EP 12: Fertility Challenges and Why you Shouldn't Have to Go Through it Alone


Studies show that 1 in every 6 individuals struggle to get pregnant, with every 1 out of 4 pregnancies ending in miscarriage. Fertility Coach advocate, and starter of the nonprofit organization, Everlasting Hope, Dr. Tara Brandner, sheds some light on the topics of reproduction, pregnancy, and miscarriage. Tara reminds us that it's something to acknowledge and that it's not something shameful or to be ignored. These topics should be talked about because chances are either you or someone you know is going through it. Tara reminds us that the journey to healing begins through compassion, community, and education.

When you're attempting to welcome a baby into your life, you may be struggling with feelings of disappointment and self-doubt. If this is you, know that you aren't alone. Listen now!


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Full Transcript:

0:00:00.6 S1: I'm Kate Cote, your host for today's episode. Tara Brandner works as an experienced doctorate Nurse Practitioner and fertility coach with patients worldwide. She received additional certification through the American Society of Reproductive Medicine and Marquette Natural Family Planning, after enduring a long road through infertility followed by a traumatic pregnancy, she turned her hurt into hope for others. She formed the first and only non-profit in North Dakota and South Dakota serving those diagnosed with this disease. She has been the driving force behind a legislative effort since 2019 to increase access to care for infertility and fertility preservation. Tara has expanded her career to providing coaching and telemedicine services that offer a personalized approach to infertility to fertility care and pregnancy after infertility. In addition, she offers a wide variety of women's health care services provided via telemedicine in North Dakota, South Dakota, and Minnesota. She has combined her expertise as a healthcare professional and personal struggle to help navigate couples through their family-building path. Hey, this is the Wellness Essentials podcast. WE for short. The We Podcast is all things health and wellness, a place where women like you can come to be their authentic selves and be a part of a community that supports them in their health journey in every stage of life. This is the podcast for engaging Health and Wellness entertainment with actionable steps you can take into your everyday life. No topic is off-limits when it comes to health and women's lifestyle. Let's face it, being a woman comes with all sorts of fun. Hear real, raw conversations and teachings from experts and everyday women who have been in your shoes and get inspired to make things happen and have the tools to do so.

0:02:14.0 S1: This is the WE Podcast. Welcome to the Wellness Essentials Podcast, Tara. I am so excited to have you on the show today. Can you tell us a little bit about who you are and a little bit about your background?

0:02:41.8 S2: I'm a Doctorate nurse practitioner, and I worked in rural health for the last 10 years, and then for about the last year and a half, I've shifted into women's health, specifically focusing on infertility and really helping women better understand a lot of the underlying diseases that typically present with infertility, but also really helping with the mental health part, educating them. I work with many women who actually are not trying to conceive, they’re maybe in college, or they're even on the other side, and they're done trying to conceive, but they have underlying diseases like PCOS, endometriosis, and then, of course, high level that touches all of them is just the mental health that comes along with it. I think when it comes to many of these diseases, there's a lot that needs to happen when it comes to education, and they simply want that, but specifically infertility as a nurse practitioner who went through it... I saw so many missing links and gaps in the healthcare system overall and a lack of support, and it actually started with a non-profit, I founded the first and only infertility non-profit in the state, there's no healthcare insurance for this disease, it's the only disease that has no insurance coverage once you receive the diagnosis of it, so I progressed to being an advocate and getting legislation started in the state to change that discussion and really educate them and try to get insurance for infertility but also fertility preservation, so cancer patients, young.

0:04:16.3 S2: There's a lot of teens living that, with cancer that don't have the money to preserve their fertility before, and so it just was super eye-opening to go through this as an individual, but one who is also in the medical system and sees what's covered and things like that, and it's like, why is my disease not valid? And why is it not covered? And so I then in the last year and a half, created as an entrepreneur, a business side to better help people. I do coaching worldwide, but I also have a really niche telemedicine practice that's tri-state here in North Dakota, South Dakota, Minnesota, to be able to better serve and reach more people through telemedicine. That is an incredible story, especially coming from your own experiences, kind of fueling the fire behind what you do, it's something that's very true, that just seeing women's health in general, we're not getting those dollars, we're not getting funded where you have to really fight for that, so how has your experience been in that world of things getting those dollars or getting even just being the advocate for infertility in women's health? It is emotional because I feel like...

0:05:39.2 S2: So I do a lot of advocacy work for nurse practitioners too, at the national and state level, and I feel it's really different when I step into the infertility space and do it, 'cause it's really personal for me too, and I can feel every aspect of... When I have a patient come forward with their story or testify, I can feel everything they've went through again, and it affects one in eight, that is so many people that are living with this silently and they're in a not good space mentally or physically to even tell friends and family that they're going through it, 'cause we know 61% of women do not share with friends and family, they've been diagnosed with infertility, so I also feel very honored to be able to represent such a large number of people and be that voice for them. So in 2019 is when it first started, and I more than doubled support in 2021 when we went through it, 'cause it's only every other year that legislation meets in North Dakota, you know that but it was just... eye-opening to see last-minute people sharing with their personal district legislator, their story and flipping them from red to green right down to the hour before, and so I think it also showed me, Wow.

0:07:00.0 S2: Our stories and our voice is so powerful, I could talk to them all day long, but it was when they heard from their own person living in their district, that was what really meant a lot, so it's really just been this eye-opening experience, I felt so empowered. They know at the capitol, I'm not going away. And when I say the capitol, that includes insurance companies know me, like if they hear my name, the insurance commissioner know, they all know, businesses that either for or against this know, and so it's something that I'm dedicated my life, I'm not stopping. So there's insurance coverage for this, 'cause once again, I just... As I'm talking about it and go back and I'm just like, How is this covered? I could insert many things, how is this covered? But this isn't... Let's work together. Let's really sit down at the table together. Then outside of legislation, which I've been trying to do and have had some success with, but it's like let’s try harder than outside of this to make this change and acknowledge this disease for what it is. That is so important, and the work you're doing is...

0:08:07.5 S1: I'm sure it's so intense, but it's so fulfilling because it's gonna be helping women and like you said, sharing our stories and using our voices, and I didn't realize so many people didn't share their stories about what they've been through, especially with infertility, but I could see it as being something that we wouldn't wanna share, but sharing is what ultimately is gonna get it known that so many women are suffering.

0:08:38.4 S2: Yes, yes, it's hard where there's the stigma and this like weird feeling that is hard to describe sometimes. I've been asked many times, why do you think this stigma is around there? And the only thing I keep coming back to is because we have been told or not told subconsciously consciously, I don't know what it is, that we don't talk about our reproductive system, and that includes things like miscarriage, we don't grieve as a society or as a whole when someone has a miscarriage like we do when someone has an actual physical being that they've seen and met pass away, but the reality is, is that this was life and this is a loss, and it is really a hard space to be in, and we're met with unhelpful comments, whether it's miscarriage or infertility: have you tried this? Well my one friend tried this, or why don't you just relax is the common one that we always talk about, or things like that get tossed around and it's like, You guys... This is a disease. Do people say that insert whatever disease it may be, you don't meet people with those comments or any other disease essentially, you're kinda like, Oh, how are you doing? You're doing okay? That's how we need to flip as a culture and view this too, instead of saying, Well, I know someone that had troubles too, and they did this and it worked, it's like, No, don't say these things if we're opening up to you about it, we are in a vulnerable place and we've allowed you in, just how are you doing? I'm really sorry you're going through this. And it can just be as easy as that and let conversation flow.

0:10:17.2 S2: That's true.

0:10:18.1 S1: I agree. I think more empathy in this category and this situation is so needed because it is so…women, we need that and we feel like I couldn't imagine... I haven't suffered any loss myself, but I have friends who have lost and who've had miscarriages, and that woman feels so, so much unnecessary guilt, and can you kinda go into the psychology of what you do? I'd love to hear a little bit about what is going through someone's mind when, whether a miscarriage or just infertility. In trying to get pregnant.

0:10:58.2 S2: Yeah, so there's been studies that have been done that show this is the fourth leading cause, being diagnosed with infertility, specifically is a fourth leading cause of trauma in women. Like I said, 61% don't even share with friends and family, there's been studies that demonstrate it’s as stressful as going through cancer treatment and the depression and anxiety goes for men and women, actually, 'cause we know that 50% of infertility is actually malefactor... Well, it breaks it down to one-third male, one-third female, one-third both or unexplained, and so there's a side that we're missing too with the men and the spouse component, that when it comes to this disease as well. We feel a lot of, both men and women, failure, what did I do wrong? Did I do this? Was there something I could have did differently, like you just said, you nailed it, that's exactly what goes through our head, and so we need to catch that mental health aspect of it really early on, and sometimes all they need is just to connect with a support group. Or one other person, go have coffee. That was one thing I longed for, where is somebody locally in the state, when I say locally or tri-state area that I can drive to go have coffee, I had amazing support on Instagram and Facebook groups and things like that.

0:12:20.0 S2: Never met them, that only goes so far in my head, it was that personal connection that I longed for so deeply to have, and so there's that piece of the support, it's our family and friends just once again saying, Hey, how are you? And checking in, but what I do as well, is I screen them, there's special screening forms too that we can use when they are going through treatment to check specifically for the mental health of their well-being... For that side of it. And so then I have a list of resources. Maybe it's counseling, acupuncture. Like I said, support groups, my latest favorite thing that's really been effective is hypnotherapy, and so just I know all of these other resources and tools that are out there specifically serving the fertility community because not everybody understands infertility... Even the professional field. So a big thing that we did with Everlasting Hope, the non-profit was put together a whole resource page from... Oh my goodness, attorneys to chiropractors, to any special lawyers that deal and understand infertility, so you're not having to sit and re-explain or being met with resistance when it comes to terminology or understanding, they can go click that and find somebody in that area that serves them without having to explain everything over or put themself in a position where that person may or may not say something that's not...

0:13:54.0 S2: Doesn't understand it. They just wanna understand it. So I really have this big data bank or resources, we'll call it, toolbox, I call it a toolbox a lot, that can set people up to improve their mental health when going through it.

0:14:08.8 S1: I think that is huge, and having that support system is one thing that, especially as women, we thrive in, that we thrive in with community within each other and finding common ground, and that is a huge thing, so that is great to have those resources. You talked about one in eight... Correct me if I'm wrong, one in eight women struggle... Or couples struggle with it. Has this always been... Or is this something that has been on the rise? Can you share about why the stats are so high...

0:14:43.5 S2: Yes, so it comes from... That number comes from a National Data Bank, and it comes from those who have actually sought treatment, so knowing that cost is the number one barrier to treatment and not everybody's coming to seek treatment, there's been some numbers that feel actually closer to one in six, and maybe even more miscarriages, one in four. And so there's some of us that believe it's probably actually closer to that one in four, one in six number, but it goes off of how many actually go in to seek treatment. They only have certain ways they can collect that data... Right, it's like when you enter a reproductive clinic or you get coded or billed with that number, that is when you get put into that data bank where they can collect that, and so that comes from some national numbers, we know that at one point, the numbers were close to 34,000 in North Dakota impacted alone, just in the state by it in, South Dakota same, Minnesota was a little higher. When they start to open up about it and go seek that treatment, that's where we're getting that number. There's been some surveys that have went around once again from national companies, trying to get workplaces even to add this insurance benefit, and that's when we'll see employees come forward and be like, Hey, yeah, I had that.

0:16:06.0 S2: They'll say, I had it and I didn't share or do it or didn’t do treatment or whatever the reason may be. I had infertility and The... So we wanna always encourage people too, who perhaps had infertility, even if my fourth-grade teacher has a 21-year-old son and she came forward and testified for us for legislation, even if it did impact her in the past, we wanna hear from you because that helps with numbers and stories and awareness efforts too, and so... Long and short, yes, the numbers are actually one in eight for infertility, one in four for miscarriage, but we think based on some other numbers, it's probably closer to one in six. That's a lot of people, if you think of your inner circle or your workplace, that's a lot of people. I didn't open up about sharing, you wouldn’t know that now, I can talk about this all day. And I did not talk about it until I had a miscarriage and failed three rounds of treatment, and when I opened up about it in my small, six-person... Six-person clinic, my secretary was going through the exact same thing at the same time, and so it really is eye-opening, how many are sitting right next to you or in the same office or connection every day that have had this...

0:17:25.3 S2: Or are currently going through it.

0:17:28.2 S1: It's so impactful to hear those numbers and hear how... I just had a brunch the other day, four of my girlfriends were over, one actually has opened up about her struggles. You're right, when you get those groups together to start talking about it, more and more women are coming forward and saying they've been having troubles as well, so... You talked a little bit about your personal journey. I'd love to learn a little bit about your journey and how this started that fire in your heart to follow this, so can you share a little bit about what you personally went through?

0:18:01.0 S2: Yes, absolutely. I always like to think my story starts similar to many like you're told, try for a year, some are told six months, depending on. Which I don't believe anymore. My whole view on that has changed completely like if something is off with your body and doesn't feel right, that is when you go to seek treatment. So I would like to disclaim that, like do not wait for six months or a year if your periods are abnormal or you just feel like something isn't right, or you just want a preconception work up to make sure everything's okay. Go for that. Do it like a well female exam and have a conversation, but I did the whole year. In that year, we had a miscarriage, tried naturally, and that was what triggered me. Something isn't right. It got dismissed it, by my first health care provider completely along with some harsh, rude comments in my opinion, so I went and spoke with my actual OBGYN, who's amazing, and she's like, We're done, it's time for you to go see reproductive health. And I was like, Thank you. And I hadn't hit that quite full year yet, so I was very thankful that she caught that when the initial person disregarded it and sent me on to the next step quickly.

0:19:11.8 S2: So we met with them and decided that doing IUI or intrauterine insemination was the next best thing, and so we did three rounds of that back-to-back and they failed, and I always joke, I could write a book about the third round failing, 'cause we were just so mentally exhausted as a couple going through it. You have to give shots at very specific times, and the tornado siren’s going off, and I grabbed it and did it in our basement. And my husband at the time was like, Just leave it. And I'm like, No, I'm not. No, no, there's no tornado, chances are, outside and if there is... Well, I'm taking the shot with me, and so I gave it in our tornado cellar. So I live in rural North Dakota, and the main medication I needed for that cycle wasn't available and was like, Oh, the doc was like, I'll send it down to your pharmacy. I was like no, trust me, I work there, they won't be able to get this... That's a specialty medication. And I had to drive, I think it was over 200 miles just to get this and to find out they had to overnight it, 'cause no one in the whole state could actually get this certain medication. So it was just like the whole cycle, parts of my procedure were off and we just joke, we just laid there after, I was like, This isn't working.

0:20:26.5 S2: He was like, We need a break. Like absolutely. The timing of all of this was the day I miscarried. So that was months, months prior, I had been selected for a once-in-a-lifetime opportunity to go to Washington DC for a month with the American Association of Nurse Practitioners for a health policy fellowship. So the time in that fellowship was when baby would have been born a month after this failed transfer, and so I always think timing, stuff like that is unique and little did I know is how important that would be in the future of legislation that I'm doing to date, but we took a break. I met a family friend of ours in the meantime, who works for one of the top fertility centers in the world, essentially, and he explained a lot... He's an Embryologist, he took time. That was when I really opened my eyes... As I was like, there's a website that shows data on clinics, like what... and treatment. Okay, and he just opened my eyes to just a general... Next up, we were looking at was IVF. And we did end up switching clinics, going out of state because of what I learned from him, at this point, I had Unexplained, which was a mind game, as a medical provider...

0:21:42.9 S2: You can't explain what's going on with me? I don't get to just put that in charts. Sorry! Not quite sure, but let's just throw spaghetti on the wall and see what's happening! I was just like distraught over this. And so finally at the new clinic, he was like, you have endometriosis, which is my whole other passion project. I've opened myself up to learning more about and how we can treat that and all of the things... And a lot of what I think is happening is there's a lot of silent endometriosis causing infertility, and so he totally changed my protocol and a lot of my weight came off my shoulders, 'cause as a healthcare provider just felt like I was just like... At their first clinic, I was angsty a lot. Here, I just felt like I could like, Okay, this guy is one the top docs in the world, people from other countries come to see him, Tara, let him do his thing. I don't care about anything but his brain, just... What are we doing next? So did IVF, we had two embryos, transferred them both and we have a four-year-old now, so one took... And there's this whole side of grieving that came along with that, I was grieving the loss of that other embryo, and then what I realized was becoming pregnant after infertility is not that wonderful, it is so full of fear and anxiousness and worry, and this whole other side happened.

0:23:07.5 S2: And so I really help women through that too, I work with a lot of women that once they become pregnant after infertility, I hang with them for quite a while, if not the entire pregnancy, I've had some women stay with me the whole time, just to have somebody to connect with, to talk to, to make sure that something isn't being missed. I help them find an OB that understands infertility too. We are different unicorns coming into the OB clinic than I would say, Sally, who became pregnant naturally. We’re not her, you've got to give us more time, you have to treat us a little bit differently, you have to understand the emotional side that comes with pregnancy after, because my journey kind of changed at 32 weeks, I started to bleed, I was helicopter-ed out, and there was a lot that came with that, luckily, everything was wonderful and fine, but I had lived away from home for four weeks and that was trauma I had on top of coming out of...trauma of infertility, and then I had an emergency c-section at 39 weeks, so it was just like, boom, boom, boom, boom.

0:24:16.9 S2: I never really got this like break until, even then you have a newborn baby, coming out of infertility, and there's emotional mental health that comes with all of that that I help women with as well. And so just going through all of that, I've just had to kind of tell myself, there's so much more to going through this than just me, and so I've really turned it into using my hurt to provide hope for others and try to change the dialogue within the medical community, within just the space on how we look at this disease, we should look at it no differently than heart disease and diabetes, just because it's our reproductive system, it just needs to be viewed differently as a whole...

0:25:04.7 S1: That is incredible, like sharing your journey like that too, and you have that first-hand experience, although very, very painful, you now can help but know what other women are struggling with, especially these residual factors being helicopter-ed out, tornado warnings, like these are things that are life happening during when you're trying to create life. And that is a huge factor. So it's good to hear you and people like you are out there being that support to women that... Those are things like an average person wouldn't think about... I wouldn't even think about those things, 'cause I've never had that experience, but then when you get those women who do, or I could in the future, I might be calling you if I have anything like that. So you shared a little bit about that, the residual things, the impactful things, can you share about some... If any, are there certain things, diseases that are maybe... Like you said, the endometriosis, are there other things, specifically are there any UTI issues, like are UTIs tied to infertility or other diseases that may be correlated with infertility rates?

0:26:19.7 S2: Yes, the most common ones I see is PCOS or polycystic ovarian syndrome, endometriosis, thyroid disease is a big one, and once again, there's a lot of... I just say there's like spaghetti thrown at the wall when it comes to how providers approach them. Very differently, whether it's family practice or OBGYN, let's even bring in... Now, the whole naturopathic side of it, right? So there's this big... What I've seen to that I have failed to talk about it, that I feel needs to be talked about is there's eastern versus western medicine, and I'm really trying to create this mindset, whether it's with patients or their healthcare providers, when I do talk to them, there's space for both of them, because whether one likes it or not, patients are seeking these things out on their own as they should be, and we need to be open to it and not so closed-minded, “there's no studies to support that” or whatever, it's like, patients don't care about that. You know, they're doing it. So either educate yourself on it or say, Hey, let's find a provider who better understands that stuff and they can become part of our healthcare team.

0:27:34.8 S2: What I really try to focus on is creating a multi-disciplinary healthcare team approach to this disease, and that often includes a naturopathic, chiropractor, physical therapy, your OBGYN, your family practice doctor, your reproductive doctor, acupuncture, you name it. There's a whole list that I feel is part of this team, like diabetics, I always say get five people on their healthcare team and that's acceptable, so I want to change how the healthcare community views this disease and sees it more of a healthcare approach and hopefully, it is bringing someone like myself into this picture too, that has this high-level vision and understanding of all those different disciplinaries, so I can help better, I help people kind of...Have you thought about this yet?  Here's why, and there is plenty of data, let's just use acupuncture, to back acupuncture and fertility in hormonal health and those kinds of things. So I have advanced training from the American Society of Reproductive Medicine and with Marquette Natural Family Planning, so I even when above and beyond my nine years of schooling to get a better view of what's available and what are my patients doing, they're doing these things.

0:28:53.9 S2: They are out there in support groups, they are talking to others, they know what's going on. As a healthcare provider, I've now educated myself, Okay, why... Let's look into this. What's going on this? Why is this working? What's the thought process? Why do probiotics help vaginal health, there's actual studies out there on it, let's take a look at it. Vaginal health is very important to reproductive health, and more and more data's coming out on things like that, and I know people are very busy, healthcare providers are very busy, and they're doing many other things other than just reproductive health. That's where I feel I can come in and help that puzzle piece, and I take a lot of time to just educate patients, that's what they need a lot, they need someone who understands, someone who's gonna listen to them... Listen to them and hear them out. And I can hear one time, I'm like, you have PCOS, you have endometriosis, you've been completely overlooked. Those diseases, PCOS, for example, data has shown it takes three different healthcare providers and the patient bringing forward, “Hey, I have PCOS. Here's why I think” doing a case study presentation basically to their healthcare provider before they get the diagnosis. Endometriosis takes seven to 12 years to get diagnosed before someone actually hears them out and sends them to the right provider, and so it's things like that that have just really opened my eyes as a healthcare provider, and been like we need to do better as a whole and hear patients out, it's unacceptable because once again, in my head, I'm going, there is no other disease that's taken this long, this much effort on the case of the patient to be heard.

0:30:42.2 S2: And I just use PCOS all the time, 'cause there's a couple of different criteria in the medical side of it that can be used for the diagnosis, and you don't always have to have an ultrasound, you don't in fact. You don't need an ultrasound at all that shows polycystic ovaries on your ovaries to make the diagnosis, and providers are kind of stuck in that, and so it's really me going “Hey, healthcare providers, let's update ourselves a little bit, or find our patient somebody who is... and be okay with patients seeing more than one provider and knowing they're gonna come back to you, they're gonna stay with you, if you don't hear your patients out and they’re being met with resistance, they're gonna find somebody else. We don't want that, we want them to stay with you, right? So let's create a health care team, let's acknowledge we don't know it all, and there's other providers out there that do know little pieces of the puzzle that could help, there's not one big thing that's gonna help with this, it's multiple little pieces of a puzzle coming together to help our patients, and let's be open to that and help, listen, just listen to our patients and help them navigate through this, whatever road they wanna take, whatever route of treatment, whether it is for fertility, for PCOS or for endo or just improving our reproductive system as a whole, let's hear them out and help them find the right person in addition to us and what we're doing on a daily basis.

0:32:10.9 S1: That is so true, what you say, and the nuance is like... I love the word nuance, I've been hearing it more in the medical field is, it's not black or white, it's not this or that. It's every patient, every person who comes into that office has a very unique case, and one case could be a mental blockage of allowing pregnancy to happen up to a case who has a severe hidden cancer diagnosis in there and everything in between, a lifestyle, everything like that, so it's nice to hear more people coming out and talking about those realities that it's not black and white, it's very nuanced. Can you go into more details about how are you educating women or couples on this, probably when they come in, they're very like, We take on the blame like I did this, my body isn't working, and how do you shed light on those different nuances...

0:33:17.2 S2: I love that. You are absolutely right. One of the very first things I do when I get them on, I'm like, How are you... Tell me anything at this point that you feel you need to be heard on. Let me hear what you've been through, where you're at. I talk a lot about what barriers or what is it that's keeping you up at night, what feels heavy on your shoulders, and that's how I start picking away at how we're gonna approach this, What have you tried? What have you been reading about?

0:33:46.0 S1: What are you being told about?

0:33:47.2 S2: Let's hear it. I had one girl and she's like, I was on TikTok and in my feed now is parasites. She's a young 20-year-old, was in a different country, and came back with stomach issues and I'm like, Well, let's see what's out there. There's gotta be something out there to test this, and she's like, No one's ever heard me out on this, they think I'm crazy like I can't eat anything without getting sick to my stomach and having all these GI issues. They've done all the traditional stuff to rule everything out, you don't think I'm crazy? And I was like, No, let's look at it, let's explore it. It might not be me, but I can find someone who understands that and we can bring them into our circle. I've had three of them in one week come forward. I feel like there's something to this, you know. And so it's like I might not be the person that can treat the parasite, but I know a couple of people that can... So let's do some testing and get you set up with them or I can consult them and see what's going on with that.

0:34:46.7 S2: And so it's really like, what are patients reading? What are they hearing? What are they seeing? I don't have time, like I said earlier, we don't have time always to be staying up to date on every little thing, but they are... The way our social space is nowadays, patients are more educated than ever and have access to so much information, and I try to rip Google away from my patients, when they come to me, I'm just like, Okay, instead of going to Google, you are going to come to me from now on. So that's one of the big things that is my coaching clients. I'm like, If you're gonna go to Google, you put it in... I have a special app that we use that they can communicate with me at any time, I'm like, If you're gonna do that, you have to also come to me so I can help change the direction of your ship and your brain and all of that, like which direction are we sailing with this, but you can go to Google then afterward. But yeah, like I said, the reality is, they're talking more to each other, there's just more dialogue going on about this, and it's really...

0:35:51.5 S2: I break it down into analyzing what they've been through, what are the barriers, what's keeping them up at night, depending on their own personal story and what they've tried, basic things like supplements, there's many providers who don't even wanna touch supplements. I'm like, You guys, stop. This is like the most basic thing is to bring in fertility supplements, you're that scared of a probiotic and vitamin D and Myo-inositol, come on... There's plenty of data to back Myo-inositol for PCOS, don't scare your patients out of supplements. And then it's looking at how is your lifestyle? You might need to evaluate your lifestyle, and that includes mental health, sleep, your environment at home, communication with each other, food, fitness, all of that. I look at and analyze all of them, and many have it in place already, others don't. I'm not a personal trainer, I'm not a nutritionist, I have a nutrition program, but some need more than that, and so it's finding them the right people to bring into our healthcare team. And then it's goals, we've set goals, every patient walks away at the end with goals a lot of the time during our first visit, they will get a PowerPoint lecture from me, I do a presentation, a lot of that's like PCOS or endometriosis, just so they can walk away with some education on their disease, and then we meet and keep going over things and making sure that they are in control.

0:37:18.9 S2: If it's too fast, we slow down, if it's too slow, we speed up, and they're always, I think just being heard and then knowing they have control back. That is a huge part of what I do. A huge part. I always make it known, no question is too silly, my inbox is always open, I may not get back to you right away, but just that it's a safe place to ask and bring up anything... I can't tell you how many patients I see, a large majority, if not all, are like, I've brought up this issue to multiple healthcare providers and no one's hearing me out, that is a lot of what I see. And so it's just, reassuring them, Hey, I'm sorry that's happening to you, sometimes this field can be busy and rushed, let's talk about it now, let me help step in here and see how I can help you, and I allow myself time for them, which I know is not available and able to happen with many providers, but it's then just knowing that there is people like me exist that can be brought in and help navigate these people through the diseases easier.

0:38:26.7 S1: That's incredible. And so good to know that you're available 'cause that I think is... That's a huge percentage of just like if a woman or couple is scared and having that fear and just that letting them rest their shoulders like, hey, there's someone out there who wants to help me and is open to exploring all possibilities, just to have that freedom, going into your office, knowing that is gonna help the success rates incredibly, I think. The team at Checkable Medical is famously fussy about what goes into their bodies, optimal health at every stage and every age is key to living a life you love. Choose better supplements with superior ingredients and simple, easy-to-absorb formats that fit into your daily life. Feel your best with Checkable Wellness. If you're ready to get started, check out, for more details. Your healthcare begins at home. I wanna touch into one thing, how do you feel the impact of our lifestyle, like we talked about lifestyle and all these different factors, how do you feel like modern lifestyle, especially for a modern woman... We're busy, we're rushed. We have to juggle so many things.

0:39:49.4 S1: I call it juggling the hats, we don't wear them, we juggle them. We're juggling these hats. How do you feel that is affecting our overall women's health in reproduction?

0:39:59.5 S2: I believe it plays a huge role and is part of what I've seen... So I do some hormonal testing a little bit differently, I do a lot of Dutch tests or urine testing on women, and almost everybody's cortisol levels and our ability to... The body's ability to manage cortisol levels is significantly impaired, and so a lot of what we don't understand too is like if your sleep is off, there's a lot that goes on doing our circadian rhythms and our cortisol levels, and that plays a huge role in insulin resistance and all of the things tied together like we have to think of the body as a whole, it's not just our ovaries, well, our ovaries are connected to an endocrine system that do a lot of other things, and so... That is a huge part. There's a lot of back and forth on food sensitivity testing, for example, too... A lot of women will be told to cut out dairy or gluten for PCOS, which could be great for them, but what it's like garlic and egg whites is causing inflammation, and like we have to kind of hone it down a little bit more and make it more individualized and personal and figure out what is going on with that person.

0:41:11.9 S2: So I do a lot of... All of what I do is individualized because I don't think each person is alike I have people doing shift work, we know shift work actually has been studied and tied to an impaired reproductive system, which they believe is our circadian rhythm and sleep cycles throwing off our hormones, our endocrine system, which in turn causes an inability to ovulate or an impact on cortisol levels and stress, and then we see weight gain and things happening, we're not gonna tell you to quit your shift work job, right. Or maybe... Maybe I will, we'll see. But it's one of those things where it's like, we gotta do an assessment, what can we change, what are we in control of, what are some things that we can pivot a little bit in your lifestyle to help better regulate your insulin levels, better regulate your cortisol levels? A lot of it is like, Let's just try this supplement or two, and let's just shift this around, 'cause we can control that right now, we can help offset some of these high spikes in cortisol levels with changing a few supplements around, for example, or changing how you're eating on your night shift and on your days off, you're gonna do this, and night shifts, we're gonna do this, and we have to understand too, if you're checking LH-strips and ovulation kits, we gotta be careful around a night shift time, it's gonna throw basal body temperatures off. There's...

0:42:32.4 S2: All of this is stuff that goes into our lifestyle that impacts our overall health from mental health, gut health, reproductive health, you name it, and I've really had my eyes opened to that in the past few years of advancing my training as a provider in this role, and being more open to what is going on the other side of medicine and having conversations with healthcare providers that are in this field and how can we work together, because working together to understand how lifestyle and gut health and all of the things impact reproductive health will only benefit our patients, you're only helping them by, once again, being open to it and educating yourself on it, and understanding that lifestyle has a huge role in reproductive health for men and women. There's a lot that goes into men, this is all for them too, so I try to tell my patients, Hey, we gotta get hubby on board, because if you're cooking for a fertility lifestyle for you, he could benefit from it too, we can improve his sperm count, we have to talk about the sperm count too. I usually wanna see them as well at some point because their sperm health usually needs some improvement as well, and it's just easier if you're both doing this together, let's just get pill planners for both of you, you're gonna get a pill planner, make it cute.

0:43:57.2 S2: Make it fun, make it a thing you just do together that it's not us as a female all the time that has this heavy load on us, it's them most of the time, more than often than not, that has a role in this too, but if not, let's just have them do something, let's cook together, let's change how we're eating its exercise together, let's do our supplements together to make this like a unity, so it doesn't feel so heavy on one of us all the time being the only one doing it. When we're trying to improve our reproductive health.

0:44:28.5 S1: This has been such a great conversation and knowing it is a couple of things, it's not just all on the women's shoulders, it's a couple... It takes two to create a baby. So that is huge.

0:44:43.5 S2: This has been such a great conversation.

0:44:45.8 S1: I wanna open it up to you. Do you have any last things you want to add that we haven't covered yet, just to put that cherry on top of the conversation?

0:44:55.5 S2: Yes, a lot of what I wanna yell from a mountain top is I just wanna empower people listening, that they are their own best advocate when it comes to their health care, you are in control. Your healthcare provider works for you, and I don't want people to feel so tied down to one person that they've seen since they were little, or they've seen for the last five or 10 years, if they feel like they're not getting heard, or if they feel things are being overlooked, that gut feeling, that intuitive feeling is there for a reason in life, especially when it comes to healthcare, you truly know your body best, you are in control of what direction you get to take with it, you get to create your healthcare team, and I never want you to feel unheard, dismissed. Your healthcare providers blowing you off or saying, I am the doctor, or they're writing off as depression and anxiety, there's just so much... Another new term is like medical gaslighting that's going on and things are being missed every day because these patients are coming in and coming in and coming, and they know something is wrong with them.

0:46:19.6 S2: They've had these symptoms. No one's acknowledged it. I just wanna continue to shine a light on, you know what's best as a patient, find a healthcare provider that will listen to you and keep looking for one until you have found that one, because they are out there. They do exist. And it's something that we need to get over. I have to stay with this one person. Get a second opinion, bring other people into your healthcare team, start today, even if it's been six months or six years or 15 years of being overheard and your symptoms still are there, start fresh and let's find somebody who will hear you out and listen to you and dig deeper, go that extra mile to figure out what's going on with you, especially your reproductive health.

0:47:11.1 S1: Amen, that is incredible. This has been such an enlightening experience just to have this conversation, I think this is gonna be great for our listeners to just know that they do have a voice and that there's a lot of light shedding on that medical gaslighting now, and you know myself as well as so many people I know have experienced some sort of that in their life, I'd love to connect our audience with you, where can people find you if they are looking for a provider or know someone who might love your services and get a lot of benefits, how can people connect with you?

0:47:47.7 S2: Yes, so I'm super active on Instagram, TaraBFertility. My website's I have a podcast where we do little short segments of Educational tips or inspiration at Hopeful Hints: An Infertility Podcast, I shine a lot on the diseases that impact infertility over there as well, and really to just know. Even if you go to my website, I have a chatbox that goes directly to me, and to just drop in any time, day or night, it's always me you're gonna get... When you do that and to just know, I'm a safe space. There's a safe space out there to, Hey, what do you think about this, or just to feel heard and validated, and if I can't help you, I will find somebody that can help you, and we'll create that healthcare team together.

0:48:37.5 S1: Thank you so much, Tara, this has been wonderful. This has been such an... An enlightening conversation and we appreciate having you on the Wellness Essentials Podcast.

0:48:47.8 S2: Thank you so much for having me. Yes, and thank you everyone for tuning into the Wellness Essentials Podcast, and we will see you again next time.

0:49:01.9 S1: We hope you enjoyed this episode of The WE Podcast as much as us. If you want more wellness goodies, head over to for show notes, links, and resources mentioned in today's podcast. Remember to hit subscribe on your favorite podcast platform to get all the wellness details as soon as they are released. Cheers to living your healthiest and happiest life.