I’m excited to have joined Meg Faith recently for an Instagram Live on “For The Baroness,” and delighted to be sharing our conversation on The Egg Whisperer Show. In this episode, we dive into how tailored approaches can transform fertility journeys, especially when it comes to customizing treatment plans based on unique patient needs. We covered everything from the importance of a thorough diagnosis to exploring innovative treatments like ovarian PRP and rapamycin.
We discussed the critical importance of understanding every patient’s story and why I believe, “There’s just no such thing as unexplained infertility.” From cutting-edge treatments to the emotional rollercoaster of fertility journeys, join us for this moving conversation.
In this episode, we cover:
- My path into fertility care and why personalization matters
- How I approach diagnosis first (including the TUSHY Method) before treatment
- When to consider innovative options like ovarian PRP and rapamycin—and what to avoid
- Practical strategies for handling failed transfers and managing conditions like adenomyosis
- Hope, resilience, and real patient stories that inform the future of fertility care
Resources
For the Barreness on Iinstagram
Find Dr. Aimee’s Fertility Essentials & Supplements
Transcript:
Dr. Aimee: Hi, Meg.
Meg Faith: Hello. How are you doing, Dr. Aimee?
Dr. Aimee: I’m doing great. Call me Aimee, if you want.
Meg Faith: I had so many people message me when I started doing these lives saying make sure you reach out to Dr. Aimee because this is just a wealth of knowledge. So, I really appreciate it!
Dr. Aimee: Thank you.
Meg Faith: And I know you’re very busy, so I’m going to get right into the questions because I had a lot of people send me great questions to chat with you about. First, just getting to know you a little bit, letting people get to know you. You’ve been in this field for over 20 years, your website said, but can you tell me a little bit about what inspired you to go into fertility care specifically?
Dr. Aimee: Yes. It’s just a personal journey. It has to do with my mom. My mom had many miscarriages. I knew when I was 3 that I wanted to be an OBGYN. I know that’s hard to believe. I knew when I was 12 that I wanted to be a fertility doctor. The office that I’m sitting in right now, this space is the same office my father worked in for over 40 years. I started working for my dad when I was 12, and my mom had many miscarriages, even late second-trimester miscarriages. She’s one of the strongest women that I’ve ever met in my life, and I would just hear her howl in the middle of the night. I said, “I need to dedicate my life to helping women who are suffering with this problem,” and so I did a bunch of research on recurrent pregnancy loss in between college summers, between summers in med school.
I’m super obsessed with helping people have healthy pregnancies. That’s a good obsession. It might not seem like a good term, and I’m okay with that, but I run at 100% and I’m obsessed with helping each and every person that I meet.
Meg Faith: I value that so much. My issue is recurrent miscarriages, and I think that in the community we hear a lot about getting pregnant, but it can be challenging to find a doctor who also doesn’t leave you at nine weeks and rather says we’re focused on keeping you pregnant. That’s the goal, getting to the end with a healthy pregnancy.
Dr. Aimee: Yes. I used to tell people I’m like herpes, I’m always with you. That’s not so much a compliment, so I’ve changed my story and I say that I’m like your luggage, you always know where I am. Once you graduate past ten weeks, just know if there is anything that you need to run by me, just let me know. I don’t want to be the person that finds out after the fact that something has happened that was wrong. If you are sensing something is wrong or if something does go wrong, let me know right away.
Meg Faith: That’s amazing. I have heard from your patients as well just how incredibly accessible you are, how you give your direct contact to them so people can reach out, and I think that’s amazing. I’m close friends with a lot of your patients. You have a lot of people go to you when they feel like they’ve kind of tried everything else or they feel like they’re just being given these cookie-cutter protocols that everyone is getting, and that’s not what you do. Can you tell me a little bit about how you make sure you’re customizing for each patient that you see?
Dr. Aimee: Absolutely. The first step is to come up with a list of what the possible issues are and see what we can do on our own before we start treatment to fix them. For example, if you’re 43, what do we want to do? We want to support your egg quality. If the sperm is not as good as good quality, we want to run some extra tests on the sperm. Before we even start IVF, we want to start supplements, we want to see a reproductive urologist, we want to check testosterone, we want to start Clomid for men.
If there’s adenomyosis or endometriosis, I don’t want a patient learning that after three failed transfers and a couple of miscarriages. We want to figure that out upfront because that’s going to be part of how we prep for transfer. We may not address endometriosis from the beginning because we might want to do IVF first. If I were a patient, I wouldn’t want to find out these things along the way in piecemeal. I would want to know all of the things upfront.
Then I design a plan for the patient that will hopefully address all of the issues that we know that we have. Then I prepare for transfer. I don’t just roll the dice. I present things to patients kind of like a menu, these are all of these things that you can do and these are the reasons why you might want to choose these and why you might not want to choose a certain option as far as testing. Then we talk about transfer protocols, why I’m going to use what I’m going to use for them, so that they don’t have to rely on ChatGPT to explain it to them. Certainly, my patients are super educated and I have a sign in my office that says, “Don’t panic. Just email me.” You know? There’s no question that is stupid or bothersome. There’s also no picture that you can’t send me. I get patients that send me lots of pictures. “I saw this clot. Can I send it to you?” I’m like you don’t need to ask, just send it to me. I have a lot of ass pictures, too. “Am I doing it right?” I think I need to delete that from my phone.
But that’s my process. I want to make sure that everyone is really excited for their transfer, that they feel like they’re ready for it, that there’s no other tests that they wish they had done, that their stress levels are low, they’re sleeping well, because if something doesn’t work, I don’t want anyone to ever say to me, “I shouldn’t have done the transfer. I knew that there was more testing that I should have done. I knew that this wasn’t a good time because my husband and I are fighting.” Those are the kinds of things that I want to avoid.
Meg Faith: Absolutely. I love that you bring in, too, external considerations.
Dr. Aimee: 100%.
Meg Faith: All of that makes a difference. When you work so hard to make those eggs and make those embryos, it’s like the most valuable thing you have, and you don’t have an indefinite number of them.
Dr. Aimee: I want to say something. I think people assume that no one cares about you and no one gives a shit anymore and no one knows your story. Those embryos are the most precious to you, and just assume that your clinic doesn’t value them in the same way. That’s really sad to say. That’s kind of where we’ve gone. That’s obviously not how I feel. When a transfer doesn’t work, it haunts me. It’s like what else can I do to help this patient? I know that there are variables that are not in our control. There are genetic issues that can happen with embryos even if they’re PGT-A normal. I think patients need to learn more than ever now how to be a good fertility patient, and part of that is knowing your own story, knowing your diagnosis, and not relying on the clinic to just know everything about you. You almost have to remind people what you’ve been through every time you go to a clinic these days.
Meg Faith: Yes. And it’s traumatic to have to repeat it. I’ve heard you say before, “diagnosis before treatment,” but that’s not the norm in a lot of clinics. I’ve been to clinics before that before they’ve even met me in person, we’re just having a phone consultation, they’re talking about the protocol they’ll put me on for IVF.
Dr. Aimee: They’re even setting the doses. They’re setting the doses for your medications and they haven’t even seen you for an ultrasound. They’re giving you a calendar without even a baseline ultrasound.
Meg Faith: Right. Then it’s like throwing spaghetti at a wall and hoping one eventually sticks. I’m sure you hear this a lot, but I know a lot of people get very frustrated when they’re just told it’s unexplained infertility. What does that mean to you when a patient comes to you and they say, “Doctors have told me I have unexplained infertility.”
Dr. Aimee: The first thing that I say is bullshit.
Meg Faith: Right?!
Dr. Aimee: It means that it wasn’t explained enough and not enough testing was done. There’s always an explanation. If let’s say you’re 38 years old, your AMH is good, sperm is good, fallopian tubes are open, it’s age related, assume it’s an egg quality issue. Right? If let’s say you have euploid embryos and it’s not working, you need to look for silent endometriosis, adenomyosis, immune factors, the microbiome. You have to keep looking. There’s just no such thing as unexplained.
When a patient gets that diagnosis, don’t call them out on their bullshit. What you’re going to say as a patient, you’re going to say, “Thank you so much,” and then you’re going to say, “What are the possible explanations in a case like mine? What do you think it could be?” Because they’re not going to not say anything to you, hopefully they’re going to have some sort of answer, but there should be some sort of helpful reply.
I asked a patient to do this the other day, it was a second opinion consult. She was having early miscarriages from euploid embryos. Then I asked her, “What does your doctor think the problem is,” and the answer was implantation issues. I’m like no, I know, but what is causing the implantation issues? You know what I mean? We need to get to the root cause of what is going wrong.
Meg Faith: I really appreciate that because whenever I think about even the idea of somebody saying that they have unexplained of any other kind of medical issue, who would take that? My friend who is a dermatologist says no one would come to me if I would say that’s an ‘unexplained’ rash. We need to explain it to treat it.
Dr. Aimee: I give presentations to large groups about this, and I make the analogy of exactly that. You have shoulder pain, you go to urgent care, what are they going to do? They’re going to do an X-ray, they’re going to see what’s wrong. They’re not going to say, “It’s nothing. Just deal with it for a year. We’re not going to do any tests. It’s unexplained.” That would never happen.
Meg Faith: Absolutely. Okay. So, I love the name of this, I love how you get all these acronyms. Tell us what the TUSHY Method is.
Dr. Aimee: It’s triple-X porn, it’s my new website. I’m just kidding. It is not.
Meg Faith: Those photos on your phone!
Dr. Aimee: It’s where I put all the ass shots that all my patients send me from their progesterone annoyance. It is not. I promise you guys it is not.
It’s basically me getting sick and tired of patients coming in and saying, “I have unexplained infertility,” and they only had an FSH level checked, or an estrogen checked, or an HIV level in a blood count. I came up with the acronym because there are five tests you can do. T is for tubes, U is for uterus, S is for sperm, H is for hormones, Y is for your genetics.
Most people can get to a diagnosis by doing those five tests. Patients can then advocate for themselves because it’s easy to remember TUSHY. How can you forget that? It makes everyone giggle. That’s why I came up with that, so it’s an easy way to remember to get your TUSHY checked. I think everyone should do that, honestly, before you even start your fertility journey. Kind of like the analogy that I share all the time, that if you’re going to make a cross-country trip, you’re not going to just jump in your car and start driving. You’re going to make sure that you took your car to the mechanic, they checked under the hood, they put gas in it. We have to do the same thing with pregnancy. Pregnancy is one of the most important times in our life, so I feel like we need to give it as much attention as we would a trip across the country.
Meg Faith: It’s so funny you mention the photos. I’m thinking back to when a friend was flipping through my photo album looking at my dog’s photos, and then she got to one and she was like, “What is this?” I was like, “Oh, that’s just blood clots in my underwear. Keep going.”
Dr. Aimee: I get those pictures probably once a day, “You have to see this clot, Aimee,” or, “What is this white thing that just came out,” and I’m like send it to me so I can tell you.
Meg Faith: Yes. Somebody just asked in the chat, the acronym is TUSHY, T-U-S-H-Y.
Dr. Aimee: All of my acronyms come with websites, so TUSHYmethod.com, you can go to that website and learn more.
Meg Faith: You did mention one, so I had quite a few people send me DMs asking for you to talk about this. They had an AMH test, and the number was very low, and now they think, “I’m hopeless.” Can you explain AMH and what should somebody think about if they do have a low level, what are their options there?
Dr. Aimee: Yes. AMH, first of all, I call it “always mean hormone.” You might have heard me say that. It’s mean. It makes us feel bad. But you have to separate the facts from your feelings. The thing is that AMH is not a good fertility test. It’s the closest thing we have to a semen analysis for a woman. I can’t give a woman a cup and say, “Here. Give me your sperm.” I wish I could. But I can do an AMH, and it kind of tells me how many eggs I would expect from them if I were to do IVF for them. It allows me to set up what their IVF pyramid would look like, how many eggs I would get, how many could potentially be mature, how many fertilized eggs, how many blasts, so then I can make a fertility plan for them based on their age.
Let’s say you are 38 and your AMH is 0.2 and you want two kids. Well, we might need to do six IVF cycles. That doesn’t mean you have bad eggs. It does not. It just means that this is your number. Everyone’s number is different. I can have a patient who I get two eggs from, and I get two euploid embryos. I can also have a patient who has 20 eggs and gets no euploid embryos. Isn’t that unfair? It’s unfair to everybody.
I wish that this was reversible. I wish there was more that I can do, aside from some of the experimental things that I am doing now to help patients, but there really isn’t anything that works 100% of the time to try to reverse ovarian aging. So, the most important thing is get your level checked, don’t take it personally, do your best to be in the best shape of your life, take your supplements, and go to a doctor that won’t shame you and start talking to you about donor eggs and start bullying you about that.
Meg Faith: I appreciate that a lot. You mentioned technology. What are some of the experimental things that you’re excited about that maybe we’re still trying to understand, but there are tools and resources that you’re like these are things I’m trying and I’m seeing results in?
Dr. Aimee: Yes. The first thing is I’m 75 years old. Do I look it? I’m just kidding. I’m not.
Meg Faith: Oh my gosh! For a second, I thought, can I meet your dermatologist?
Dr. Aimee: I wish I could put a filter on this so I’d look even younger. No. I’m 49. There’s a reason why I’m saying that. I take a repurposed drug called Rapamycin, it’s 5 milligrams once a week. I’ve been taking it for over two years. I’m not going to share my fertility levels with you because it doesn’t matter, but they’re crazy good, like you would never believe.
There is research showing that Rapamycin can increase longevity by about 15% in humans. I want to live forever. I know not everyone can relate to that, but I just know that I want to help as many people as long as I can while I’m still here. The reason why I’m telling you about this is that in the animal studies they noticed that in the animals they gave it to, it reversed their menopause and they had healthy pups. It was in mice.
Then brilliant researchers out of Columbia University did the Vibrant Study, so what they found… they hypothesized that women who took this drug delayed their menopause by five years.
Meg Faith: Wow.
Dr. Aimee: My average patient is 42 years old. That’s huge. If I can do something to delay menopause and also help you have a healthy baby and improve your chances with IVF, why not? It’s off-label. It is FDA approved. It is not illegal to use it. It’s considered experimental, so you have to be okay with that. There are a couple of side effects. I get some zits once in a while, I get mouth sores once in a while. I don’t care. When I see a zit, I’m like okay, I’m aging backwards, I’m 16 now.
But that’s one of the things I have been using in my practice for over two years now, since May 2023. I can’t believe it’s already been that long.
The second thing that I’ve been doing for much longer is ovarian rejuvenation, and that’s with using ovarian PRP. Then there are other supplements, like Ova and NAD, red light therapy, sometimes I ask patients to consider hyperbaric oxygen therapy. I use peptides in my practice. The peptide that I use is Sermorelin. I also use HGH. I’ve been using HGH since probably 2008, so that’s nothing new. But those are just some of the things that I’ve been doing. I have Google Alerts on everything and I follow longevity medicine, all the newest things that come out of longevity journals, because things that can extend our lifespan are things that can potentially help improve and support egg quality, and potentially help improve a woman’s fertility, too.
Meg Faith: That’s fantastic. Some people are asking in the chat, just so you know, I will make sure to put this on the website with a list of all these notes and tips and write them all out. If you miss something taking notes, don’t worry, we’re going to have the script go up live for everyone.
That’s so interesting. I love that you’re also using these yourself, so you can speak to what the experience is, what the side effects are. Is there anything that you hear people recommend that you would say no, it doesn’t work, I haven’t seen any good results from it, I wouldn’t recommend that one, anything you see people talk about in the fertility world?
Dr. Aimee: Yes. Glutathione. Not a fan. Don’t think it works. DHEA, forget about it. I think it just raises testosterone levels and it’s not good for eggs. When it comes to transferring, I’ve seen people use drugs like Viagra compounded. It sounds sexy, but I don’t think it helps. Trental is a pill that when it came out, we thought it might improve the lining, but I don’t think so. HCG infusion, I would say no. Of course, I’m not your doctor. These are the things that I recommend to my patients, so if for your doctor this is a tool in their toolbox that they’re like, “I swear by this,” then consider it. These are just things that I have strong feelings about.
Meg Faith: Absolutely. I think that a lot of these meds end up costing people time, too. Right? When people pursue something, you lose precious time. So, we do as patients have to make these really…as they say, ten different doctors will have ten different opinions, so we have to think at the end of the day, “What am I going to try,” knowing that this is going to take months, maybe years, and that time will get lost.
What are some other reasons you see people might cost somebody precious time when it comes to infertility treatments, when it comes to trying to conceive, trying to stay pregnant, where do you see people like that’s time lost and people don’t have to lose time?
Dr. Aimee: I would say patients who have a plan, like they know how many kids they want, but they waste time doing IUIs. I would say if you’re 39 and you want two kids, you can still do IUIs, but preserve your fertility, do a cycle of egg freezing or embryo freezing first. I think people sometimes think in their head, “I have to do six IUIs first before I can do IVF,” and that’s just not true.
It’s diagnosis then treatment. If your diagnosis is I’m 39 and I want two kids, the treatment is to preserve your fertility. I feel like people sometimes waste time with treatments that they’re going through additional procedures and treatments that aren’t going to be successful for them, especially along the lines of sperm. I hear so many times, you know how you said unexplained, “my husband’s sperm is low, but it’s unexplained.” I’m like why would you do IUIs with low sperm? That doesn’t help. IUI doesn’t make bad sperm better. It just doesn’t. I think IUI is good for people who fight around ovulation. I’m like just take it out of the bedroom and bring a cup to my office, I’ll take care of it.
In general, I think missing diagnoses like endometriosis and adenomyosis can certainly waste years of a patient’s time.
Meg Faith: So, you know I have endo and adeno, but I’ve had doctors say, “Well, we just keep trying until it eventually works.” My doctors say do these other things. How would you approach somebody who has that diagnosis?
Dr. Aimee: The first thing is to see if the endo or adeno has affected the fallopian tubes. Endometriosis can create inflammation in the tubes, so if it’s been over a year since you’ve had an HSG, that’s one thing that I always do. If there’s a hydrosalpinx, then I would recommend laparoscopy. If you have symptoms and if there are obvious signs on ultrasound that your ovary is, let’s say, stuck to your uterus, your uterus is severely flexed or tipped back, then maybe you should also consider laparoscopy and not just medical treatment, so I also consider combining both the laparoscopy and then also medical therapy. If you do laparoscopy and there is no sign of deeply infiltrating adenomyosis and there is no sign of adenomyosis, which is the inflammation in the walls of the uterus, then you can skip medical suppression. No one wants to be made to feel like a post-menopausal or menopausal woman, but the reality is sometimes treatment still is required for that.
If you have adeno, make sure it’s adequately treated. Sometimes one month is enough or two months is enough. For most patients, three months should be enough. Have an honest conversation with your doctor about how severe it is, where it is, and what the risks are going into a pregnancy. We know adeno can increase risk of implantation failure, miscarriage, second-trimester loss, postpartum hemorrhage, and hysterectomy.
I don’t want patients to have a bad outcome and then say, “I wish I had known that. If I had known that, I wouldn’t have moved forward in this way.” Typically, I offer patients Depo Lupron or Orilissa. For patients who are worried about the mood side effects because they might have mental health issues currently, I recommend that they consider birth control with Letrozole daily. I like Orilissa, twice a day, 150 milligrams, with Letrozole, two tablets at night, and Norethindrone 2.5 milligrams at night. I add calcium, NEC, NAD, CoQ10, red light therapy.
Then at the 60-day mark, if they have good ovarian reserve, I highly recommend the modified natural FET protocol, even after suppression. So many doctors are like, “You can’t do modified natural after suppression,” and I’m like yes, you can, you’re just lazy. The thing is it makes no sense to suppress a woman and then hop her up on estrogen, because now you’re restimulating the inflammation. How the heck? Why does that make sense? It does not make any sense.
Meg Faith: Totally. How long would you say after doing that somebody has then to try to transfer or try naturally after they’ve done suppression?
Dr. Aimee: Well, with suppression and then trying naturally, it’s tricky. The thing about suppression is it’s almost like you need an exorcism by the time you’re done with it, it takes so much out of you, it’s so draining. It’s hard for me to recommend suppression and trying naturally because I feel like trying naturally, the likelihood is so much lower than doing a transfer. We really want, if a patient is going to do suppression, to give themselves the best chance of pregnancy as soon as possible, to take advantage of the benefits from suppression.
Meg Faith: Yes. A right-away kind of thing.
Dr. Aimee: Yes. Then within the protocol, sometimes I consider things like Tacrolimus, Neupogen, the antihistamine protocol, HGH to help with the uterine receptivity, and Neupogen on the day of transfer and afterward, in addition to steroids and aspirin. I know it sounds like a lot, but I have a nice spreadsheet, a template, and then I just go through and see what I want to do for each individual patient.
Meg Faith: That’s great. I’d love to touch on something you said a little earlier, which is how you do feel the heartache of a failed transfer. Can you speak a little bit to when you do have a patient with a failed transfer, what do you do next, how do you decide whether or not to move forward with another or to step back and reassess? What are some things you might look at? Let’s say this was with a PGT tested normal embryo.
Dr. Aimee: This is what I teach patients who see me. I do fertility consulting, so when patients see me, it doesn’t mean that they have to come to me as their doctor. I tell them when you’re planning your transfer with your doctor, ask them, “If this transfer doesn’t work, what would we do differently next time?” I want my patients to know the answer to that question. I don’t want them to wonder why we didn’t do that this time.
Some of the things that we talk about at the start, because I want them to know that if it doesn’t work – because sometimes it doesn’t – that there is a plan, there is hope, I’m thinking about things already. Some of the things I think about are some of the additional treatments that I just talked to you about. I think about maybe transferring, depending on the quality, more than one embryo, so potentially transferring two embryos. If we haven’t done some of the implantation tests that I offer the patient at the start, we talk about doing those tests, like looking at the microbiome, looking for silent endometriosis. It just depends on what we did previously and then what we want to add. Let’s say we did all the tests, but we didn’t do uterine PRP or Neupogen. Typically, for the second transfer, I’ll add those two things in.
Meg Faith: That’s really helpful. I appreciate, also, that thought of approaching even before, “If this doesn’t work, what would we do differently,” because I have had that feeling you’ve expressed of looking back and saying, “I wish we had tried this first. I wish we had done that.” It’s such a hard feeling to think that because fertility treatments can be overwhelming, emotionally and physically. Do you have any advice that you offer to patients when they are starting the process of how to handle what is to come emotionally and physically?
Dr. Aimee: One of my other websites, FertilityTeam.com, builds your team up front. Therapists. Don’t stop exercising. A lot of patients stop that, and that’s bad for mental health. Find a good acupuncturist. Acupuncturists can be a great member of your fertility team, they’re really smart. Find a mindfulness practice. The easiest thing to do is find your happy place. I always ask, “What’s your happy place?” Do you have one, Meg? I’m asking you. Do you have one? I have one.
Meg Faith: It’s in my library with my dog, who is on my lap right now.
Dr. Aimee: As soon as you’re stressed, you just go there. Then just get educated. Don’t assume that when you walk into that clinic, like we said earlier, that everyone knows who you are, why you’re there, what you’ve been through, what your goals are, what your beliefs are, and what you want to do next. You have to share that with them. I teach patients to have a little blurb about yourself. When you send in an email, you just say, “I know you’re so busy. Just in case, I just wanted to remind you, this is my story.” Right? If you have questions that you want answered at that visit, you can say, “Just real quick, I wanted to send in my questions ahead of time so that you have time to look at them because I know you’re so busy and I want to make sure that I don’t take too much of your time asking these questions. I just want to send them ahead.” You can do that for yourself.
I think just educate yourself. ChatGPT is a great resource. If the answers you’re getting are too over your head, you can actually upload all of your information, upload your labs, upload your age, and talk to ChatGPT as if you’re talking to your doctor. You can say, “I’m 37 years old. These are my levels. What are my chances with IVF? What are my chances with IUI? What is IVF?” Then if it’s too over your head, you can say, “Please explain it to someone who has a high school education in terms of science,” or a seventh-grade education in terms of science, or you can say, “Please use analogies that are easier for me to understand.” I actually use ChatGPT quite a lot to do that for me because I have patients where they’re like, “I still don’t get it,” and I’m like let me come up with an analogy. I suck at analogies, so I’ll be like, “ChatGPT, give me an analogy.” Then I present it to the patient and they’re like, “Oh, that makes so much more sense. I totally get it now.” So, I want you to get it. I don’t want you to go into your IVF cycle with unanswered questions. You just don’t know what you don’t know. The more you know, the better things will go.
Meg Faith: So true. We don’t know what to ask for if we don’t even understand it. There are doctors who kind of tell you to get off Doctor Google, but it’s like I want to be informed. I don’t have a medical degree, though at this point, I’m basically a med student.
Dr. Aimee: It’s not just the doctors. There’s a culture in clinics where it’s not the doctors answering questions anymore.
Meg Faith: That actually is one of my questions. In the medical system in general, what is a change you wish you could make so that the whole system is better for women and for fertility patients?
Dr. Aimee: That people talk to their patients, and they’re just not. When patients have failed cycles now, they’re getting booked two or three months out to review their cycles.
Meg Faith: If they review it at all.
Dr. Aimee: If they review it all.
Meg Faith: Someone even mentioned going through a failed transfer and then they just said, “When your period comes back, call us and we’ll start all over again.”
Dr. Aimee: I see the messages, because patients send me the messages that their clinics send to them. The reply starts with, “You’re just getting a lot of misinformation from the web.” I’m like no, you’re just gaslighting the patient to justify why what you’re giving to them as the protocol is the only option, and that’s just not fair.
Meg Faith: I really appreciate you saying that. I’ve started saying to doctors in general, just everywhere, especially after so much time when we’ve tried it their way, I’ve started saying, “I’m going to add this because another said it, don’t tell me no, just tell me if you think this will do harm and why, because if you don’t think it will do harm, then I want to try it.” You mentioned a few things about acupuncture. What are some other lifestyle tips that we can take on right now, no matter where you’re at in your fertility journey, that you always recommend?
Dr. Aimee: Listening to EDM music. I love EDM, it always puts me in a good mood. Strength training. Getting good sleep. I ask my patients to get the Oura Ring. Do what you can to decrease stress. Make sure you have a healthy BMI. Make sure your relationships are good, with yourself first and then with others around you if you’re partnered. No one goes through IVF to then share a baby with someone 50% of the time. I see so many couples who go through this journey and they think having a baby is going to fix the problems that we have, so I think it’s really important to do that first.
Things that you can do today…Follow an anti-inflammatory diet. Strength train. I have my weights in my office, between patients. If you look around the corner, you’re going to see all of my weights. I have a mirror there, and I just do curls. Get your steps in. Those are easy things that you can do.
Meg Faith: All really great advice, and just great advice in general, even if you’re not trying to get pregnant.
Dr. Aimee: Totally.
Meg Faith: Just lifestyle healthy advice. I am curious, and this is a tough question, I’m sure it depends on the patient. Is there any point where you might say to a patient, “I just don’t think this is going to happen.” What does that look like, what point of the journey is that?
Dr. Aimee: I’ll just give you an example. Let’s say I have a patient who is 44 years old, her AMH is 0.1, and she still wants to be given a chance. I’m going to help you. I’m not going to bring up egg donor. Patients know that that’s an option. I’ll just say to them the likelihood is not zero, but it’s low. Then I’m going to say let’s give this six months, let’s do everything that we can. At the six-month mark, as we go through the journey, they’re going to see it in real life. It’s one thing to see it on paper, someone handing you some statistics and a chart, but it’s another thing to live through the experience. If you’ve lived through the experience, because this is such a spiritual journey, then you can see for yourself, oh yes, this isn’t working, I can now have closure and move on.
At the six-month mark, I say let’s talk about what we’ve learned so far. Does it make sense for us to continue, how are you doing? Patients will often tell me when we’re at that point where we usually are on the same page, they say, “I think I’m ready now. Let’s talk about other options.” I don’t want patients to think that I’m giving up on them or I don’t believe in them, so that’s how I approach things. Same thing for transfers. If I’ve done all the things, we’ve explored everything, and a transfer just isn’t working, then usually when I’m ready to talk to the patient about it, because they know that we’ve done everything, when I bring up the topic of considering surrogacy, they are ready to hear it.
Meg Faith: That makes a big difference. You always want to, at least. I think so much of overcoming grief and overcoming is even just thinking it’s time to get off this hamster wheel is knowing you tried everything possible.
Dr. Aimee: Right.
Meg Faith: I’m not going to look back and wonder. I won’t ask you to violate HIPAA, but do you have any stories where you’re like it worked for someone and no one else believed it would, and you were able to say we made it happen, we did that?
Dr. Aimee: I have stories that I’m allowed to share. I had a patient who named her daughter after me, Aimee, same spelling, she tells the story all the time. She went to a clinic and they told her, “Even if you had all the money in the world to do as many IVF cycles as possible, it will never work with your own eggs.” She has a daughter named Aimee now. I didn’t tell her to name her daughter Aimee. Actually, she has twins. I got two eggs, two embryos, I transferred them both fresh day three. I think they’re starting third grade. I got their first day of school picture today. That is a true story, and I’m not violating HIPAA, she tells the story. I actually have a picture of her, she gave me two roses. There’s a picture she gave me that sits in my office just to remind me of that story. I’ll never forget it.
I have countless stories. I have a patient FSH of 119, no joke, and she has, I don’t want to share how old the child is, I don’t think that would be identifying information, but same thing, she wasn’t given a chance. The reason why it worked for her, I think, is because she was under 35 and I did a lot of the things that I’ve talked to you about, like ovarian PRP, we did some HRT, and I was able to get her to ovulate. She now has a child.
I see miracles every day. I just know that unless you try, you’re just not going to know if it’s going to work or not. There are obvious situations where you know it’s not going to work. I feel for the woman who comes to me over 50 who still has hope in her heart, but at this point, I can’t do anything to reverse menopause once it’s that far.
Meg Faith: Where do you see fertility care in the next 10 years? Sometimes I feel like it’s advancing so quickly, and other times I’m like gosh, it must be so far behind. What do you think 10 years from now is going to look like?
Dr. Aimee: Ten years from now, I think patients are going to be talking avatars and not humans. The majority of people are going to need fertility care because we’re being poisoned from the minute we’re in utero. I think this generation of children aren’t going to have kids until they’re in their 50s, so the only way they’re going to be able to have babies is if they froze their eggs in their 20s or 30s and if we are able to master in vitro gametogenesis, where you can take a cell and convert it into an egg.
I think our live birth rate is tanking. You see these stories where people are saying more women over 40 are having babies than women under whatever age. It’s not because women over 40 are more fertile. It’s just because people are waiting too long to have babies and infertility rates are rising. I think we’re seeing higher rates of PCOS, higher rates of endometriosis, and we need to get ahead of it.
I do predict also – you can see I have lots of predictions, I have this crystal ball – my other prediction is that the government is going to pay – I won’t name his name because I’m a little mad at him right now for reneging on covering IVF, but I do think that as a society, the only way that we’ll be able to continue is if the government steps in and pays for us to preserve our fertility at a young age. Because 25-year-olds don’t want to have kids anymore, at least not in the Bay Area. Everyone waits. A lot of people wait until over 40. It just makes the journey a lot harder when you do that.
Meg Faith: I would love to end with one question, but a couple people have put some questions in the chat. I would say, because a lot of them I did ask throughout, but a lot of them are also very specific medical questions, so I would definitely visit Aimee’s website because it’s a wealth of knowledge and resources there. There are a couple of different pages that give a lot of information. But then the advice that she gave earlier, which is plug these questions into ChatGPT. Ask questions with your testing, put your numbers in there. It’s so helpful.
Before I ask my last question, also, I will make sure this Reel is saved on our pages with a transcript so that people can find all of these notes and tips which have been so helpful.
I would love to hear from you. I’ve been in this for a long time, I’ve had a lot of losses. So many of the people who follow me have shared this with me. They send me DMs and they’re just having one of those days where they feel hopeless. They’re not ready to stop, but they’re struggling so much thinking there is a chance. What message would you like to relay to people who still so badly want to be a parent, but are starting to lose hope in it?
Dr. Aimee: You’re going to make me cry. The first thing I’d say is hope never killed anybody. You just have to remind yourself of that. It’s not going to kill you. It’s okay. If you have hope in your heart, there’s a reason why.
Sometimes people are not practical about their hope, they’re just not hopeful based on science, there aren’t scientific reasons for them to have hope, and that’s a different story. I think you have to ask yourself, “Are there scientific reasons for me to still be hopeful, yes or no?” If the answer is yes, then just believe in that and keep going. If the answer is no, get help for that. My 54-year-old who still thinks when she’s in menopause that she’s going to be able to have a baby with her own eggs, she needs help. She needs help to resolve that and just stop doing what she’s doing. I can’t get her there. She needs some professional help to make her believe and understand what science can do for her. But I think in general, if there are scientific reasons to have hope, then continue to be hopeful. Find a team, surround yourself with people that will cheer you on and not bring you down.
I can share this story with you. I have a patient who did 23 IUIs with me. She was 43 years old. She had her baby at 44. I have an oil painting of her daughter that sits on my piano. True story. I’m allowed to share this story with you. Everyone told her she was crazy. Everyone told her that she had lost her mind. Her daughter is in the seventh grade, just started school today. I share that story with you because I have 23 gray hairs from all those IUIs. If you think about how many years, how much treatment she did, she didn’t give up hope, she just believed. Some people have that endurance and that’s part of their journey, and there is nothing wrong with that. It is your journey.
So, F’ – I’ll say other bad words, I’ll say funk what other people say. It’s your journey. It’s not their journey. Just believe in yourself. Make sure that you have a partner that’s supportive. If you have a partner that’s a douchebag, doesn’t show up, and isn’t there for you and asking you those three questions, “What can I do for you? How can I help you? What do you need?” then really reevaluate your relationship. But that’s how I would answer that question.
Meg Faith: I love that so much. I have had so many hard moments over the years, and then following you, seeing how you care for your patients, knowing that there are medical providers out there that aren’t just doing this because that’s the field they fell into but that they genuinely care and genuinely listen makes me feel more hopeful that I can keep doing this because they’re out there. Aimee, I appreciate you so much. Thank you so much for taking the time to chat with me.
Dr. Aimee: Thank you. I hope we get to do this again. I just want to do one plug. I also have an IVF class once a month, it’s EggWhispererSchool.com. That’s an opportunity for patients who cannot be my patient to join, so if you’re listening in and you’ve been adding questions and you’re like, “I want to learn more, I want to ask her questions about my case,” I run these courses or this class for folks. It’s a live Q&A just like we’re doing. I don’t stop the class, the class doesn’t end until every question is answered. I invite people who are interested in learning more about their scenario and they don’t necessarily feel like they can do a full consultation with me, it’s okay. You can join the class and I’ll do what I can to help you during the session.
Meg Faith: That’s amazing. I just wrote that down, too. Like I said, I’m going to get this saved immediately from Reels because Instagram is great that way, and we’ll have a transcript up really soon. So many good resources, so many good tips. I absolutely love it. Thank you so much, Aimee. Thank you, everyone, for joining and following along. Hopefully, we can all stay connected and DM each other and keep pushing through everything we’re going through.
Dr. Aimee: Thanks again, Meg. Take care. Bye.
