, youâre saving time and saving money by putting that in right away. But, like you said, if you gave the person 18 months to do all four transfers, either way, whether she did testing or not, sheâs going to have a live birth, itâs just that it may take 18 months longer and more time and more stress and trauma around that transfer. Correct?
Dr. Beth Taylor:
Agree.
Lorne Brown:
Now, when people get older and they have three or four embryos, if you donât test and you spend 18 months putting them in and say theyâre all abnormal, this is when it becomes individualized, right?
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
They may miss out on the opportunity of doing another cycle to get a normal embryo. So, if they did four, if youâre able to get four day five, and all four abnormal, then this individual, and theyâre in their late thirties, they right away can think about doing another IVF to see if they can get a normal embryo, versus if they wait and put these in and they donât know, 18 months later, at age 30, 18 months is a lot of time for egg quality to decline.
Dr. Beth Taylor:
Thatâs right. 18 months matters in your late thirties. Thatâs right.
Lorne Brown:
Yeah. So, with our listeners, itâs important that thereâs the testing but then thereâs the expertise that you get when you talk to somebody like Dr. Taylor, because it becomes individualized, it comes the emotional, financial costs, but also the cost of time, and so stats will say you got the same chance regardless, so donât put them in. I donât know if you know, Beth, but before I was in Chinese medicine, before I was an accountant, my degree is in math, and so my stat teacher said, âStats always lie.â So, you can make stats say anything you want, so be careful of the statistics in general, and thatâs where you need to have that personal individualized care which you guys offer, to ask those questions. What about the embryos that come back? So, if an embryo is abnormal, you guys wonât put them in because itâs not going to work, or youâre going to create a deathly ill child.
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
Thatâs the idea. You guys wonât transfer abnormal embryos.
Dr. Beth Taylor:
We have exceptional circumstances but generally we wouldnât advise. Itâs not going to give them a baby, and thatâs what they came for.
Lorne Brown:
So, theyâre not going to get the baby, and our goalâs healthy baby.
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
When you do the genetic testing, youâre testing for chromosomes. So, do they have the right number of chromosomes? There are some conditions that this will pick up, correct? I know it picks up Down Syndrome.
Dr. Beth Taylor:
Yes, thatâs right.
Lorne Brown:
But, this is not testing for some severe genetic diseases, the PGT-A test.
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
So, you have another test for that. If you know thereâs a serious illness, a hereditary illness in the family, thereâs another test for that.
Dr. Beth Taylor:
Yeah, thatâs right.
Lorne Brown:
Well, weâll talk about those. I also want to talk about just the mosaic embryos as well before we go onto those, just to let people know whatâs available. But, itâs not always black and white with the testing. So, you can have a normal embryo or abnormal embryo when you do the PGT-A testing, but sometimes you get a mosaic embryo, and thatâs where we see a lot of controversy about whether you should transfer them or not. Can you tell us what thatâs about and how you look at that in your clinic when you see couples or women that have mosaic embryos?
Dr. Beth Taylor:
Right. Youâve said it right. When we get a report back on the embryos that were tested, it will be normal, abnormal or mosaic, and about 20% of the time it will come back saying mosaic. Youâll know that when we do the biopsy of the placenta or the trophectoderm, what weâre actually biopsying at those cells, thereâll be a cluster of cells, 10 or 15, 20 cells, some number of cells are coming out in that biopsy, and theyâre sent off. What happens is that if theyâre all normal, we call the embryo normal. If all of those 10 or 20 cells are abnormal, we call it abnormal. But, sometimes two cells in there will be abnormal. Weâll have the Down Syndrome number of chromosomes or some other chromosome problem, but the rest will be normal, and so they call that a mosaic. Now, thatâs when youâll talk to your doctor here or one of our genetic counselors, and say, âHey, what do you think about this mosaic? What does that really mean?â Remember, if we didnât do this testing, we wouldâve put that mosaic embryo into you.
Lorne Brown:
Yeah, thatâs an important point, I want to bring this up. Before this testing was ever created, invented, but Iâve been practicing since 2002, since 2000, 2002 with fertility, that was IVF. You guys were putting in abnormal embryos because people get quite concerned, âOh, my god. I have an abnormal embryo, a mosaic.â If I donât test you, thatâs what IVF was. You guys were putting back abnormal mosaic embryos-
Dr. Beth Taylor:
Put in mosaics for the last 30 years, thatâs right.
Lorne Brown:
All the time.
Dr. Beth Taylor:
Yeah.
Lorne Brown:
Anybody youâre not testing right now, because you donât test everybody, theyâre likely putting back abnormal, it doesnât work, or mosaic embryos.
Dr. Beth Taylor:
Thatâs right, and weâre not creating a whole bunch of genetically abnormal kids, and we know that because thereâs been nearly 6 million babies born from IVF around the world, most of those are not PGT tested, and weâre not causing problems. So, we know that transferring mosaics is a fine thing to do. It does have a lower success rate though because sometimes that mosaic reflects that, yeah, actually there are a lot of abnormal cells in this little one, and so probably itâs actually not that healthy and itâs less likely to stick. Then in other times, we know that the bodyâs really good at healing and it will heal out or expel or not procreate, proliferate, I should say, those abnormal cells, and so you end up with a normal healthy child.
Lorne Brown:
I just got to bring a little Chinese medicine part because this is what I love when I see the medicines coming together. This is one of the tenets of Chinese medicine that the body has this innate ability to heal. If it has the right environment, it can self correct within reason, and itâs neat that you guys⊠This is something thatâs discussed in 2000 years old, how they observed the body. But, now with the lab, you guys are actually seeing some of these embryos that you see themselves, correct?
Dr. Beth Taylor:
See it self correct. Youâre absolutely right. Yeah.
Lorne Brown:
If you have a healthy egg, and this is why we love doing the preconception care, Iâve been told that sometimes spermâs not so great but the egg also does some repair even if it gets an average guy. So, again, we have a strong female, you can still⊠Itâs kind of like how the familyâs raised, right? You got the strong female, that feminine energy, you could create a good child. I will share with everybody that you can have divine masculine, that means thereâs feminine energy there. Iâm not talking you have to have XY chromosomes here, Iâm talking with that feminine energy. But, we see this with egg quality and sperm quality that the egg sometimes can-
Dr. Beth Taylor:
Can heal.
Lorne Brown:
⊠sit there and take average not so good sperm, and then it does some correcting and makes a fine embryo.
Dr. Beth Taylor:
Thatâs right. Yeah. So, we will see that that correction happens. So, mosaics are worth considering in having discussion, but the current threshold is 50%. So, if 50% or fewer of the cells are abnormal, generally encouraging people to transfer those embryos.
Lorne Brown:
Okay. Youâll always still transfer the normal embryos first. So, if you have genetics⊠If you biopsy the embryos and you have, say, four come back, three are normal and one is mosaic, you put in the normals first, one at a time normal is well, right?
Dr. Beth Taylor:
Thatâs right. Thatâs right.
Lorne Brown:
So, the mosaic is the last one of your selection, you still go through the normals.
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
You guys are seeing pregnancies and healthy babies from these mosaic embryos that are below that 50% threshold.
Dr. Beth Taylor:
Thatâs right. We are, and in our local data weâre presenting this fall at the Canadian Fertility Society meeting, and also there have been other publications of thousands of mosaic embryos, and no surprise weâre seeing healthy babies.
Lorne Brown:
This is what I like about the integration because I feel that the preconception times, so the lifestyle, the diet, the meditation, what weâre doing with the acupuncture and laser, and our clinics, at preconception weâre helping the sperm and egg get to their peak potential, the time of conception. Or, when you do IVF fertilization, and you guys are like youâre doing the grading, youâre like the report card. âDid we study well enough? Did we prepare well enough for this exam?â During the IVF, when you guys do what you do so marvelously with your drug protocols and going in and retrieving and how your lab just can grow such nice embryos out to day five, itâs just a nice integration and itâs a nice opportunity to see how well weâve been able to help prepare that body, that cellular environment to help them reach their peak potential to give them a better chance.
Dr. Beth Taylor:
I couldnât agree more. I think that creating a healthy embryo is a marathon, and at the fertility clinic what we do is we provide water and cheer on the embryos at the last two miles. But, what you guys are doing is actually getting them ready for those last two miles, and thatâs so critical because we are really neglectful of that first part of the race, which I think we really lean on you guys and should moreso to give us the best possible eggs to get to that beautiful finish line.
Lorne Brown:
Well, and thatâs the key. So, the goal is the finish line, healthy baby. We share three groups. So, thereâs Acubalance, or if youâre seeing your Chinese medicine, naturopathic physicians, you got the fertility clinics, so in this case itâs Olive, and then you have the person going through IVF. So, thereâs three of us that have a shared goal of that finish line, which is a delivery of a healthy baby with a healthy mom, and if a fatherâs involved, a healthy father, right?
Dr. Beth Taylor:
Thatâs correct.
Lorne Brown:
Thatâs the goal. You said it, weâre at the beginning, that big part of that race, so we help in that part of the marathon, and the way you said, youâre giving the water at the end, yeah, but if you donât finish the race, you didnât finish the race. So, thereâs integration. So, there is no⊠We just need both parts and your part is so exciting, the western part, the technology, Iâm always so fascinated with it, which is why I enjoy integration that we do with you guys, and Iâm glad that you see the value in the marathon in preparing before the IVF.
So, what are the others⊠Weâre going to go into the receptivity side, the uterus side, because not all genetically normal, chromosomally normal, So, the PGT-A, whatâs on average the success rate when you put in a normal embryo?
Dr. Beth Taylor:
So, itâs about a 75% chance youâll have a positive pregnancy test, and then about 8% will be miscarried after that. So, itâs about a live birth rate in the mid 60s.
Lorne Brown:
So, again, letâs just put that into perspective, and itâs unfortunate but we canât⊠Unfortunate as in thereâs no guarantee, right? Nobody can say, and run from anybody that says if you work with me a hundred percent success rate-
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
⊠because it doesnât exist at the time of this recording, anyhow. But, in 2002 the success rate was well under 30%, I think.
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
Now, you can get up to 60%. In nature, meaning youâre not doing IVF, youâre in your twenties, and youâre having unprotected sex and trying to conceive, the chances are what? 25, 30% each cycle?
Dr. Beth Taylor:
Thatâs right, yeah.
Lorne Brown:
Youâre saying 60% live birth rate through genetic testing. So, pretty impressive then, what technology can do to help us increase your chances in a cycle to get pregnant, without IVF genetic screening in your prime is in that 30% range, and with the testing itâs over 60%.
Dr. Beth Taylor:
Thatâs right. IVF was the first big leap. I think PGT was the next big leap, but I canât, and brighter minds may be able to, but I canât see the next big 10, 15% leap myself. I can only see two and 3% leaps, and thatâs this Receptiva, that sort of testing. I canât see the next 15% leap in pregnancy rates per embryo transfer, but I can see where the low hanging fruit, Chinese medicine, some new technologies like laser ultrasound, certain medications, certain testing of the endometrium, the microbiome, all those things that are kind of coming at us now, I think, each one is 2%. Then many two percent will get us to another 10% rise. So, then a year or two from now, weâre sitting here talking about 75% live birth rates.
Lorne Brown:
Youâre right. Anybody whoâs gone through fertility treatments will take 2%, 3%, 4% increase, because-
Dr. Beth Taylor:
We will all do it all day long. Itâs true.
Lorne Brown:
Weâll do it all day long, and I think we didnât see PGT really coming through either. I donât think it-
Dr. Beth Taylor:
No, no.
Lorne Brown:
⊠was super obvious, and so stem cells, or somebodyâs going to figure something out, Iâm sure itâll come, but for now weâll do the marathon. Weâre going to talk about these things where you talked about the microbiome and all those things about receptivity because I remember when genetic testing started, they thought it was the solution again, that weâve solved kind of infertility, and itâs turned out thereâs a big increase in pregnancy rates doing this, or saving time as you shared, and weâve learned that the uterus plays a big part too, because I think back in the early â2000s my experience was, my understanding was, a lot of the fertility clinics kind of dismissed the uterus, âWe just need to get a good embryo.â They werenât so concerned about the uterus, but now you guys are very concerned about the uterus, and it makes sense because, again, yin yang and Chinese medicine, thereâs always this handshake, right? One may look like itâs more important, but still without the other, you donât get it, right?
Dr. Beth Taylor:
Isnât that true?
Lorne Brown:
It doesnât happen. Maybe weâll circle⊠I know I told you guys weâre going to talk about the other testing for other diseases, I think itâs basically you guys just have other biopsies that you can look for diseases, right?
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
So, you can bring that in. But, when these normal embryos arenât implanting or youâre seeing implantation failure, they donât make sense, you guys now are looking at the uterus in more detail for its receptivity. Can you talk a little bit about that? I think thatâs why weâve been on site with you guys for a while is weâre there to try and help with uterine receptivity-
Dr. Beth Taylor:
Receptivity.
Lorne Brown:
⊠because on transfer day, the marathon is over, we canât do anything to prepare embryo quality, itâs all about uterine receptivity. So, letâs talk about the technology and testing that you guys are doing to find out about uterine receptivity.
Dr. Beth Taylor:
Right. So, even when I first⊠Well, when we both first started, we used to just blame the embryo when a woman didnât get pregnant after a transfer, âThat must not have been a good transfer.â But, then we have testing that shows, âNo, actually this is a normal embryo,â itâs chromosomally normal, it looked beautiful under the microscope. Geez, that really sort of shifted our focus to the uterus, more than ever. Thatâs led to some groups doing some really neat things, looking at the microbiome, looking at levels of infection in the uterus, and looking at what proteins are in the uterus when an embryo sticks and what are there when it doesnât stick, and are the right genes being turned on to make those proteins at the right time? That is receptivity testing, endometrial receptivity analysis is what itâs called, ERA, and thereâs several groups around the world.
We use one from iGenomics, which is the biggest ERA testing group in the world, but there are others doing this kind of work. What we do is we know, people have studied this in the â90s, and in the early â2000s, what a uterus that will stick an embryo, what the protein and gene profile looks like, if you take some of the uterine lining out and look at it on the day of implantation. So, we know what that looks like, and then if youâd biopsy someone, and say, âWell, actually yours doesnât look like the receptive one, how can we make it receptive?â Then we can get some advice in changing progesterone dosing is the big thing weâre changing right now.
So, ERA is involved in taking a biopsy of the lining of the uterus, around the time that you were going to put an embryo in, and saying, âHey, is this a receptive lining?â And the answer is yes or no. If itâs not a receptive lining, what can we do to make it receptive. Progesterone dosing is the big one, but I think thereâs going to be more things come out over time about how we can make that uterine lining look more sticky.
If you were to just take the population and test every woman walking down the street, youâd find that most women actually have a receptive lining, so only about 15% of us donât have a receptive lining, but picking out that 15% and helping them make their lining receptive, now youâve upped your pregnancy rates in that group of people, youâve really helped that 15% of people and overall youâve raised your pregnancy rates. So, again, thatâs chipping away, getting higher and higher and higher pregnancy rates, but youâre really benefiting the 15%, and this is, again, going back to your stats background, Lorne, and personalized medicine mixing together in a brew that can really help people and really harm people.
So, a lot of people take an ERA and go, âWell, if you look at statistically then, most people donât need this test, so we shouldnât be doing it on everyone.â But, boy, that 15% of people who had their lining identified as not receptive and it was adjusted and made it receptive and they had a child, that was big for them. So, that person needed it. So, now youâve got to put a lot of people through this test without a benefit to them. So, when I talk to patients, Iâm saying, âIâm going to talk to you about a test that I think is important for you to do, but you probably donât even need it.â
Lorne Brown:
Letâs talk about those who could need it, and weâll bring in, again, so I got my math background, I used to be an accountant, now Iâm doing Chinese medicine, and I really think it helps with this discussion-
Dr. Beth Taylor:
Sure.
Lorne Brown:
Because the policymakers are looking at the budget, as they should, right? Taxpayersâ money and insurance money, and so if itâs a small percentage, the average population, they canât recommend it, right?
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
Because theyâre just going on stats. But, there is no average human being. Thereâs just you, right? The person in front of you. But, we make decisions based on the population. But, in this case, thereâs the individual in front of you, and the individual in front of you wants this thing to work, and this is where it becomes individualized. So, first part is you use this, the statistics, to help us make general ideas, and itâs general, and this is why you still want to talk to the experts. So, talking to you is where you find out where it does benefit that individual.
So, thinking of somebody who is going through a donor egg cycle, like Iâm thinking of the cost for that individual. The donor egg cycle is much more expensive than an IVF with your own eggs, for example. So, this is where the⊠Iâm not saying donor eggs should do ERA, Iâm bringing up that if somebody is doing donor eggs, in most cases they have been on this journey for a while.
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
So, there is a cost emotionally and financially for this person, and so now theyâre not looking to see a failed one or two more cycles before you recommend an ERA. Iâm sure that if I was that woman in the chair, and I did a donor cycle, or you put in a normal PGT-A embryo for me, and it didnât work, and then you say, âWell, next time weâll do an ERA.â I would say, âWhy didnât we do it the first time?â
Dr. Beth Taylor:
Thatâs right, yeah.
Lorne Brown:
So, this is the individualized side of it. So, can you talk more about how you counsel, and so the women can go and talk to their experts about this test and why you like it, even though only 15% of the population may benefit.
Dr. Beth Taylor:
Itâs tricky, and weâve published some studies largely by Dr. Gary Nakhuda, but weâve published our experience here and a few other groups have published their experience where you take a hundred women and you put them through ERA, and statistically speaking you donât see a huge benefit until youâve had failed embryo transfers, right? Because on the statistics side, you need failure to show a delta, to show an improvement. So, we donât see a big push for ERA before the first embryo transfer, and if youâre going to be a purist, an evidence-based doctor based on population studies, youâre actually not going to do an ERA before your first transfer, youâre going to wait one or two failed transfers, and thatâs what a purist would do.
But, the truth is is that you look at the person in the eye and you go, âYou have one embryo, youâve been trying to have a child for seven years, this is a test, it takes a month to do, costs about $1,800, that will allow you to walk into that embryo transfer knowing that you really did everything you possibly could, that science can give you at this moment in time, I think itâs worth considering this test, and Iâll walk through what the test involves. The harm of the test is only the cost. You do lose a month because youâre going to go through the whole treatment as if you were putting an embryo in, but you donât put an embryo in, instead you sample the uterine lining.â
Lorne Brown:
Yeah, I want to share that with the listeners. So, when you do this receptivity test, itâs like what you call a mock cycle. So, theyâre not trying to get pregnant that cycle.
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
Youâre just going in and youâre biopsying when you would want to have put in the embryo and seeing what it looks like because youâre going to do the same thing the next cycle, and so you want to make sure that itâs receptive.
Dr. Beth Taylor:
Exactly right, and then you have the biopsy. The biopsy hurts. Had one done myself, they hurt, and Iâve done thousands of them. Itâs much like getting your ears pierced. Itâs like, âUgh.â Itâs a really sharp pain and then itâs done. The pain might last 20 or 30 seconds, a little longer than your ears pierced, I guess, but it is that kind of sharp pain and then itâs done, and then we get the results, and then the next month when we go to put the embryo in, weâll react to those results and say, âHey, you actually need higher dose of progesterone or eight more hours of progesterone,â or whatever that test result comes back, and thatâs really helpful, and so you can act on it right away.
Lorne Brown:
The reason youâre doing this, because we didnât really talk about this, is the window of implantation when the uterus is receptive to that embryo, is not indefinite. Itâs not like your whole luteal phase, not the whole second half of your cycle, there is a window even though youâre not going to bleed for 14 days after ovulation, or if you put in the embryo in day five, youâre not going to bleed likely for nine more days, but you donât have nine days for implantation to start. There is a window, and thatâs why youâre doing this to match up the window when you put the embryo inside the uterus.
Dr. Beth Taylor:
Thatâs right. Sink it up. Thatâs right. Thereâs times when it doesnât make sense to do that. The couple who has five chromosomally normal embryos and they want one child, maybe you put it, you do one or two transfers before going through that testing. But, for most people, making sure the soil is being optimized and really looked at before a transfer, does make sense.
Lorne Brown:
Again, it becomes that individualized care where I often say this in my practice, âThereâs no right way to do this.â If there was, everybody, weâd have the same thing done, and there is no right way to do this, and these things arenât free. So, I often say, âIf money wasnât an issue, hereâs what we can do,â right?
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
But, itâs important that weâre not making the decisions for the people that weâre seeing. Weâre there to inform, and guide, counsel, and make sure theyâre safe, right?
Dr. Beth Taylor:
Agreed.
Lorne Brown:
Thereâs a reason⊠We donât let our patients do whatever they want. There’s a reason, safety. But, itâs their body and they have to make that decision, and so they canât make a decision unless they have the information to make the informed decision, and that sounds like what youâre providing. So, Iâm glad weâve talked about this is the ERA test, the endometrial receptivity array, right? Is that what this oneâs called?
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
What about⊠This is where Iâm interested in, I think, the EMMA test, the endometrial microbiome test. Is that the one youâre using? Is that the name for everybody or are there different companies now doing the uterine biopsy for the microbiome?
Dr. Beth Taylor:
There are other companies but weâre doing it all through genomics. So, when we put a woman through the biopsy, as I mentioned, it does hurt, theyâve spent a fair amount of money to get to that point, theyâve taken medications. What it was five years ago is it was tested for receptivity with that sample. But, then the scientists were like, âWait, okay, so we can look for that. Now, what else can we look for? What else can we learn in that biopsy sample?â So currently the test doesnât just look at ERA, it now looks at the microbiome and it looks for endometritis. So, looking at bacterial content in the uterine lining. Look, I think in five years from now, itâll be looking at a hundred different things, but as it stands today, weâre looking at three different things in the uterine lining.
Youâre right, EMMA is the check for the microbiome, and thereâs an ALICE is the third part, so ERA, EMMA, ALICE, and the ALICE part is to look for infection, which is detected up to 10% of the time depending on the underlying diagnosis the woman has. So, those parts are looking at bacteria, and itâs funny, when I trained in the â90s in medical school, we were taught that the uterine lining was sterile, and itâs only been in the last 10 years, I think, people have really appreciated, âHey, wait, it actually has lots of bacteria in it. In fact, itâs got a microbiome and this is what the microbiome should look like if the liningâs receptive.â
Because itâs so new, I donât think we have a very sophisticated knowledge yet of the endometrial microbiome, itâs right now the feeling is that lactobacillus dominant endometrial environment is probably good, and people have shown this, if youâve got the bulk of bacteria in your uterus is lactobacillus, youâre more likely to get pregnant, and so if people are low in that number, then weâll give them vaginal lactobacillus probiotic which will then migrate up through the cervix into the uterus and repopulate it with the right bacteria, and that, again, so I say as it stands now, is lactobacillus,
Lorne Brown:
Those canât see, but I have a little bit of a smile on my face, and Iâm thinking of my naturopathic positions in my clinic at Acubalance balance, because Iâve heard Dr. Beth Taylor used the term microbiome and probiotics and lactic bacteria a couple times, which back in the day in the early 2000s, was considered craziness. But, itâs neat to see how the integrationâs coming, and neat from the publicâs perspective, because back in 2000 and 2002, there was a left hand and right hand and we were kind of doing different things or doing it independently and often disagreeing, which is very stressful for the patient.
Dr. Beth Taylor:
It was. I agree.
Lorne Brown:
Now, just to see how things are evolving, and that openness and that the science is there, because you practice evidence-based medicine. Back then, you just didnât see the evidence for it, and now youâre seeing the evidence. Weâve been looking at the microbiome for a long time, the gut microbiome in particular, and like you said, we thought the uterine environment was sterile, and now weâre seeing itâs different. I know, in our clinic, we still like to address the gut microbiome because itâs just the way Chinese medicine, naturopathic medicine understands the body of systems, that there is nothing separate. Even though they look separate, everythingâs always communicating and impacting. So, we believe one day weâll see and understand how the gut microbiome is communicating with the vaginal and uterine microbiome, right?
Dr. Beth Taylor:
Yes, Iâm sure of it.
Lorne Brown:
Like anything, sometimes you treat downstream as if you donât always have to go to that place that you want to target. Itâs the story I like to hear where the little boy asks the doctor, âHow is me swallowing this pill going to make the pain in my foot go away?â The pill just knows where to go, and so itâs the same thing that sometimes when we just work with the soil, the environment, the cellular environment, through diet, lifestyle, exercise, sleep, supplements, the things that we do, then they start to communicate and have a systemic effect, and so we donât always have to look for the source of where the symptom is, we can treat holistically knowing that, going back to the beginning of our conversation, the body has this innate ability to heal. It can be self correct if we just give⊠The plant analogy here. So, if we just pull out some weeds and give proper sunlight, fertilizer and water to the plant, it can thrive, and thatâs the same thing with the cellular, the body.
So, itâs great from the patientâs perspective that weâre seeing the integration come together where the left and right hand are green and theyâre working together, right? Theyâre working together, which is what weâre seeing here. So, this is fantastic with the testing. I know you guys and us, weâll use the probiotic vaginal suppositories especially for those frozen embryo transfers. In our clinic, I know the west hasnât quite got there, the IVF clinic, so much. But, the naturopathic and our clinics and Acubalance, weâll still address the gut microbiome with the speculation that that inflammation and that gut microbiome, if itâs out of balance, itâs probably impacting all parts of the body, and we know this through how it affects skin, how it affects mood, and so we just know that itâs probably in the best interest for the organism, being the human being, to make sure that gut microbiome in balance as well.
Dr. Beth Taylor:
Iâd like to see that even extended out through a better focus on the biome through pregnancy.
Lorne Brown:
Yes.
Dr. Beth Taylor:
I think what you guys are doing is important. We have blinders on. We want to get the positive pregnancy test through that first trimester, but so many second trimester, third trimester complications, I think, weâre going to realize one day, as you guys already have though, that thereâs a microbiome linked to preterm birth and early ruptured membranes and second trimester pregnancy loss.
Lorne Brown:
Yeah. We know vaginal birth versus a C-section, for example, going through the vaginal, that microbiome, what thatâs doing for the child in its immunity, so thereâs a benefit to that. Now, I have C-section babies, so Iâm not saying C-sections are bad.
Dr. Beth Taylor:
So do I.
Lorne Brown:
Okay? Because I know, itâs so easy to offend people. There is a time and place for C-sections. But, if itâs because you want to go on a trip, personally, I donât think thatâs a good reason to have a C-section if youâre trying to focus on the health of your child, if youâre doing it just because itâs convenient. But, if itâs going to save the life of the child or the mother, I think C-sections, they save lives. But, if you can have a vaginal birth, and again, Iâll never go through a birth, so itâs easy for me to say that, if you can have a vaginal birth, you should do it.
But, if we take away the pain and all the other stuff that goes with it, the joking here, but the serious part is I just want to share with what Dr. Taylor and what Bethâs saying here is the pregnancy is key as well in that microbiome, and itâs interesting because the Chinese idea or understanding of health, weâre also knowing, with science, how itâs being confirmed. For example, they say the health blueprint of your child⊠In Chinese medicine, they didnât use the word health blueprint, they said prenatal Jing and postnatal Jing. So, the health of the child is based on the health of the parents at the time of conception, but they said that conception is based on three months before on average. Then the health of the mother up to birth is creating the prenatal Jing. So, youâre influencing the health blueprint of the child, and then after the child is born, they call it postnatal Jing, and in the west now we call that your genetics, and so you get your genes, and then epigenetics.
So, what we would call how youâre living leading up to conception, and throughout the pregnancy, in Chinese medicine they say youâre constantly impacting the health of your child, good or bad, based on how you eat, sleep, stress, all that stuff, youâre constantly impacting it. Then once a childâs born, how you raise your child, feeding, thatâs how youâre impacting it. We know telomere lengths, so the little plastic tips on the end of chromosomes, theyâre not plastic tips, but we know how-
Dr. Beth Taylor:
We know, exactly.
Lorne Brown:
⊠thatâs all epigenetic factors. So, itâs neat how weâre seeing that in science. So, going back to the implantation, because this is an important part, this is the finish line, in a sense, of the IVF process. If you have a normal embryo but the uterus isnât receptive, then we donât get a pregnancy or we get a chemical pregnancy. So, when you guys do the biopsies now, youâre doing three things then, because you can do it all in one test.
Dr. Beth Taylor:
One sample. Thatâs right.
Lorne Brown:
So, youâre testing for uterine receptivity, so thatâs the window of receptivity, and if it doesnât look like itâs the right window, then the treatment on your side is you may adjust the timing and dosage of progesterone, and then you put in the embryo.
Dr. Beth Taylor:
Correct.
Lorne Brown:
The microbiome test, youâre looking to see what the microbiome looks like, and based on that, you may recommend a course of vaginal probiotics, and there is the concentration with the ingredients of that probiotic is important at this stage.
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
Youâll do that, and I see you guys doing that a lot for your frozen embryo transfers.
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
In our clinic, weâre starting to just tell women to start to do it just-
Dr. Beth Taylor:
No harm.
Lorne Brown:
⊠whether youâre doing an IVF, or trying to do it naturally, right? Just, again, youâre costing yourself money is what youâre costing. But, other than that, we see some benefits. Then youâre looking for chronic endometriosis. So, is this inflammation just from an infection or is it looking at other forms of inflammation or endometriosis, or is it just looking for inflammation from a bacteria infection?
Dr. Beth Taylor:
Itâs just looking for a bacterial infection, and whatâs interesting is that the people that have it, they donât have symptoms, but they will not implant absolutes. So, if youâve got endometritis, and thatâs treated with antibiotics.
Lorne Brown:
Yeah. People probably have cases. I have a relative who had infertility, and this was before this test existed, and her doctor just put her and her partner on antibiotics for a month, saying there could be an underlying infection, and then sheâs had kids after that, and now you can test for that.
Dr. Beth Taylor:
Thatâs why we were just treating it without the test, right?
Lorne Brown:
Yeah. Yeah.
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
Sorry, I interrupted you.
Dr. Beth Taylor:
That biopsy can⊠Yeah, I was going to extend the thought because you said endometriosis. So, that biopsy can also test for endometriosis. The sample goes to a different lab, and itâs looking for a protein called Bcl-6. So, that is expressed in women with endometriosis. So, thatâs different from endometritis. Endometritis is infection, endometriosis is a different condition that can cause infertility and it can be diagnosed. If itâs bad endometriosis, it can be seen on ultrasound. If itâs mild, it generally needs a surgical procedure where a cameraâs put inside the woman to diagnose it, or now you can potentially diagnose it with this biopsy of the uterine lining looking for Bcl-6.
Lorne Brown:
Rather than putting through a laparoscopic procedure to look for the endometriosis, thatâs the surgery you were talking about where theyâll diagnose it. You can do a biopsy as well, looking for a certain marker. Endometriosis can lead to infertility, so this is another reason to check for-
Dr. Beth Taylor:
To consider that test. Weâre doing that test as much because the evidence is not as strong for it. But, I think, again, itâs a very early onset test. So, I think as it gets better refined, we might have a better role, but that is a way for women who are wondering if they might have mild endometriosis to be diagnosed.
Lorne Brown:
Just to show that weâre kind of up to speed here, I just want to give a nod to the endometrial function test, which we talked off camera that the evidence is growing but itâs a fairly new test, but itâs another receptivity test just to let our listeners know, because I know in some places in the state, some clinics in California are using it more often, and thatâs looking again at the uterine receptivity, and thatâs two biopsies that they do for that test.
Dr. Beth Taylor:
Right. Yeah.
Lorne Brown:
So, what youâre doing is amazing because you keep going forward with the technology and you keep finding those two percents, four percents, 50% jumps, and again, you guys have your process and the evidence has to grow as well, and I like how you guys bring in the technology or youâve been the pioneers and head of the curve for so many things at Olive Fertility that youâve brought in at your clinic, before other clinics started embracing them in Canada. So, itâs always great to be working with you guys to know that our patients are getting the best of technology to help increase their pregnancy rates that theyâre going through in IVF, and the diagnostics that you get to offer.
Going back to the genetic screening, I know weâre going to wrap here for our listeners and for your time too, Beth, the other question I want you to help put their hearts to rest. Some people are quite concerned and protective of their embryos, and theyâre concerned that when you do the biopsies youâre sending their embryos away. But, thatâs not the case, right?
Dr. Beth Taylor:
Thatâs right. We should clarify that. We are just sending those cells. The embryo stays here at Olive.
Lorne Brown:
Right. So, itâs lovely because theyâre so ready to parent and love this baby and itâs just we forget that, because in the medical side you can get so into the medical side, but thereâs a person attached to that embryo.
Dr. Beth Taylor:
Thatâs right. They want to know where their embryos are going.
Lorne Brown:
I find that amazing because Iâve had people cross from me, and theyâre quite upset and worried, and the question I ask is, âWhatâs the worry aboutâŠâ And, âIâm just worried about my embryo because itâs being shipped,â and what happens to this and that, and I have to reassure them, âThereâs cells going that will never become part of your baby, itâs been sent away to test, but your embryo is safe and sound locked up in this little freezer packet.â
Dr. Beth Taylor:
Thatâs right. People ask will they get dual citizenship or something? They donât. The embryos theyâd never left here.
Lorne Brown:
All right, letâs wrap up a little bit about the integration, where you guys are at with Olive, and how Acubalance and Olive are doing that integration. So, you guys have some amazing diagnostics and procedures that youâre doing, and some great research. You are practicing integration. I noticed that you guys have like teams now, so you really are embracing that patient centered care approach, which is so well received by patients. Theyâve really been looking for that over the decades, and you guys are offering that.
Acubalance goes on site to do the acupuncture and laser acupuncture on transfer day, help with uterine receptivity, and we get to talk a lot, our teams get to talk a lot-
Dr. Beth Taylor:
Itâs been terrific.
Lorne Brown:
⊠about the integration, and you are now a proponent of preconception care is what I heard. Thereâs a marathon here.
Dr. Beth Taylor:
Thatâs right.
Lorne Brown:
Youâre so modest or youâre humble how you downplay, like youâre at the end of the race with the water. I mean you guys are there at the beginning, middle, throughout the whole process, because youâre doing the testing, so much of the workup, and all the things that you do outside of the IVF cycle, and so thatâs where the integration is great. Weâre doing the conscious aspect, which is what this podcast is really about. But, I do believe that it is bidirectional health in fertility. What I mean bidirectional, I mean it on two levels. The mental emotional impacts the physical, and the physical impacts the mental emotional. So, we need to address both, and itâs my personal opinion that itâs the conscious work, the mental emotional, the mindfulness is the missing link for some women and men on this journey, it can be the tipping point, but also the idea of this physical body needs the integration, the mental and emotional that I mentioned. But, we need the integration of the east and west here as well.
So, thereâs stuff that you can be doing to help optimize your fertility, and the stats show that age is still the biggest determinant of egg quality. So, that doesnât mean if youâre 40 or 42, that you do all this preconception work and youâll have eggs of a 30 year old. You can only have eggs of a 40 year old if youâre 40, but some people biologically are behaving 46, 47, 50 at age 40, and so can we help you get to be biologically 40. This is the part that you do with diet and lifestyle and supplements and stress reduction and mindfulness. We offer acupuncture and laser as well, and I think itâs a really nice fit when the high technology that you offer and the hands that we offer come together for these couples. So, I hope we help together make many more babies, and in that, healthy babies, healthy moms, fathers involved, healthy dads as well.
Dr. Beth Taylor:
Thanks so much, Lorne. I couldnât agree more. I think when all the best aspects of all types of medicine are working and pulling on the oars in the same direction, the patients benefit and we benefit with more babies.
Lorne Brown:
Weâre there guides. So, what I got from our conversation today is the individualized medicine that youâre looking for, the listeners, the doctors are there to inform and educate, and so come with questions, right?
Dr. Beth Taylor:
Come with questions, come with ideas, talk to them in Acubalance, and because those patients come to us best armed with the right questions, the right direction, rather than going off in all directions wondering what to do next. They come more focused, ask questions, advocate for yourself, bring up a new idea you heard about on Facebook and letâs talk about it because thatâs going to help you be a better patient in terms of understanding whatâs best for you, and understanding the rationale for our treatments. Yeah, I couldnât agree more. I jumped onto your same [inaudible 00:54:45], because I knew where you were going with that, and I just wanted to⊠Iâm echoing it before you say it.
Lorne Brown:
Like the marathon, the analogy you used, you have to prepare. You donât just start a marathon, right? Itâs not going to end well, itâs going to be difficult. Marathons arenât easy, but a lot of people do them and enjoy them, and so the fertility journey is not easy. With preparation, so, being educated, Beth said, go on Facebook, and if you hear something, ask, right? Sometimes itâs not a good idea, sometimes itâs interesting. So, being educated and doing the stuff that you prepare beforehand, and thereâs so many things that you can do through diet, lifestyle, sleep, exercise, community. Thereâs so many things that are still undervalued in our society because itâs hard to measure, although weâre starting to measure the benefit of them, that is in your control that you can do. Weâre happy, and I know I told you earlier about the integration at Acubalance, weâre happy to coach you around that.
But, itâs not like the IVF clinics like at Olive, that they only know the technology. They know about the supplements now too, theyâre talking about probiotics, theyâre aware. They may not offer everything like that, but theyâre aware of who does, and that whatâs available to you, and so you got to prepare for that marathon, and itâs the same thing for trying to conceive, if itâs not happening easily, thereâs prep that you can do to make the journey smoother and more enjoyable, because it is a challenge, and hopefully we get you across that finish line.
Dr. Beth Taylor:
Thanks, Lorne.
Lorne Brown:
Beth, thank you very much, and Iâll see you on my next transfer day there. Iâm on call on Friday.
Dr. Beth Taylor:
Excellent. Weâll see you Friday. Take care.
Lorne Brown:
Thank you so much for tuning into another episode of Conscious Fertility, the show that helps you receive life on purpose. Please take a moment to subscribe to the show and join the community of women on their path to peak fertility and choosing to live consciously on purpose. I would love to continue this conversation with you, so please direct message me on Instagram at @drlornebrown. Thatâs Dr. Lorne Brown. Or, visit my website, lornebrown.com. Until the next episode, stay curious, and for a few moments, bring your awareness to your heart center, and breathe.
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