Welcome to The Egg Whisperer Show. I have someone that I’ve been following for a really long time and I am so excited to finally have her on the show.
Welcome, Dr. Natalia Grindler. Thank you for being here today. I love the way that you talk about being one with nature and your practice and fertility. I go to your page and I just feel so relaxed and good about the things that we’re doing as doctors. I really appreciate you coming on so that we can dive into fertility from your amazing perspective so that others can learn from you as well.
Before that, I just want to talk to our listeners about you. You are double-board-certified in OBGYN and reproductive endocrinology and infertility. You use evidence-based medicine to enhance your patients’ fertility naturally with diet and lifestyle recommendations. We’re going to talk about some of those things today.
You’re also a mom to three boys. Outdoor adventures are something that we see you talking about a lot, and they obviously keep you grounded. You live in Denver, Colorado, and you practice with Conceptions Reproductive Associates of Colorado.
Dr. Aimee: Let’s talk about fertility myths. Then we’re going to talk about toxins, nutrition, positivity, all the things that you know so much about and we’re going to learn from you about. As a fellow myth buster, you bust myths every Monday. I know you talk a lot about birth control pills, unexplained infertility, and age. Which myths do you hear the most often in your office?
Dr. Natalia Grindler: There are a lot. There’s so much shame and stigma in our field of infertility and pregnancy loss.
I think that in general as women we can tend to internalize medical problems and blame ourselves, because somehow if we blame ourselves, we think we can control the outcome. “If only I hadn’t gone for a walk after embryo transfer, then maybe I would have gotten pregnant.” Or, “I caused my pregnancy loss because I had a cup of tea.” It’s just not true.
One of the most common myths I hear is: “I’m not actually trying to conceive until I’m tracking my cycle or using an app.” That’s not true. If you’re not using contraception and are sexually active, then you’re trying to conceive even if you don’t realize you are yet.
Another one that I like to bust is, “Everyone in my family has had no difficulty getting pregnant, so I shouldn’t either.” I think that’s particularly true when women try to reassure me, “No, my mom had me at 42, so it should be okay for me now too.” But your mom’s 42 is very different from your 42. Think of just how different our lives are. That matters.
Another one that I talk about probably every day is, “No one in my family has health problems, so I shouldn’t need genetic carrier screening.” I’m not trying to one-up you, I really am just giving you all the information you need to decide what’s the best way for you to have a family. If we’re doing testing, why not have more information?
Dr. Aimee: I would agree with you on all of those, 100%. Other than checking out your feed, how do you tell your patients what they can do to discern between fact and fiction with the stuff that they’ve read about?
Dr. Natalia Grindler: It’s hard. I think one of the things that I love about social media is that there’s so much out there. There’s so much information out there and people are creating a dialogue about infertility, whereas previously it was so isolating. But it’s hard when you’re not a physician to know who you can trust and who you can’t.
I personally think it’s helpful when patients come to visit with me with a list of questions or concerns. Sometimes just the process of writing them down and taking a moment to intentionally think about it, patients are like, “This doesn’t make sense, this sounds crazy.” When in doubt, talk to your REI.
Dr. Aimee: I agree. Don’t Google it. Just talk to us. We’re faster than any Google search, YouTube, you name it. We can give you the answer a lot quicker and it will be better than anything that you’re going to read online, for sure.
Dr. Natalia Grindler: But I’ll be the first to admit that I totally get the Googling idea. With my third kiddo, I went down a Google rabbit hole. Even though I am trained as an OBGYN and an REI, at 2:00 AM I was Googling how to go into labor because I was so convinced that there was something I missed in my medical training and that Google would have the answer. And it didn’t. Just email your REI.
Dr. Aimee: I want to talk about toxins. I’ve learned so much from you about them and their impact on our bodies. It’s been getting a lot of attention recently, and for good reason. Can you tell us a little bit about limiting toxin exposure could perhaps improve your success with fertility treatment? Or can it?
Dr. Natalia Grindler: That’s a great question. I just want to take a step back. When we talk about toxins, the ones that I’m referring to are specifically chemicals in our environment that we’re all exposed to that can interfere with how our hormones work, or what are called endocrine-disrupting chemicals. I’ve focused the majority of my academic career on researching how these chemicals in our environment impact our reproductive health.
The truth is really frightening. There are so many chemicals that we’re exposed to that can impact our hormones. Whether it’s chemicals in plastics called phthalates being associated with earlier menopause, or worse outcomes in the IVF lab, or lower numbers of eggs, all these things have been associated with chemicals, so I think it’s absolutely something that we have the potential to control for our outcomes.
Dr. Aimee: How do you inform your patients about that? Is this something that you bring up at your new patient consultation and say you want to talk about environmental toxins and see what you can do to reduce your exposure?
Dr. Natalia Grindler: Yes. I try to talk to all of my new patients about it, but I’ve realized that not everyone is receptive to it and not everyone is interested in it. I tell them, “If this is something you want to talk more about, let’s talk about it. If not, you can check out my Instagram page.” Because sometimes it’s so overwhelming just getting in the door of a fertility doctor that you don’t want to keep overwhelming them with information, which is kind of what we’re doing one way or the other anyway.
Dr. Aimee: Have you met (I should introduce you if you don’t know her) Dr. Jenna Hua from Million Marker?
Dr. Natalia Grindler: No.
Dr. Aimee: She’s great. She has a urine test and you basically journal all of the things that you are exposed to during the day and then she’ll measure all of the endocrine disruptors that she can detect. Then she’ll give you feedback as to what you’re exposed to and what you should change, and then you can do the test again to see if your exposure has also changed. It’s a pretty cool test. I’ll have to introduce you guys.
Dr. Natalia Grindler: Absolutely.
Dr. Aimee: How do you advise patients? Can you give us just a quick checklist of things for people who are listening who aren’t necessarily going to come see us, what are the things that you suggest they do?
Dr. Natalia Grindler: The first thing I always tell patients is to really think about what their food is coming into contact with. Start in your kitchen. You want to avoid storing any food in plastic containers or heating food up in plastic containers. Use glass containers as much as possible. Instead of drinking out of plastic water bottles, drink out of glass water bottles. That’s typically something that is really tangible and easy to start with that most people start with.
Once you do that, what I challenge patients to do is every time you’re buying something new for the house, whether it’s a cleaning product or you ran out of lotion and you need a new lotion, try with the healthiest alternative. I don’t want you to just go raiding through the house and throw everything out. That’s so overwhelming and you’ll go down a dark rabbit hole like I have done in the past, it’s just too much. In general, I say anytime you’re going to Target, find the healthiest lotion, or find the things that don’t have any fragrance added to them.
Dr. Aimee: I remember a patient years ago told me she was allergic to receipt paper. I didn’t realize how what she said would always stick with me until now. I thought, “Who is allergic to paper?” Now I know that she knew about environmental exposure to BPA and how it’s in receipt paper. That’s always stuck with me, so I never touch the receipt paper.
Dr. Natalia Grindler: Good.
Dr. Aimee: One of the most common questions that I know we both get, especially after an embryo transfer, is what should I eat, is there anything I can do diet-wise that will improve my chances? I tell my patients that I want them to aim to be in the best shape of their lives when going through fertility treatment. What do you feel is the best advice for patients when they’re trying to conceive and trying to get pregnant with or without fertility treatment?
Dr. Natalia Grindler: We’re very similar in our approach. I encourage women to be the healthiest they can be. Specifically, I say if you want to clean up your diet, now is the time to do that.
In general, I recommend just avoiding processed foods, so eating more fruits and vegetables, less meat. Make sure you know all the ingredients of what you’re putting into your body. Then there’s pretty good data to suggest, particularly around the time of embryo transfer or IVF cycles, avoiding any sweetened beverages.
Dr. Aimee: I kind of do like a Diet Coke here and there, but I could do without it if that’s what my doctor tells me. I have patients who say they drink Dr. Pepper or Mountain Dew, and I’m like: definitely avoid that.
Dr. Natalia Grindler: Yes.
Dr. Aimee: What about losing weight? It’s such a sensitive topic for so many people. Sometimes when I bring it up, I feel bad, like I’m going to hurt someone’s feelings. Obviously, if you can’t tell, I’m a very sensitive person. How do you approach the topic of weight and the ideal weight for your patients who are either going through retrieval or a transfer?
Dr. Natalia Grindler: I’m also a really sensitive person. It was something that I had to learn how to talk about with patients.
What I can tell you is that your weight is a fact, it is a neutral fact. So, I can say you are overweight based on your body mass index, your BMI. I always tell people I can’t change your age, but your weight is something that you can potentially change. By framing that way, as this is something that we can potentially change to dramatically improve your chances of fertility treatment working and decreasing your chances of having any kind of adverse obstetrical outcomes.
Dr. Aimee: I love how you just used that term, neutral fact. That’s something that I’ve learned about you, and I think that’s part of how you can use language to think about things in a positive way and not a negative way, because neutral sounds very peaceful. I like neutral. I’m just curious, how did you learn to use that language around medicine and medical terms, because that’s not something that I was exposed to? Is there a story behind that?
Dr. Natalia Grindler: Definitely. I have been doing a lot of growth and development over the past year. In particular one of the things that has really helped me are life coaches. I started by listening to podcasts that talk about how we can change our outcomes.
I think in general as women we tend to assign emotional thoughts to everything. What I had to learn about myself is that those thoughts dictate our feelings, and then those feelings will dictate our actions, which lead to results. That’s what I learned through a life coach.
The truth is we have so much more control over our thoughts and our results than we realize. A great example is, it doesn’t happen often but when we do have patients that are failed follow ups because our treatments don’t work, you have the option to decide, “I’m dreading this consult. I feel like a failure. I didn’t do a good enough job as a physician,” or you can see it as this is an opportunity for us to really take a deep dive into her medical history, all the other tests that are available right now to help empower them to make the best decision for their family moving forward. Once I realized that we have that choice, I was like, oh, I don’t have to be bummed out if I have to have hard discussions with patients sometimes.
Dr. Aimee: I used to go through lots of cupcakes and chocolate boxes in preparation for those calls, but there is definitely a way to change your outlook about those conversations and to turn them into learning experiences. It sounds like you’ve definitely done that.
How have you seen your positivity help your patients?
Dr. Natalia Grindler: I think it’s important to go back to the research.whenever possible. There are research studies that show that couples that walk into transfer day with some swagger, that they’re like, “I know this is going to work,” have higher pregnancy rates. If you’re not feeling confident about your transfer, then why are we doing this? What do you have to lose by trying out positivity?
I think part of it is that our patients, by the time they even get to us, they’ve been through so much and they come with these battle wounds that they’re protecting. They almost don’t want to let themselves believe that happiness and success is possible, because they’ve been disappointed so many times before. I really try to reframe that like, “We’ve figured out why things aren’t working, this is the fun part, this is where you get to believe that you’re going to be successful.”
Dr. Aimee: I love it. One of my coaches has the mantra if you believe it, you can achieve it. Of course, with fertility treatment, it is not that easy. I tell my patients: hope never killed anybody, there’s nothing wrong with being excited right now, in this moment. Especially when we give patients good news, like they’re pregnant, it’s very natural and normal for our patients to think, “What else is going to go wrong?” like they can’t believe the information we’re giving them, they’re so afraid to be happy. I really totally love what you’re saying, and I appreciate it so much.
Recently I saw from your social media that you took a break for a while, and you came back very refreshed and invigorated. I love everything that you’re doing and saying. Share with us, what did you learn during that time?
Dr. Natalia Grindler: Yes. I had a major life change that impacted my family and their health. I needed to be authentic and take the time to focus on us healing. So, I needed to reset my intentions for my use of social media. Part of it is I just needed to be completely away from social media for a while.
Once I did the work that we had talked about, I learned that we get to choose how we want to live our lives, spend our energy, and dedicate the use of our time. Once I changed the framework of: I don’t have to do social media, I’m choosing to do social media because I have exciting things I want to share, it was really the mindset that I needed to change to have my voice back again.
Dr. Aimee: I’m glad your voice is back, because it’s stronger than ever. Is there anything else you’d like to share with our listeners and viewers?
Dr. Natalia Grindler: For anyone going through a hard time, I want to encourage you to stay true to yourself and what you need. You’ll get through this, I promise.
Dr. Aimee: Where can people find you and your work?
Dr. Natalia Grindler: On Instagram I’m @ nataliagrindler_md, and I work at Conceptions Reproductive Associates in Colorado.
Dr. Aimee: Awesome. Thank you, Natalia. I hope you’ll come back and join us again.
Dr. Natalia Grindler: I would love that.
Dr. Aimee: Awesome. Thank you.
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