How Modern Technology can Help Provide Options for Fertility and Pregnancy by Dr. Fru [Episode #779]
This week’s topic is: How Modern Technology can Help Provide Options for Fertility and Pregnancy by Dr. Fru
I am so excited to have my very special guest, Dr. Karenne Fru, who is a Fertility Specialist and a double board certified OB/GYN and REI (Reproductive Endocrinology and Infertility). Listen in as Karenne shares why there are so many issues with fertility today, the latest on sperm technology, what IVF is doing that natural conception can’t do, and so much more!
Issues with fertility today…
The latest on sperm technology…
Why nurturing the embryo has a tremendous impact on the health of the actual child…
What IVF is doing that natural conception can’t do…
IVF technology in the third stage of pregnancy…
Making fertility accessible and affordable…
Who is a candidate for IVF…
About Dr. Karenne Fru
Dr. Karenne Fru completed a BA in Biology, then matriculated at the Medical College of Georgia completing both MD and PhD degrees and became the first black MD/PhD that program had ever graduated. Dr. Fru chose to subspecialize and pursued Fellowship training in Reproductive Endocrinology and Infertility (REI) at the National Institutes of Health in Bethesda, MD. I am currently double board certified in OB/GYN and REI. She has been very deliberate about centering her practice around the vulnerable patient and making my patients’ goals her goals, too. She has extensive experience being a patient herself and brings this background, as well as medical training, to all of her patient interactions.
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Note: The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate. This is due to inaudible passages or transcription errors. It is posted as an aid, but should not be treated as an authoritative record.
Namaste loves and welcome back to our Monday interview show where I am thrilled to introduce you to Dr. Karine Fr, who is a fertility specialist and a double board certified ob, B G Y N and r e i, reproductive endocrinology and infertility specialist. She’s originally from Cameroon and as we’ll get into in the show today, she really was drawn to this field after seeing how it was affecting women in her country and came here to the US with such a mission of empowering women and families everywhere who really want to be parents with technology that can help those that are struggling. So she is passionate, she is brilliant, and I think it’s important that we talk about these different options that are out there today because with the rise of chemicals and endocrine disruptors and stress and many other things, there are more struggles that are happening in the world around, you know, being able to conceive and have healthy pregnancies.
So this was a really important aspect of pregnancy and fertility that we wanted to cover today, and I’m also excited to share that Dr. Fr will be adding her wisdom to our upcoming Holistic Mama fertility, pregnancy, and postpartum courses, which are going to be launching. And so, yes, with all that being said, I am so, so excited to share this conversation with you today.
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Interview with Dr. Fru
Kimberly: 00:00:53 Dr. Fr I’m so excited to be here with you today. Thank you for joining us.
Dr. Fru: 00:00:58 Thank you for having me on the show.
Kimberly: 00:01:01 So I’ve been doing research around all these various assisted reproductive technology options here today, and I’m so excited, Dr. Fru that I’ll also be interviewing you for our upcoming fertility, pregnancy, and postpartum course, which we have been working on four years, actually since I was pregnant with Moses, who’s two and a half, you know, wonderful
00:01:24 <laugh>. Dr. Fru became this like big monster of a course. So now there’s three, because we really wanted it to be really, um, comprehensive and really share so much. So this was a missing piece of the puzzle. I’m really, you know, grateful. I feel really lucky that I was able to conceive and, um, you know, get pregnant naturally with my two sons. But there is a huge need to educate and to talk about, you know, assisted reproductive technologies, all the egg freezing and the I V F and all these options that are available today. So I did research and I came across you and your amazing work, which we’ll get into today and your journey. And we had a conversation, and you’re a mama too. And so I’m really excited for us to talk Mama to Mama, and also absolutely <laugh>, you know, practitioner to student. I’m really a student in this area. Um, Dr. Frus, I’m really excited to chat with you today. Thank you again so much.
Dr. Fru: 00:02:21 Thank you for having me. Um, the areas that you’ve touched on are absolutely of utmost importance. I feel like an educated patient is more of an asset, and, uh, most of my job is getting to know what the patient knows, fill in the gaps, give them options that they might not have considered before to address a problem that, uh, plagues about 10% of the population. So it’s not exactly like a rare disease.
Kimberly: 00:02:53 Mm-hmm. <affirmative>. Well, Dr. For, for a minute, can you give us a brief background about, on you and how you chose to go into this field of fertility work?
How Dr. Fru chose to go into this field of fertility work
Dr. Fru: 00:03:04 All right. Well, um, I’m Dr. Karine, free <laugh>. I’m currently the, the medical director of Oma Atlanta. And how I landed here, um, is a, is a long journey, but the impetus of it started with growing up in, uh, Cameroon Aran, uh, country.
Kimberly: 00:03:35 I
Dr. Fru: 00:03:35 Love Africa. Conservative so
Kimberly: 00:03:36 Much. Yes, very much.
Dr. Fru: 00:03:38 Uh, wonderful people, wonderful food, but also very specific gender and age specific roles. Hmm. So, um, being born as a woman, I was acutely aware that my value was in eventually reproducing. Mm. And as we were an agrarian society, the number of children means the number of workforce assigned to that particular family.
Kimberly: 00:04:08 Right.
Dr. Fru: 00:04:09 And I knew from a young age that I did not want to grow up to reproduce.
Kimberly: 00:04:15 Mm.
Dr. Fru: 00:04:15 But what I did want to do is figure out a way for the women who are unable to be, uh, mothers, who to become mothers, their husbands retained the right to replace them with, uh, younger women.
Kimberly: 00:04:29 What Cameroon
Dr. Fru: 00:04:31 Have children mm-hmm. <affirmative> presumably to have children. And, uh, he could either divorce you or, uh, you would stay on to take care of him, the new wife and her children.
Kimberly: 00:04:46 <laugh>. Oh my gosh. To this day that goes on.
Dr. Fru: 00:04:50 Of course it does. Um,
Kimberly: 00:04:52 Perhaps, oh my God. I mean, this is shocking.
Dr. Fru: 00:04:55 So, to me, helping African mothers become mothers was really the big push because I thought the stakes were higher.
Kimberly: 00:05:09 Yeah. Your
Dr. Fru: 00:05:10 Whole life trajectory depended on whether you were able to successfully reproduce or not. And, um, your value to society, your whole worth was tied up in that. And I wanted to provide people with the tools to be able to treat a very treatable condition. And, and that was, was the whole push for going into reproductive medicine. That, and I’m a bit of a nerd, and I got a PhD in ovulation. <laugh>.
Kimberly: 00:05:43 What? You can get a PhD in ovulation. Yes,
Dr. Fru: 00:05:46 You can, you can incredible, you can get a physiology degree and study ovulation in a very granular way using our, um, cousins non-human primates.
Kimberly: 00:06:00 Wow. Wow.
Dr. Fru: 00:06:02 So that’s what I did.
Kimberly: 00:06:03 This is an incredible story, Dr. Fru, which, you know, organically leads me to the next question about why are, I mean, I know it’s not one thing, it’s multifactorial. Um, but why are there so many issues with fertility today? And it’s interesting what you said about agrarian African society because we’re often told, oh, there’s a lot of toxins in the environment, which we know is true. Right? There’s all these endocrine mimickers and hormone disruptors and things like that, and people are waiting, you know, till they’re older. But I imagine, you know, in Cameroon, what you were describing, there’s probably less toxicity because it’s more rural and people aren’t waiting as long. I imagine.
Dr. Fru: 00:06:44 Not,
Kimberly: 00:06:45 Not necessarily,
We discuss why there are so many issues with fertility today
Dr. Fru: 00:06:46 Not typically. But, uh, Keon also has a very high literacy rate, and more girls are okay getting educated. So the pregnancies are not happening in the late teenage early 20 years. They’re happening more mid twenties to thirties. And at that point, there is a higher likelihood for fibroids to become problematic. It’s prevalent among women of African descent. We tend to have them earlier at higher tumor burden with more consequences, um, to our daily lives and reproduction. So some of that is playing into it. Also, the health of the Wouldbe fathers is playing to whether the, the sperm quality is, um, adequate. So maybe the reasons are not quite the same, but the whole world is moving in the same direction. Yes. To more education, more industrialization, fewer children, to give them better opportunities. Um, and so, you know, it, it’s going to continue to be a problem.
Kimberly: 00:07:58 Well, it seems like there’s all these other factors which I hear about more, which are growing. Things like P C O S, you talked about fibroids, ovarian, cts, there’s a lot of, um, women’s potential issues. Of course, there’s the men, which we’ll talk about next <laugh>. But with women, there’s things that can happen, like you said, quite young. So you know, this, you know, when we’re talking about assisted reproductive technology, this can be something that’s available if you’re trying to have a baby when you’re 25. It’s not, I
Dr. Fru: 00:08:28 Just, you have 25 year old patients,
Kimberly: 00:08:30 <laugh>. Yes.
Dr. Fru: 00:08:32 Yes.
Kimberly: 00:08:33 So, you know, there’s a lot of technology involved here, which I am like, wow. Blown away with. And so when I was doing research, Dr. Fr I found, you mentioned you’re part of Ooma and I was reading online, they do this here. I wrote it down. It’s, um, like this, uh, insight sperm technology. Yes. Which is really interesting because <laugh>, I started reading about I V F, you know, I think it started in the eighties. And they would put everything together in a Petri dish and just sort of see, seeing what happened, you know, what lines up. But today they’re able, or tell us what you do at Oma. Why is, how are you identifying the best sperm? How does that help with healthy, well, it seems obvious, but tell us.
The latest on sperm technology
Dr. Fru: 00:09:12 I, well, it, it’s not super obvious cuz I have to explain this to patients. Uh,
Kimberly: 00:09:17 David. Okay, good. I don’t, I don’t sound dumb then. <laugh>.
Dr. Fru: 00:09:20 No, no, no, no, no, no, no. Uh, most, most humans assume that reproduction is this spontaneous and highly efficient process that just happens. And what I tell them is that it is actually a very inefficient, uh, process and it requires at least two gaits and a uterus.
Kimberly: 00:09:48 You’re right.
Dr. Fru: 00:09:49 So it is always a, a two gamut problem, cuz most women come in assuming that the problem is theirs and there’s a alone to bear mm-hmm. <affirmative> and then have nothing to do with it. And the uterus is like this innocent bystander when each piece is equally, uh, important. So the, the egg, uh, is the larger of the two, uh, gammy because it contains, uh, genetic material. It contains, uh, organelles. It is a store of, uh, proteins and other molecules that are needed for the cell division that ensues after, uh, fertilization. And that the stuff in the egg is responsible for the first three days of development. Hmm. So that’s the egg. Super important sperm is a DNA N delivery device. <laugh>, if you get
Kimberly: 00:10:49 I like
Dr. Fru: 00:10:49 That a damaged device, the DNA n tends to be damaged as well.
Kimberly: 00:10:53 Hmm.
Dr. Fru: 00:10:54 So, uh, what we do with OMA sperm insight, it does live morphological assessments on all the available sperm.
Kimberly: 00:11:07 Mm.
Dr. Fru: 00:11:09 So things that the human eye has tended to do, kind of scoring sperm in real time. Mm-hmm. <affirmative>, the OMA sperm insight does it grades them color codes them so that it’s an aid to the embryologist for sperm selection, which is then subsequently injected into the egg. That process is called intracytoplasmic sperm injection or ixi. And that, uh, is to facilitate, um, fertilization. It doesn’t guarantee it, but it facilitates it. Um, so
Kimberly: 00:11:40 Does, does that mean Dr Fr because they’re selecting the sperm, so specifically it leads to healthier babies or better outcomes in these fertility treatments or
Dr. Fru: 00:11:50 Both? That is the, that is the goal <laugh> that the goal
Kimberly: 00:11:53 Yeah. Makes sense.
Dr. Fru: 00:11:54 The goal, the goal is to then have these beautiful, uh, embryos, uh, that then have the opportunity to become beautiful people. Hmm. But as I tell all my patients who acquire egg donation or sperm donation, um, but egg donation, especially the environment in which the gestation happens and the, uh, embryo develops into the fetus actually matters in what genes get expressed. And when, um, if the mother is under stress, either health-wise or physical, that will have impact on, uh, on their embryo and how it develops into a baby and impacts long-term for that child. So women in areas of war, it, there’s those babies grow up to be smaller humans than those that were conceived and delivered in peacetime.
Kimberly: 00:12:57 Interesting. So you were, you were saying, Dr Fr we make, you know, you can make it healthy with the best sperm, you create these embryos, but then once it’s, um, put into the mother, the, the pregnancy itself, we know, we know the nurturing, there’s all the cross crossing the placenta, emotionally, physically, which you’re eating. All of this has a tremendous impact on the, the, the health of the actual child.
Why nurturing the embryo has a tremendous impact on the health of the actual child
Dr. Fru: 00:13:21 Correct.
Kimberly: 00:13:22 Yeah, that makes total sense. So it’s not an end all beyond made this perfect. You get an egg donor or sperm donor, it’s all perfect here, and we put it in, it’s already perfect. You, we still have work to do. Right. You can’t cut corners with
Dr. Fru: 00:13:35 Nourishments. It never ends. I tell people, uh, when they’re new patients and not yet parents, um, that this is a job for the rest of your life. And it starts now, my first goal, my first goal is to get my patients as healthy as possible
Kimberly: 00:13:57 Mm-hmm.
Dr. Fru: 00:13:58 <affirmative> compared to, um, them conceiving. Um, and then it is their job to maintain those healthy habits that we have instituted, uh, in order to assist with us having the best outcome. Mm-hmm. <affirmative>. And then selfishly, I want all my patients to live well into their old age so that their children have the benefit of their presence for a long, long time.
Kimberly: 00:14:22 Oh. I don’t think that’s selfish at all. Dr. Fr I think that’s beautiful for the community. We see that it’s not, like you said, just a short term job being a parent, being a mama. It really is, um, these different phases. You know, my older son just turned seven a couple days ago. Like, wow. Like, it just keeps changing and getting more beautiful. It keeps unfolding, you know. Um, so Dr. For, you know, for, for our information though, because this is, this is so interesting. Let’s say, um, someone does have healthy eggs and then you can identify their partner has sperm that’s healthy. Correct. What is IVF doing that natural conception can’t do? I, I, when you, you mentioned that ixy or inserting it in, is it that sometimes it just has problems that sperm and the egg have problems coming together? Like how is the IVF actually helping to keep people pregnant? <laugh>, it may sound basic, but I really don’t know the answer and I’m sure a lot of people don’t.
What IVF is doing that natural conception can’t do
Dr. Fru: 00:15:23 No, I’m sure a lot of people don’t. I hope they get educated because it’s a conversation that we need to have. It’s yes. Now, part of how we have babies, there’re over 3 million babies in the US conceived and born from I V F. So let’s just move on <laugh>. Yes. Yes. And, and those babies grow up into people. So, um, what I remind my, my, my staff of is that our product when we’re successful is people, not babies because they grow up. That’s, that’s the whole thing. Yes. Right. So, um, there are a couple of things that we do to address infertility and the state of all the people who are fertile before they come to see me, meaning they just spontaneously conceive, have a normal pregnancy, deliver their baby. What is happening in that instance is this kind of random matchmaking between the egg and the sperm. Once the egg gets ovulated or released, um, and their sperm present within the reproductive tract, the next couple things that happen are of utmost importance. So the sperm has to successfully deliver its dna n a, into the egg to cause fertilization to happen. And then that egg needs to start the cell division to become an embryo
Kimberly: 00:16:44 Mm-hmm.
Dr. Fru: 00:16:44 <affirmative>. And it does that over the next five or six days that it tumbles as it tumbles down the fallopian too. And then the hope is that, is it implants inside the uterus that’s implantation.
Kimberly: 00:16:57 Mm-hmm. <affirmative>.
Dr. Fru: 00:16:58 So every time people say they’re trying to conceive and they’re having sex around the reproductive window, they’re trying to facilitate this matchmaking
Kimberly: 00:17:07 Mm-hmm.
Dr. Fru: 00:17:07 <affirmative>. And then when pregnancy doesn’t happen, it’s either a fertilization issue, an embryo maturation issue, or an implantation issue.
Kimberly: 00:17:18 Hmm.
Dr. Fru: 00:17:19 And what I explained to them is that in the normal course of a menstrual cycle, a woman will release one, maybe sometimes two eggs. That’s how we have fraternal twins. Yeah.
Kimberly: 00:17:32 Um,
Dr. Fru: 00:17:34 And then, and then that egg or eggs is exposed to sperm, and we hope that all these processes downstream happen, uh, appropriately. And the young healthy woman in whom I get 15 eggs, that’s multiples of what happens in one cycle.
Kimberly: 00:17:53 Right.
Dr. Fru: 00:17:54 And I can stimulate the growth and development of multiple follicles in one cycle and collect them all at once. So now we can discriminate against how those eggs behave. So the total number that is retrieved is not all mature. Correct. So then all the mature ones then are given an opportunity to be fertilized. That will not be 100% typically. And then there’s a further attrition as that fertilized egg starts dividing, becoming an embryo and developing until that day five, day six, when it is, um, at a state that is ready for implantation.
Kimberly: 00:18:36 So, so yeah. Okay. So it’s, it’s helping like those, I I it’s clear like the, the first part, it’s random. You’re get, you have the better sperm, you’re inserting it, you’re growing it in the lab, so that makes sense. The first two parts of it, you’re efficiently getting them out. You’re sorting, you’re doing chromosomal testing. Yes. So the best chance of having the healthiest embryo and also helping it come together.
Dr. Fru: 00:18:59 So you, you brought in the aspect of chromosomal testing, there’re two, there’re well, there’re really three kinds of tests we can run on embryos before we transfer them back into a woman. Hmm. Um, and one is a general test that just looks for chromosomal abnormalities. Things like trisomy 21, 18 13, which people have heard of because some babies wind up getting born with those chromosomal abnormalities, but most likely they end in miscarriage.
Kimberly: 00:19:27 Okay.
Dr. Fru: 00:19:28 And, and so, but we have, you know, we have individuals with down syndrome running around. So, but the, the, the general, what is called, uh, pre-implantation genetic testing for aneuploidy will screen against chromosomal abnormalities, general chromosomal abnormalities like that.
Kimberly: 00:19:45 Got it.
Dr. Fru: 00:19:46 The second level of testing as if the parents, the intended parents have both been, um, screened for carrier states.
Kimberly: 00:19:54 Mm mm
Dr. Fru: 00:19:56 And they’re found to be ca both carriers of a recessive trait like, um, cystic fibrosis or sickle cell.
Kimberly: 00:20:05 Mm.
Dr. Fru: 00:20:06 Then in addition to doing the general chromosomal analysis, we can then identify the chromosomally normal embryos and then look for those that do not have two abnormal copies so that we can discriminate against those. Those would not be made available for transfer.
Kimberly: 00:20:26 So it’s after all the testing, which is a huge advantage to getting pregnant naturally, that you can, you know, with, with the world, you’ll just be honest with the world being toxic as it is, and there’s so much coming at our bodies and it’s a, it’s a huge advantage in that way. You can test
Dr. Fru: 00:20:45 The
Kimberly: 00:20:45 Actual embryo
Dr. Fru: 00:20:47 Mm-hmm. <affirmative> mm-hmm. <affirmative> mm-hmm. <affirmative>, and, and we can do it from, it’s not perfect is the other thing. I remind people it is not perfect. Of course, we take the sampling of four to six cells out of the hundreds of cells that are present in the blasty stage at which this, these embryos are frozen.
Kimberly: 00:21:06 So then Dr. Fr, how does, um, I V F help the third stage? I believe how you’ll explained like the transfer into the uterus versus a woman, you know, if you’re conceiving naturally in a kind of implant, how does this technology support holding or keeping the baby growing in the uterus? I guess, especially if, let’s say someone’s had trouble, um, naturally conceiving, they’ve had a bunch of miscarriages, you know, naturally on their own. How, how does this, um, technology help that kind of patient?
IVF technology in the third stage of pregnancy
Dr. Fru: 00:21:38 All right. So with recurrent pregnancy loss, the number one reason that is identifiable for that is chromosomal abnormalities.
Kimberly: 00:21:47 There you go. Okay. <laugh>.
Dr. Fru: 00:21:50 No,
Kimberly: 00:21:52 That is as direct as it gets. Okay. So it’s this nature’s way of, you know,
Dr. Fru: 00:21:57 Screening out Yes. That which will not sustain a life.
Kimberly: 00:22:02 So it’s not, you know, often that the woman’s uterus isn’t able to be healthy enough. That happens sometimes, but it’s usually the actual, like, let’s assume that embryo’s really healthy Dr. Faru. Yes. And, and then, but this person just has had, you know, like multiple miscarriages, but that, that, um, patient can still be healthy. Their uterus is, can still able to be healthy to carry the child.
Dr. Fru: 00:22:27 Oh, absolutely. I’ll use myself as an example. I have had, yes,
Kimberly: 00:22:31 Thank you.
Dr. Fru: 00:22:33 Six pregnancy losses.
Kimberly: 00:22:35 Mm.
Dr. Fru: 00:22:36 And at the end of that, I underwent IVF myself, not because I couldn’t get pregnant, but because I kept having miscarriages.
Kimberly: 00:22:44 Now is that genetic to have, or, well, what makes someone have multiple miscarriages? We don’t know.
Dr. Fru: 00:22:50 It’s, it’s, it’s not super clear. So recurrent pregnancy loss is, uh, unexplained in 50% of cases. Wow. We really don’t know yet.
Kimberly: 00:23:01 Wait, so doctor, was this part of your journey into fertility worker you were already working in? Oh,
Dr. Fru: 00:23:07 I was already working. <laugh>. Wow. I had committed to this bath before this happened. Kimberly: 00:23:13 Wow. Dr. Faru, and then you became a patient yourself.
Dr. Fru: 00:23:17 Oh, I’ve always been a patient. That’s why I went into medicine.
Kimberly: 00:23:20 Wow. That’s incredible. So now how old are your children, if you don’t mind sharing? Oh,
Dr. Fru: 00:23:25 Not a problem. Um, my oldest daughter, uh, pregnancy number four is five mm. And my youngest daughter, the result of genetic screening for aneuploidy, uh, pregnancy number eight is two and a half
Kimberly: 00:23:46 Right around my babies. Well, now my oldest is seven, and, uh, my youngest is about two and a half. Yeah. Oh, what a beautiful story.
Dr. Fru: 00:23:55 It, it, uh, it is adorable and I hope it, uh, encourages somebody out there, um, to hang in there. Uh,
Kimberly: 00:24:04 Yeah.
Dr. Fru: 00:24:05 Because usually while you’re going through it, um, whatever your fertility journey is, it feels very isolating. Mm. And so I always tell people there’s one patient who, whose journey I can share with you, <laugh>, without breaking any laws. And that’s myself,
Kimberly: 00:24:29 <laugh>. Well, also, Dr Fr this is, this is so inspiring. I think all of us can think of people that are struggling or I, I know. I can think of many, um, friends and, and just acquaintances and people. And so one of the things I will, you know, I, one of the reasons I’m also very excited to talk to you amongst many others in my research was that I found you and Oma because it’s all, it has this technology, but it’s also really affordable. So I was doing research and, you know, it was, you know, something, 9,000 or whatever, you know, parts of the process. And I found Dr. Fr places that were, you know, five times as much.
Dr. Fru: 00:25:05 Oh yeah. Easy. Easy. So
Kimberly: 00:25:07 Then easy. So then what we’re doing, what’s happening is people are getting priced out of these options. It becomes Correct, you know, this elitist thing. Yeah. Which isn’t, you know, we see that in many areas of society, this being one of them. So I’m really excited to promote you your amazing cl like Oma, because it’s got this technology, it’s also affordable. So can you, can you talk about, I mean, the founders, I don’t know who the founders of your brand are. Is that part of their ethos to say, Hey, this is an issue across the board, so we need to make this accessible to people?
Making fertility accessible and affordable
Dr. Fru: 00:25:40 So <laugh>
Kimberly: 00:25:41 Yes. Tell me
Dr. Fru: 00:25:43 <laugh>. So, um, I, I mean I, I partner with Oma because I agreed.
Kimberly: 00:25:49 Yeah. I
Dr. Fru: 00:25:49 Agreed. Um, my, my maybe the, the very core of me, um, realized that the women I set out to help could not have access to me. Right. And I did not need money to be the reason why a totally dedicated and capable individual could not become the parent that they wanted to be. Wow. I feel like it’s, I feel like it’s a calling, you know, it’s like a, like a vocation. Like, um, like joining the, I’m Catholic, so like joining the priesthood as an honorary, it’s a, it’s a calling.
Kimberly: 00:26:32 Yes. Spirit, parenthood spirit, spirit place, this talent in you to serve in this way.
Dr. Fru: 00:26:38 Yeah. And, and well, no, the, the calling to parenthood, I mean
Kimberly: 00:26:42 Oh, oh, that yes. Yes. For the
Dr. Fru: 00:26:44 People who wish to be parents. Cause not everybody wishes to be a parent. And I support that.
Kimberly: 00:26:49 Yes. Absolutely.
Dr. Fru: 00:26:50 The only people who should be allowed to be parents are the ones who want the job.
Kimberly: 00:26:55 Of course.
Dr. Fru: 00:26:56 I think it should be an act of affirmation. Mm-hmm. <affirmative> not an accidental assignment or a burden.
Kimberly: 00:27:06 Right.
Dr. Fru: 00:27:07 If a parent, if an individual does not wish to be a parent, we should arm them with all the tools to not be a parent and just live life
Kimberly: 00:27:17 Mm-hmm. <affirmative>
Dr. Fru: 00:27:18 In their terms. Mm-hmm. <affirmative>, if they wish to be a parent, I it feels discriminatory. Yes. Why do we have it so prohibitively expensive? Yes. That only certain parts of the population can access the care because the, the, the disease, the diagnoses are not restricted to only a certain economic demographic.
Kimberly: 00:27:44 Exactly. And so that’s what I found. Dr. Fru, I was looking around even here in LA where we live, and it was crazy <laugh> how big inexpensive places were. And they didn’t have any sort of new technology. They were just sort of these big centers in LA and which shall remain unnamed. One of them, um, became popular because one of the Kardashians went or something like that. But then I, you know, I’d interviewed them or, you know, these preliminary interviews, I said, well, what’s different? You know, what are your technologies? How are you sorting the sperm? And it wasn’t anything they could really speak to. So then I kept going, and then I found, you know, your, your clinic Dr. Fruit, I found you that, you know, OMA with the technology and the affordability. And I thought, wow, people need to know about this because across the board, if you really do, like you said, Dr, you really wanna be a parent. And I’m so passionate, I love being a mother, and we wanna support other potential parents. And it shouldn’t have to cost your whole salary <laugh>.
Dr. Fru: 00:28:44 Well, well, the founders didn’t think so. So, um, the company was established by, uh, three guys. Uh, there’s, uh, RGGI Singh who has a background in mathematics. And then, uh, wow. There’s, I know, uh, there is, um, Sahi Gupta, who is a, um, a physician by training and got interested in the infertility part of, of the problem of the healthcare problem, and established several clinics in India before moving here. And then there’s, uh, Karen Josie, who is also I, mathematician engineer type. And they, uh, had this idea, which is very different from, I think the more capitalist driven ethos of our healthcare system. I’m not saying anything against anybody, but if the market supports a certain price, why would anybody in their right mind go under that? So, but these guys being, you know, kind of outsiders thought, no, let’s do this. I think we can do this, uh, more efficiently. I think we can do this, uh, without costing an arm and a leg. And, and, and I think we can make innovations that actually improve outcomes. So that is the problem they set out to solve. And they found like-minded physicians who were like, yeah, let’s do that. <laugh>. Wow.
Kimberly: 00:30:23 You know what Dr. Fu, this makes me so happy to hear, and we all have stories like this, but makes me think of a friend, and I won’t mention her name. She lives in New York City. She’s a, um, nurse practitioner mm-hmm. <affirmative>. And she really wanted to be a mother. Mm-hmm. <affirmative>, she never found, she never ended up finding a partner. She never got married, but she was, you really wanted to be a mother. And so she went through the process. She got a sperm donor, she did I V f, she did all this stuff. And eventually she did end up with a daughter. It, it was a long process, but she has hundreds of thousands of dollars in debt. She had to take out loans for all her fertility treatments. And so of course she’s overjoyed. It’s priceless. Right. Her daughter’s priceless. But I look at her struggle now. You know, her daughter’s four years old. I mean, she has enormous loans, you know, so anyways, <laugh>. So I just, I think that, you know, who needs more stress? Does anybody need more financial stress? You know, on top of,
Dr. Fru: 00:31:20 Absolutely not. So
Kimberly: 00:31:22 Anyways, I just wanted to highlight that as is amazing and on top of the technology, and I wanna get more into the, um, technology. I have a couple more questions for you, Dr. Fru, unless you wanna add Absolutely.
Dr. Fru: 00:31:32 Go ahead.
Kimberly: 00:31:34 <laugh>. I love this. Um, so let’s go back to this, um, you know, or who is a candidate now for I V F, right? Because we said it’s not about age. Mm-hmm. And you have, let’s say all these conditions and we’ve had, um, you know, Dr. Fise on talking about pco P C O S and this growth. There’s just so much. Can you talk a little bit about women’s issues? And then we’ll talk about what’s going on with sperm, but with women today, what is going on? Like what, I mean, has P C O S always been there, but n but now it seems like it’s growing. Did we not talk about this stuff? Do you think Dr. Fr that there’s just so many chemicals, you know, so who’s a candidate today? Is it, you know, at any age if you’re trying to conceive for a certain amount of time? Is it, you’ve had a couple miscarriages, like what is it, who, who’s who’s, who’s the target?
Who is a candidate for IVF
Dr. Fru: 00:32:28 Anyone who has a reproductive problem that needs to be solved? So
Kimberly: 00:32:34 At any age, all these issues.
Dr. Fru: 00:32:36 Well, let’s not say any age, cuz then Oh,
Kimberly: 00:32:39 Well, yeah. I mean, like physi
Dr. Fru: 00:32:40 That introduces a whole different crop of considerations.
Kimberly: 00:32:43 Right, right.
Dr. Fru: 00:32:46 <laugh>, there’s the question of how old is too old <laugh>. Right. Right. Um, so physiologically, there, there comes a time in every woman’s life when the communication between the brain and the ovaries shuts down.
Kimberly: 00:33:08 Mm.
Dr. Fru: 00:33:10 And the brain yells and the ovaries doesn’t respond. That’s terminal dysfunction. It’s a marriage that’s headed for divorce, that is menopause.
Kimberly: 00:33:21 <laugh>. I’ve never heard it described quite that way. That’s very interesting.
Dr. Fru: 00:33:27 Well, most people get it. They they get it.
Kimberly: 00:33:29 Yeah. You
Dr. Fru: 00:33:30 Know, we, we all have examples of people who’ve gotten divorced and we go, oh yeah, that needed to happen.
Kimberly: 00:33:36 <laugh>. Yeah.
Dr. Fru: 00:33:36 Yeah. But for us, it happens whether we ask for it or not. Uh, if it happens before, if this dysfunction happens before age 40, it is called primary ovarian insufficiency. If it happens over 40, it’s just terminal ovarian dysfunction. And those people are candidates for assisted reproductive technologies with the use of donor eggs.
Kimberly: 00:34:03 So you can still get pregnant, your uterus can hold Dr. Fr after menopause.
Dr. Fru: 00:34:10 Correct? Correct. So most older individuals, so over 40, uh, with poor prognosis using their own eggs, can still carry a pregnancy
00:34:26 Derive from somebody else’s egg. These special group of angels we call egg donors. Um, and they, you know, purchase a cohort of eggs. They get fertilized probably with their partner sperm or these days I’m seeing a lot of single moms by choice Yeah. In their forties who are not partnered. Yes. And, um, we joke that we are making designer babies cause they are picking their egg donor and they’re a sperm donor. And yes. Putting the two together for these, this very unique genetic event. And, uh, then we get their UDIs ready with, um, uh, exogenous meaning from outside of the body, uh, estrogen and then progesterone and doing a transfer.
Kimberly: 00:35:13 So wait, go back to this doctor for your uterus can get prepared for hormones. It can, if you are healthy, your, your uterus can be healthy. You can carry a baby when you’re like 50.
Dr. Fru: 00:35:25 Correct.
Kimberly: 00:35:26 Wow. You have patience in your fifties.
Dr. Fru: 00:35:29 Yes. <laugh>. So,
Kimberly: 00:35:33 So the reason it doesn’t hold isn’t the woman’s like age, like let’s say you’re trying to implant when you’re, or whatever the term
Dr. Fru: 00:35:38 Is. No, no, no, no, no.
Kimberly: 00:35:40 It’s the embryos are ch chromosomally sound they can hold in there.
Dr. Fru: 00:35:45 Correct.
Kimberly: 00:35:46 Wow.
Dr. Fru: 00:35:47 Correct. Uh, there are, there is not anymore a reason to deny women in their forties the opportunity to become parents as our life expectancy gets longer.
Kimberly: 00:36:06 Absolutely.
Dr. Fru: 00:36:07 The, the natural age of menopause is about, uh, 51 in this country. And that’s typically when I am not as enthused about getting like over that. I’m not as enthused about getting women pregnant. There are some doctors who are completely comfortable with it, but I kind of am like, let’s just work within the boundaries of what nature is already set up. Please, <laugh>. Um, because there are risks, right. Even for the healthiest, uh, older mom, I tell them what you are signing yourself up for is a really high probability of pregnancy complications. You would be followed by a maternal fetal medicine specialist. Hmm. Um, you are at risk for hypertensive complications. Your blood vessels aren’t what they were when you were 20. Mm-hmm. And you are at risk for, um, gestational diabetes. Just treat it and take care of yourself and you can, you can go through the pregnancy absolutely beautifully deliver and, and have your child to then raise. Uh, but you have to be aware of what risks you are exposing yourself to. And if they have conditions that would make pregnancy too risky, then I advise for a gestational surrogate.
Kimberly: 00:37:31 Mm-hmm. <affirmative>
Dr. Fru: 00:37:33 Now, now we’re really doing three body reproduction. We get egg donors sperm donor into somebody else’s uterus. They hand you a baby.
Kimberly: 00:37:43 Wow.
Dr. Fru: 00:37:44 Wow. And, and, and he or she is yours? <laugh> <laugh>. Yeah. As to the other things, um, so with, with my patients who do not ovulate P C O S falls in that category, we can’t do ovulation induction. And if the sperm is normal, they can just have timed intercourse. Cuz their issue is there’s no matchmaking happening cuz no egg is ever available. So we correct for that. In younger patients
Kimberly: 00:38:12 You can take medication to force ovulation.
Dr. Fru: 00:38:15 Correct. Correct.
Kimberly: 00:38:16 Wow.
Dr. Fru: 00:38:17 And then if that doesn’t work, uh, we can then, um, take the medication guarantee that there’s an a, a, an egg developed, uh, force ovulation and then do an insemination. That’s iui again that the tubes to be open. Right. Uh, needs to be present and responsive and uh, a uterus without issues. And then we wait and see if we get pregnant. We get pregnancies that way all the time.
Kimberly: 00:38:47 Wow.
Dr. Fru: 00:38:47 And then the really big guns is I b f and that can address a whole flat of problems including recurrent pregnancy loss, which is infertility due to lack of maintenance of pregnancy.
Kimberly: 00:39:03 Hmm. What about, um, you mentioned me mentioned estrogen. What about progesterone? Is that something, when, is that, I’ve heard like that helps with healthy pregnancy as well. Are you putting, are you giving that to patients when they’re in the transfer stage or in the Yes. Other prior stages?
Dr. Fru: 00:39:24 So, so, um, the uterus is a response organ. So the brain’s in charge, the ovaries like the primary hormone architect. Right. The brain talks to the ovary as the follicle is developing, estrogen is being produced in ever increasing amounts that estrogen acts on the uterus to thicken the lining. So we mimic that once ovulation happens and that egg is available for fertilization, the structure, the follicle that contained the egg turns into a progesterone secreting organ known as the corpus lutia that helps to alize or change the architecture of the endometrial lining to be receptive to an embryo implanting. We mimic that exact process Wow. With, for example, the frozen embryo transfers.
Kimberly: 00:40:28 Hmm. <laugh> this is amazing Dr. Fr just to hear about all these different parts of the process.
Dr. Fru: 00:40:36 Hmm. It’s, it’s, it’s lots of fun to me because it is, uh, simple. It’s linear, it’s logical, and it has binary outcomes.
Kimberly: 00:40:47 Well, and so there’s another area I wanna talk about because now I’m start, you know, we’re launching this course and I really wanted to include this whole aspect about the technology, but when I, I, so I went backpacking Dr. Fr for three years after college. I was mostly in Africa, in Asia. I came back, you know, just started writing books and learning and growing. And so things like, what’s really popular today I hear about is egg freezing. Right? So when I was like 25 years old, I never heard of it. It wasn’t in my mind. But now it’s become this really popular thing. I saw it on your website. You also offer it at Ooma. So can you talk about that? Who should, you know, who’s a candidate for egg freezing? When should we do it? Why should we do it? Like how, what does it entail at, at Ooma?
Egg freezing and who it’s right for
Dr. Fru: 00:41:33 Uh, I love that you bring this up because first off, it’s not a panacea mm-hmm. <affirmative>, it doesn’t solve everything and it’s not guaranteed Correct mm-hmm. <affirmative>. But it is a very powerful tool for taking ownership of your reproductive future. And for some people gives them the opportunity to defer reproduction or even the opportunity to attempt reproduction down the line.
Kimberly: 00:42:03 Mm.
Dr. Fru: 00:42:04 It was not available when you and I were younger because it was still being developed and was considered largely experimental. Hmm. It was reserved also for women who had gotten a pretty terrible diagnoses like cancer for us to extract the eggs for them to potentially use, uh, when they had fully recovered and were in remission.
Kimberly: 00:42:29 So, could we pause on that? Dr. Fuso, if someone is about to go undergo chemotherapy, you would wanna do an egg retrieval first,
Dr. Fru: 00:42:37 Correct? Correct. If someone gets a cancer diagnosis today, during that appointment, I would hope the oncologist says, do you intend to have children or do you intend to have more children? And if you do, there is a reproductive endocrinologist I need you to speak to and bring somebody with you so they can listen for you. Cuz usually you get a diagnosis like that, your brain is just buzzing all over the place. But the number one regret that people who have survived their, their cancer diagnoses have expressed is that they were, their reproductive options were taken away from them.
Kimberly: 00:43:16 Yes.
Dr. Fru: 00:43:19 And so this is a way to preserve that. And that’s who the technology was originally intended for. However, it has been proven to be so safe, so well tolerated that it’s now not experimental anymore. The recovery rate, um, after oci cryo preservation is really high. The fertilization and the pregnancy rates are just as good as when you were the age at which the eggs were frozen. So, Hmm. It is now generalizable. And I would say my ideal candidate, if I was wishing yes, would be, uh, a young woman, uh, in her mid to late twenties, who is otherwise normal weight or as healthy as can be, is exercising, sleeping well, well hydrated, and then it’s two weeks of their life. And I collect anywhere from 15 to almost 30 eggs and I freeze it.
Kimberly: 00:44:21 You know, Dr. Fr I’m so glad we’re having this conversation because it does feel like the world is changing, you know? Right. It’s like, you know, it’s setting it for the third time, but there is more chemicals, there’s more toxicity, there’s more stress, it’s faster. We’re online. So this may be a huge part of the future of reproduction is, you know, using these technologies, which you said 3 million Americans are born of I V F, who knows what it’s gonna be like in 10 years.
Dr. Fru: 00:44:48 Oh, it’s only growing. It is only growing. It’s only growing. I mean, uh, the bar to becoming economically stable is getting higher and higher. If you go back 30 years, you graduate from college, you get a job, you get a mortgage. It was that easy.
Kimberly: 00:45:13 Yeah.
Dr. Fru: 00:45:13 Now you graduate from college, you’re under hundreds of thousands of debt, you try to pay that off your job’s not paying enough. Yeah. For you to think about having a house, let alone a baby down the line, <laugh>, it seems, it seems our goals just take longer to achieve. Yeah. So most women are at the point in their career of, okay, I’m now financially stable. I have the house that I always wanted and the backyard that I always dreamed of, and I am, you know, ready to get married and have babies and they’re almost 40 or over 40.
Kimberly: 00:45:54 Mm-hmm. <affirmative>. Mm-hmm. <affirmative>. Well, let’s say Dr. Fr, you’re, listen, someone’s listening to this and they’re like, oh wow, I missed the boat. I didn’t think about this when I was 25. You know, I’m a bit older now. We are told as women, okay. With a sperm quality, which we, we still have to talk about. But with women, we’re like, oh, you’re born with all your eggs. What if you’ve been on a bunch of medication or, um, you know, things have happened. Is there anything we can do to improve our egg quality? If you’re listening to this and you wanna do some of these technologies a bit later in life? Or is it, you know, you just, you try and you see what the technology can do. I mean, you know what I’m, I’m trying to say.
Can you improve your egg quality?
Dr. Fru: 00:46:33 Um, so, so you’re, you’re trying to see if my non-ideal candidate is also a candidate for, uh, egg freezing. There’s
Kimberly: 00:46:44 Anything we can do for egg quality in general. I mean, living a non-toxic life, I imagine having less, you know, toxicity on our whole body.
Dr. Fru: 00:46:55 So, so the, the, the truth of the matter is we are a product of our environment. Yes. And we are born, actually, we acquire all, all the cells that will eventually become eggs in gestation. Hmm. And then there’s this never ending process of attrition. Well, not never ending. It ends at menopause. This process of attrition by which we, we lose the eggs and they get exposed to every stressor that get exposed to. It’s like the, the ovaries live our lives with us. Your ovaries know exactly how old you are. Um, even if you look 20 and, and it, it’s a tough realization to come to. But I think the starting off point for every woman who’s considering doing this is to get evaluated. Mm-hmm. <affirmative>. Cause when we can talk about generalities and a particular age group, you could be a 25 year old with P O I I’ve made that diagnosis.
Kimberly: 00:48:04 Wait, what’s p o i?
Dr. Fru: 00:48:05 Oh, primary ovarian insufficiency. That’s when the brain hormone levels of follicle stimulating hormone get really, really high and the ovaries are non-responsive. Kimberly: 00:48:15 Hmm. Well I was also thinking Dr. Far like a, a a friend, you know, we all, we were talking, there’s all these people, you know, like actual real life situations. Mm-hmm. <affirmative>. So she had double ectopic pregnancies mm-hmm. <affirmative>. And she got chemo somehow, you know, when you’re fallopian tube ruptured. I don’t, I’m not, I’m not exactly sure, but she had to get
Dr. Fru: 00:48:36 Oh, um, methotrexate. Yes.
Kimberly: 00:48:38 Yes. So then she said, you know, she was like, oh, now I wanna research I V F and I, and I was, oh, I don’t know. Can you still do egg retrieval after you’ve had those heavy medications or can you rep repeat? Yes. Okay.
Dr. Fru: 00:48:52 Not, not all chemotherapy is, um, what we call cytotoxic.
Kimberly: 00:48:58 That’s great news.
Dr. Fru: 00:49:00 That is great news. However, there are several but are <laugh>.
Kimberly: 00:49:04 Right.
Dr. Fru: 00:49:05 So it’s never
Kimberly: 00:49:06 Easy answer.
Dr. Fru: 00:49:06 And, and important part of my intake visit is trying to figure out the journey that you’ve been on and what your exposures have been, what your surgical history is, your medical history, um, especially significant things like bilateral ectopics. I know your tubes are compromised.
Kimberly: 00:49:30 Yeah.
Dr. Fru: 00:49:31 And you would be taking a chance. That’s somebody I would not suggest to do iui. I would say, Hey, how about I V F? Because then I know that the embryo gets dropped off in your uterus <laugh>.
Kimberly: 00:49:41 Right,
Dr. Fru: 00:49:42 Right. And not in year two, which sets you up for a medical emergency.
Kimberly: 00:49:46 Yeah, exactly.
Dr. Fru: 00:49:48 So, so when I say we consider the entire patient, that’s what I mean. So each, each, each person on this planet is an n of one experiment. I can speak to generalities, I can speak to groups.
Kimberly: 00:50:09 Right.
Dr. Fru: 00:50:09 Until I know in this moment what your labs are. I cannot give you the most informed treatment plan. It has to be specific to you and it has to make sense.
Kimberly: 00:50:27 And, and going both ways, doctor, for your demoing the woman. And then let’s say you take a look at the man’s sperm and the motility isn’t great or it’s just not of great quality. And so give them some homework. Eat healthy, you know, blah, blah, blah. How quickly can a man’s sperm turn around? I mean, of course, I know this is a general answer, but let’s say they’re very poor quality to the point where you can freeze it and use it in your I V F procedures
How quickly a man can turn around his sperm for IVF procedures
Dr. Fru: 00:50:53 Usually three months.
Kimberly: 00:50:55 Okay. That’s not bad.
Dr. Fru: 00:50:57 It’s not terrible. It’s not terrible. It is not terrible. So the thing with the guys is they are 50% responsible for infertility.
Kimberly: 00:51:07 Right.
Dr. Fru: 00:51:08 And most of them don’t think they’re the problem. Air quotes. Um, and they, they, they, they come to me and say, oh, it can’t be me. I had a baby. And I’m like, how long? How long ago? And they’re like, 14 years ago, <laugh>. Oh man. And I laughed because, uh, the other thing about each individual being an n of one experiment is that that experiment participant is constantly changing. You are not you that you were one year ago.
Kimberly: 00:51:39 Right.
Dr. Fru: 00:51:40 There’s constant flux. And for the guys, there’s constant turnover in the sperm. So whatever they have been exposed to will show itself in the sperm. And sometimes the sperm is, uh, the canary in the cold mine as to something else that’s going on with the guy. Right. So when I pick up that sperm, my next suggestion, aside from uh, a urology, uh, evaluation is can you go see your primary care physician
Dr. Fru: 00:52:11 When was the last time you got a a checkup? Right. If somebody needs to see if there’s something else going on with you. We have picked up cancers this way. We’ve picked up cardiac issues this way. Uh, you know, the list goes on. And, and, and the only thing that brought them in was infertility.
Kimberly: 00:52:30 I’d be interested. There’s such a rise in autoimmune inflammation. I wonder if that is correlated with sperm health.
Dr. Fru: 00:52:39 A stressor, isn’t it? Yeah. In the sperm do grow in the context of a body. So whatever the body is exposed to there go the sperm. Um,
Kimberly: 00:52:49 We, Dr. Fr how did the men in Cameroon react when you brought up that, you know, the ones that are trying to replace their wives with younger women that
Dr. Fru: 00:52:57 Can produced
Kimberly: 00:52:58 It might be your problem guys. <laugh>
Dr. Fru: 00:53:01 There is much work to be done.
Kimberly: 00:53:04 Yeah.
Dr. Fru: 00:53:05 It is almost never the men’s problem out loud.
Kimberly: 00:53:11 Right,
Dr. Fru: 00:53:12 Right. Um, individuals will seek out, uh, specialists and get treatment up to and including I V F without ever mentioning male factor as a diagnosis.
Kimberly: 00:53:26 Well, what if someone has okay sperm, it’s not great, but it’s not horrible. Does that, um, that insight that the OMA technology can it salvage Okay. Sperm?
Dr. Fru: 00:53:36 Absolutely.
Kimberly: 00:53:37 So you’ll find,
Dr. Fru: 00:53:38 I tell the guys, well, I tell the guys this in a spontaneous conception. So I need a threshold of 10 million modal sperm to give us a 15% chance in a good prognosis patient at a pregnancy in an IVF cycle. I need only as many perfect sperm as I have mature eggs.
Kimberly: 00:54:01 Mm.
Dr. Fru: 00:54:03 So if your partner gives me 12 mature eggs, which I consider a good cycle, then we only need 12 sperm.
Kimberly: 00:54:11 What
Dr. Fru: 00:54:13 <laugh> go in there and find us. It makes the the efficiency. Yes. So much better. So, uh, good. 30% of the people that I’m recommending for I IVF is pure male factor.
Kimberly: 00:54:29 Wow. And I was reading online too, doctor, about male age impacts male sperm. You know, there’s this idea sometimes that men are constantly producing sperm, so it’s fine forever, but there is research that it does, correct me if I’m wrong, it gets compromised as the man is older as well. So you wanna make sure that your test, again, back to the, um, this in incre, I mean, it’s just incredible, doctor, when I think about friends and people that we know that have had many miscarriages and they can’t seem to get pregnant, but then this technology is present so that it can screen out the best sperm Right. And in the chromosomal so that someone can really take it to the, to the finish line, so to speak.
If male age impacts male sperm
Dr. Fru: 00:55:13 Yeah. And you know, again, even the pregnancy rates and even chromosomally, normal transfers is 70% tops.
Kimberly: 00:55:26 Mm-hmm. <affirmative>. Mm-hmm.
Dr. Fru: 00:55:27 <affirmative> is not a hundred percent
Kimberly: 00:55:29 Right.
Dr. Fru: 00:55:30 The holy grail of research. The thing I wish I could figure out is how we study the endometrium and it’s, um, and the, and, and what that environment needs specifically to encourage implantation. There have been the, the testing that is currently available does not fully or sufficiently in my opinion, address that it hasn’t made the implantation rates any better than 70%. Kimberly: 00:56:14 Wait, so you mean Dr beyond what you mentioned before, taking the progesterone or whatever mi hormone mimicking medications you’re taking at that stage, you’re saying that there’s more work to be done to make it high. Oh,
Dr. Fru: 00:56:28 Correct. Absolutely. All we’re mimicking is what the ovary normally does.
Kimberly: 00:56:33 Right. But there’s some other factors. Well, for some reason, some people aren’t able to the
Dr. Fru: 00:56:37 Uterus, we are still in the early phases of understanding the interaction between the embryo and the endometrium.
Kimberly: 00:56:50 Mm
Dr. Fru: 00:56:53 Mm If that ever gets fully figured out, we can make it. So I hope that every transfer results in a pregnancy, especially for euploid embryos,
Kimberly: 00:57:07 Especially for, excuse me, what was that,
Dr. Fru: 00:57:08 Sorry? Genetically normal embryos.
Kimberly: 00:57:11 <laugh>. Oh, <laugh>. Genetically normal embryos. Yes. Yes. Inside of the, inside of the uterus.
Dr. Fru: 00:57:18 Mm-hmm. <affirmative>. Mm-hmm. <affirmative>.
Kimberly: 00:57:22 Wow.
Dr. Fru: 00:57:22 That’s, that’s the thing I would like to have figured out. But yes, uh, sperm does get compromised because the, the host, the person generating it, um, has aging, uh, infrastructure
Kimberly: 00:57:35 <laugh>. Mm-hmm. <affirmative>, is it easier for someone, I think I read this story Dr. Fr, where a wa like a mother, uh, like an older mother carried for her daughter. I think her like 30 year old daughter had cancer or something. Like you said, like she took out the eggs and then her like 60 year old mother carried. Is it easier in her, like someone that’s already had children, their uterus is um, more prepared versus someone that’s had many miscarriages and then has, would, would they perhaps have a harder trouble with transfer or it doesn’t translate like that?
Dr. Fru: 00:58:09 Mm. Not necessarily. Okay. Because we don’t fully understand why some people have miscarriages. Right. We think that, um, number one, there are chromosomal issues. Number two, there are structural issues with the uterus. Things like a uterine septum or polyps or fibroids. We screen against that before we do, uh, an embryo transfer in I V F. Um, and then there are metabolic things like undiagnosed untreated diabetes or thyroid problems. Mm-hmm. <affirmative>, we also screen against those and we correct for it. And then there’s something called antiphospholipid antibody syndrome, which is a, whoops,
Kimberly: 00:58:48 <laugh>
Dr. Fru: 00:58:49 Theories of clotting disorders.
Kimberly: 00:58:51 Got it. That, Dr. Fru: 00:58:53 That may not present, um, as a major clotting event in the mom, but may present as recurrent pregnancy loss.
Kimberly: 00:59:02 Hmm.
Dr. Fru: 00:59:03 So we, we, we, we check for those things of course, but 50% of the time, like I said, we don’t find a reason.
Kimberly: 00:59:11 Yeah.
Dr. Fru: 00:59:11 Mm-hmm. <affirmative> and even in women who’ve had a, uh, had three or more losses, if we just follow them into their next, they have a 60 to 70% chance of a normal pregnancy that goes all the way.
Kimberly: 00:59:28 Well look at you Dr. Far, your inspiring story. Eight pregnancies and two babies. Two
Dr. Fru: 00:59:34 Babies,
Kimberly: 00:59:35 <laugh>.
Dr. Fru: 00:59:36 Yay. Look at
Kimberly: 00:59:38 This beautiful smiling face,
Dr. Fru: 00:59:40 <laugh>. I’m like, I did it. I’m done. <laugh>,
Kimberly: 00:59:45 Dr. Fr I could literally talk to you all day. It feels like just, it’s such a gift and an honor to really get into this, which I’ve never had a conversation about this before. And, you know, to this degree, it’s been a huge education for me and I’m sure for all of our readers. Is there anything else? I’m, I mean there’s a million things, but some, anything that you think people need to know before we wrap up here? Anything I didn’t cover in the technology or the information around assisted reproductive technology?
Karenne shares a few final comments
Dr. Fru: 01:00:20 I’ll make a few comments.
Kimberly: 01:00:22 Yes, please comment.
Dr. Fru: 01:00:23 Yes. <laugh> number one, infertility is just another disease and we need to stop treating it like this taboo subject. Mm-hmm. <affirmative>, we need to stop having it shrouded in shame and isolation. We need to talk about it. We need to normalize it. It is affecting at least 10% of the population and it needs to be addressed head on. Secondly, I would challenge other clinics or spaces that in the infertility space that treat patients to consider making it more affordable and more accessible. Yes. So more people are able to access it because you don’t have to make a certain income or be graced by a certain economic situation to be a good parent.
Kimberly: 01:01:25 Yes. And
Dr. Fru: 01:01:27 They have other people, resources that you can tap into, but financial isn’t one of them. So I would challenge anyone outside of OMA to, to do that. And if not, OMA will lead the charge until other people join us.
Kimberly: 01:01:43 I love it. And that’s one of the reasons I wanted to highlight you today, doctor, for the passion, the authenticity. I’m getting goosebumps. You are doing it because you really care. And we want people to be parents that, like you said, love to be parents. So Oma is awesome in that way. It was, when I was doing my research, it really stood out the clinics. The other ones were like five times more, 10 times more.
Dr. Fru: 01:02:06 Look, I love my job and afford
Kimberly: 01:02:08 Yes,
Dr. Fru: 01:02:09 I love my job. I, I think we need to do more on patient education and uh, and it, it helps that I feel I am giving solid quality care to a demographic who wouldn’t otherwise have access to it.
Kimberly: 01:02:35 Yes.
Dr. Fru: 01:02:36 And the message is coming from <laugh>, you know, a Cameroonian, <laugh>, American, a a little brown woman. Um, you know, and I, my delivery is, is is as gentle as this conversation has been, um, is as detailed as this conversation has been because I want the patients to leave fully understanding what the problem is that we’re trying to solve at the very least and what their next steps are.
Kimberly: 01:03:15 Mm-hmm. <affirmative>,
Dr. Fru: 01:03:17 You know, I, I use this metaphor all the time. If you, if you’re listening and you’re a patient of mine, you’ve heard this before, we are now on the same team. I’m just a team Captain <laugh>, and you’re my MVPs.
Kimberly: 01:03:31 Oh, I love it. Dr.
Dr. Fru: 01:03:33 Faru and who’s
Kimberly: 01:03:35 Lucky enough to be your patient
Dr. Fru: 01:03:37 And, and a men, men you reproduction is a two body problem at very least.
Kimberly: 01:03:45 Mm-hmm.
Dr. Fru: 01:03:45 <affirmative>, please don’t put up any fuss with getting a semen analysis. Mm-hmm. <affirmative>, let’s normalize that. We just get checked. It is not a woman problem, it is a people problem. <laugh>. Thank
Kimberly: 01:03:59 You. Yes.
Dr. Fru: 01:04:02 Yeah. So I, I guess I’m a bit of a feminist. <laugh>. The world benefits from everybody being a bit of a feminist cuz we are the majority of the population.
Kimberly: 01:04:14 Well I also, you know, Dr. Fu, you’re an amazing ambassador for this because obviously you’re so brilliant. You’ve gone through the process and there’s so much strength in the gentle, this loving way that you are holding space. And that’s a really important aspect of this type of medicine. I imagine when someone’s coming in vulnerable, fragile their dreams, they wanna have a family. We really need to hold the space for that human. It’s not just another number, it’s not this Correct. You know, <laugh> statistic, but you know, everybody’s a unique human with, with feelings and goals and dreams and aspirations.
Dr. Fru: 01:05:17 We have context.
Kimberly: 01:05:19 Yeah.
Dr. Fru: 01:05:20 We hold space for context cuz it’s everything.
Kimberly: 01:05:24 Right. Right.
Dr. Fru: 01:05:25 It’s everything. And meeting your patient where they are.
Kimberly: 01:05:29 Right.
Dr. Fru: 01:05:31 Offering, offering options that align with their worldview and their expectations, but also not forcing anyone to make a decision that doesn’t feel natural or good to them. I tell my patients that the whole process should be a series of small celebrations.
Kimberly: 01:05:58 Yes.
Dr. Fru: 01:05:59 Number one, you made the appointment, you’ve overcome so much, you’re an infertility warrior, you’re searching for answers. Right. Commend anybody who makes that appointment. Right. And, and then we take it a step further. Once we complete the evaluation, we know what our options are. You’ll get the full breath of them from me.
Kimberly: 01:06:23 Mm.
Dr. Fru: 01:06:24 You’ll choose one and then we will act on it until you tell me to stop.
Kimberly: 01:06:32 Mm-hmm. <affirmative>,
Dr. Fru: 01:06:33 Then I will, you will get mental health support along the way. Um, I offer my patient patients a list of therapists. I suggest having someone help you along the process. There will be a lot of things to talk about. People getting new diagnoses that are unexpected and earth shattering male factor is one that the guys do not handle well. And I usually am suggesting talking to a therapist as a team and then alone so that they can talk out how they feel about getting this diagnosis. As women, it has been beaten into our heads over our lives that our role is to have babies and we expect, uh, us to be the problem.
Kimberly: 01:07:23 Mm.
Dr. Fru: 01:07:25 And the men are on the contrary told that they will be lords and gods and fertile till they die. Yeah.
Kimberly: 01:07:37 Right.
Dr. Fru: 01:07:38 So I think we need to change that narrative a little bit from a medical education standpoint, a from a person education standpoint,
Kimberly: 01:07:47 Definitely it
Dr. Fru: 01:07:48 Is a two body problem, at least <laugh> awesome. A two body problem. And it is solvable is the, and is is really the end goal. It is. There’s, there’s a always a solution to becoming a parent. It just depends on, you know, if you’re willing to put in the work and, and have a team that’s willing to support you.
Kimberly: 01:08:09 Wow. Well, doctor, for one last question. This has been so amazing. Anyone listening to this that wants to work with you, Dr. Faru, you are in Atlanta. Can people that are doing this technology, can they do some of it at home, like some checkups, and then come see you at certain junctions so that Oh,
Dr. Fru: 01:08:26 Absolutely. Oh, great. So we do <laugh>, we do, uh, initial visits, uh, like this. All, all the physicians in the Ooma network do, um, tele visits for the first visit. Okay. Yes. Uh, I, I like it particularly because, uh, these days we have the patients come in masked in the office because we’re very small team and we’re very conscious now in this post covid world that we’re living with Covid and, and all the other things out there. And we wanna keep our workforce healthy. So we keep the masks on in the office, but this way I get to see my patients.
Kimberly: 01:09:06 Yeah.
Dr. Fru: 01:09:07 And then I can suggest the initial workup to be done remotely. We can send orders for you to have fulfilled at your OBGYN’s office and sent to us for at least the first phase of medical management for the people who are local to or within driving distance of Atlanta. It’s better to be seen at our clinic because we don’t charge you a thing for your workout.
Kimberly: 01:09:30 Mm mm
Dr. Fru: 01:09:31 And then, um, once you go into the treatment phase, then I typically need to see you three or four times over the course of two weeks.
Kimberly: 01:09:42 Mm
Dr. Fru: 01:09:43 Mm And then after a retrieval, you can go back and we can, uh, just communicate via phone about the results of your fertilization, your embryos that are ready to be frozen, and when they get, and when they get biopsied, before they get frozen. And then the results of your, uh, testing, your genetic testing. And then, um, the workup, the preparation process for your embryo transfer happens largely at home. And then there’s one ultrasound to make sure that your uterus looks tip top and ready to go. And then you start your progesterone, and then you just need to be present for your embryo transfer. And then you can do your pregnancy test remotely.
Kimberly: 01:10:28 Oh, <laugh>.
Dr. Fru: 01:10:29 Where there’s a will, there’s a way. <laugh>. Well,
Kimberly: 01:10:33 And also Dr. Fur, there is this, um, which shall remain unnamed, a very expensive clinic in Colorado, where I know I have had friends fly into there, or people I know. So it’s great that to know that, you know, if people really connect with a doctor like you, Dr. Fr, who is amazing, um, with this process, it doesn’t have to be in the same city. There’s, you know, some, some travel. But, um, as I wholeheartedly believe with your healthcare team in any aspect, which even that involves, you know, in the, um, expanded role of acupuncturist, Ayurvedic physician, primary care physician, you really have to connect to who is leading the charge, who is caring for you. And so, um,
Dr. Fru: 01:11:18 And I encourage any patient when I meet them. I’m not everybody’s cup of tea.
Kimberly: 01:11:24 No, no, no one’s everybody’s, you don’t like me cup of tea. Yeah. <laugh>
Dr. Fru: 01:11:26 If you, if if you don’t, if you don’t like me, uh, you find another doctor, you owe it to yourself.
Kimberly: 01:11:33 Mm-hmm. <affirmative>. Well, I can’t imagine who wouldn’t like you Dr. Fr, but
Dr. Fru: 01:11:37 <laugh>, most people exist, but they find a doctor that’s right for them. That’s, and that’s ok. That is encourage that because I put too much of myself into my patients for them to not trust that I have their best interest in mind.
Kimberly: 01:11:51 Yes. Yes. I love that healthy boundary. So thank you so much Dr. Fr this has been a incredible conversation. Thank you for sharing all your knowledge and your wisdom and your beautiful heart and just an amazing human, really enjoyed forming us.
Dr. Fru: 01:12:09 I enjoyed myself, Kimberly. Thank you.
Kimberly: 01:12:12 Thank you so much, Dr. Fr.
I hope you enjoyed this incredibly informative and empowering conversation with Dr. Fr. And just remember that if you are really called to be a parent and to be a mother, which has been one of the greatest gifts of my life, and there’s struggle, just I, um, I encourage you to explore the options that are out there. And that is one of the great gifts of science and technology today that can really support us in ways, you know, as the modern world becomes more toxic and busy and rushed, there is also helpful technology that is the bright side of that.
So please be sure to check out our show notes about Dr. Fr and Oma Fertility, which is the clinic that she worked at that she, um, you know, we talked about the, the many benefits of this particular clinic and, you know, they’re in various cities across the US and also, um, you know, maybe one that if this is of interest, you could even travel to.
So it’s all over on our show email@example.com as well. Other shows I think you would enjoy other interviews, articles, recipes, meditations to support you in living your most clear, inspired, loving, peaceful, healthy life. We’ll be back here Thursday for our next q and a show till then, sending you so much love and so much gratitude. Namaste.