Introduction and personalized fertility care

Welcome, Dr. Victory. It's so great to have you here. I'm very excited to pick your brain today about like kind of the sense that I've gotten from watching you over the years and just, like, listening to your content and and feeling like, here's a reproductive endocrinologist, conventionally trained, pretty amazing at his craft.

And simultaneously, he's saying so many things that resonate with my natural, holistic brain in the sense of personalizing and really like thinking about the person that's sitting in front of us instead of like, I have a hammer, everything is a nail.

I'm just going to like, you know, dove that nail into the wall. So instead of that, I feel like you do hold this very dynamic space that is are about like, let's personalize, let's figure out which medications are right for someone.

Let's let's have better ways to understand people then, like everyone needs the same protocol. And my protocol works how many of a percentage of the time.

So thank you so much for having me. I'm very excited to be here and join you today. This is an awesome opportunity, so I appreciate that. I do think it's critical to personalize fertility care for patients.

I think in general, medicine is moving towards individualized care and the benefits of that care are very obvious in a variety of different medical fields, maybe not anywhere more so than in fertility, where every patient is different.

I mean, we're dealing with different biologies, you've got different ages, you've got different immune systems, you've got different sperm quality, you've got women with endo, you've got women with adenoids going on with fibroids.

I mean, there are so many different pieces to the puzzle that if you just try the same approach every time, sure, you're going to end up being successful, but you're going to torture the patients in the process because they may have to do it five times instead of one time or right girl times instead of fewer times.

They may need more aggressive treatment. One a simpler, more elegant solution was right there in front of you. You just weren't paying attention to the details.

Sadly, our industry, especially in the United States and even to some extent in Canada now, is heavily driven by the financial component of it all. And because we're so focused on the money, they lose sight of being doctors.

And now we've moved into a system where we're all really focused on how much IVF to we get patients to do.

Holistic factors in IVF and patient-specific protocols

I've always adamantly refused to do that, so we always talk to our patients about all of the options and I want you as a patient to choose the option that fits you.

That's great. It doesn't make sense that you do what I want you to do. It makes sense that you do. It fits you and you as a couple best. And that depends again on your biology.

Yeah, yeah, absolutely. Really well-stated. And I think that a lot of people have had a belief system that there isn't equally significant amounts of things to personal life.

But I'm curious if you could shed light on what are the things that people could be thinking about personalizing when it comes to their IVF journey, which sometimes like, you know, I've heard so many people say to me, like, Oh, this is the protocol my doctor uses and they won't budge from that protocol.

Right? And and you're here, you are like, it gives me so much hope for the reproductive medicine world because you're like, no, actually this can be personalized too. So yeah, like if you can share more about what are these things that people could be thinking about personalizing, and for those doctors out there that are listening in that are like, Oh, I never thought about personalizing that, hopefully.

Yeah, for sure. So there's no question that there are multiple aspects that can be personalized. I love your content because you're looking at a very holistic approach and realistically that's actually the basis of every person's cycle.

Look at everything, look at their vitamin levels, look at their stress levels, look at their psychological well-being, look at both individuals. Don't just focus on the women because the guys all too often get forgotten.

We're not looking at their bad habits like smoking, drinking, drug use. We're not focusing on the male weight, which can have a huge impact on sperm quality.

You know, look at their fitness levels. So there's a lot of different individualized issues that come into this from a holistic perspective that are really critical.

We have naturopaths on staff. We recommend that all of our patients consult with our naturopath. We often recommend people look at options with acupuncture.

We want to make sure that patients feel very comfortable about their protocol. Education and communication are huge. If you can educate more and you can communicate better, the patients feel more comfortable, and the more comfortable they are, the better the result they're going to get.

Given how complex and individualized treating endometriosis patients is, how do you ensure a personalized approach to their care while maximizing success rates in IVF treatments?

We're not looking at their bad habits like smoking, drinking, drug use. We're not focusing on the male weight, which can have a huge impact on sperm quality.

You know, look at their fitness levels. So there's a lot of different individualization that come into this from a holistic perspective that are really critical.

We have naturopaths on staff. We recommend all of our patients consult with our naturopath. We often recommend people look at options with acupuncture.

From the actual protocol standpoint, there's no question that different patients need different protocols that we always joke on the show and say, we're not baking cookies.

How do you navigate the unique immune system responses and estrogen levels of each patient to optimize the outcomes? So individualizing protocols is also very critical to the overall approach.

Immune system, endometriosis, and LIT therapy

And there's no question that different people need different protocols. So we always joke on our show and say, cookie cutter medicine doesn't work. We're making babies, we're not making cookies.

And I, I, you know, say it facetiously, but the reality is that it's really important to individualized protocols. Many centers use these ultra high doses of medication for patients with very weak ovaries.

If you have very weak ovaries, whether I pound you with medications or give you very little, you're literally going to make the same number of eggs. So why are we giving people these high doses which have been proven to be detrimental?

Conversely, if you've got very strong ovaries, do really need high doses. Again, you probably don't. You can make enough for less endometriosis patients.

They need a tremendous amount of individualization because their immune systems are different, their responsiveness is different. We don't want super high estrogen levels.

So there's a lot of different things that you need to customize for each patient so that your final goal is really performing the best you can with each.

Try for each and every single patient rather than I think I can do this in four tries of IVF. I never want to do four tries of IVF because I tell everybody with a last name like Victory.

Failure is not really a good option. So we want to make sure that we are successful on first try every time. So we individualize because I think it serves the patient's best.

Cheating enemy trials. This is just so individualized and it's so complex. How do you approach endometriosis from a personalized way to maximize the success rates with IVF treatments?

We do delve into the reproductive immunology and the microbiome as well, so there is quite a wealth of evidence now that the microbiome is critical and so we spend a lot of time testing and addressing that and there's no question that the immune system is important.

I don't think we've worked out all the kinks in the treatments and the tests, but we are big believers that some elements of your immune system can play a big role.

And so we offer both testing and treatments that many people don't believe in or or, you know, advocate for. And we've seen the success with that. I mean, we have a flood of people coming to us for leukocyte immunization therapy, more commonly known as LIT.

In Your Practice, you've highlighted the significant impact of leukocyte immunization therapy or LIT as it's often referred to on improving fertility outcomes for patients.

Can you talk a little bit more about how it works and its role in addressing the immune system challenges during IVF treatment? So it is a very interesting thing.

There are many women whose immune systems are either not trained to accept the embryo because it's half, you know, proteins from the male which their body doesn't recognize or their immune system is overly aggressive to those proteins because it looks at them and says, hey, that doesn't look like us.

Maybe we should kill it and get rid of it. So light therapy is where we take the males white blood cells, we isolate them and we inject them under the skin of the woman's forearm so that she mounts an immune response.

Now that she's mounted that immune response, her body recognizes those proteins and is less likely to attack in the subsequent attempts or pregnancy. So you've kind of telling the immune system, hey, you see, all these proteins don't attack these ones.

These ones are okay. And by strengthening the immune system to do that, it's much more receptive. And we know the immune system has to have what we call active acceptance of the embryo.

It's got to look at the embryo and say, Yup, that has a place here, it belongs here. I'm happy to let it, you know, foster and grow here. And if the immune system's overaggressive, it won't work.

And so our job is to kind of train the immune system to sort of say, this is going to be okay, please don't attack. This one will be fine. Nothing bad is going to happen. So that's part of what.

I appreciate your holistic approach to fertility care so much. You're one of the few Ari's out there that is actively integrating holistic and functional medicine like traditional Chinese medicine, acupuncture and naturopathic medicine.

Can you share a little bit more on how these integrative medicines of care to support a model that is actually increasing the success of fertility treatments?

Yeah, I mean, I think from the holistic perspective, I firmly believe that all fertility centers should have alternative care models on site. So a natural path, a traditional Chinese medicine specialist, someone that can provide acupuncture.

I think those therapies are critical to our overall success and the well-being of our patients.

Integrative medicine and clinic support team

I think that you probably should have a psychologist on board or social worker as well, because that can be also very helpful in helping trying to calm the whole process for the patients and having a comfort cushion, a buffer for them between the physician and the patient.

From the standpoint of of actual medical therapies, I mean, there's there's a lot we really try and use cutting edge technologies here. So examples of things that we use that we don't find everywhere else, time lapse embryo scopes where you don't have to manipulate the embryo, you can actually watch them, develop them and grow without ever pulling them out of the incubator.

Yeah, that's really cool. You mentioned the use of PRP or platelet rich plasma therapy as a method to potentially enhance fertility outcomes. Could you get a little bit more into the PRP therapy, how it works and what effects does it have on ovarian health and fertility?

Health have you see that contribute to improving markers like AMH in women that potentially have premature ovarian insufficiency or things of that sort and does it play a role in the outcomes that they're going to have with their IVF treatment?

It's called platelet rich plasma. So we draw your blood. We've know that has the platelet rich portion. Platelets are full of cytokines and growth factors and so they're known to kind of rejuvenate the tissue.

If you've ever heard of vampire facials, this is where we draw your blood from. It gets injected in to rejuvenate the skin tone. And so they realize that if you did it into the ovary, it actually could increase your AMH level, decrease your alpha level, make your ovaries of that more robust.

So it's something that we do here. PRP is just being utilized in so many different ways, so many different types of medicine. They're using it for hair, rejuvenation and skin and facial rejuvenation.

So many different ways that PRP is being applied. Even I've heard of osteopathic doctors or naturopathy doctors that specialize in bone health and for patients with arthritis and things like that really being benefited by integrating PRP into their approach or their mode of healing.

There is a need for innovation and too many times in particular, honestly, in the U. S., but even in Canada as well, physicians and fertility physicians are just kind of stuck in there.

This is what I was taught. This is what I'm going to do. But some of that technology I'm learning is 20 years old. I mean, we've we've moved from having 30% success rates to having an over 80% success rate.

You can't stay stagnant or you're really doing a disservice to the patients. And it's one thing if no one's paying for anything, you can maybe, maybe justify a bit of that.

But when they're paying for the service, how can you justify not offering people the best? And that's why we we spend our time constantly studying and experimenting, trying and then making sure that it's adequate and appropriate for the patients.

You mentioned earlier the impact of nutrition and diet when it comes to fertility outcomes. And of course, I'm a believer highlighting the role of nutrition in reducing inflammation, oxidative stress.

There's so many important influences to fertility. When we have the right nutrients, the right vitamins, the antioxidants, etc., and their specific diets.

The most well known is the Mediterranean diet. That's been talked about a lot. There's a lot of research on how it's particularly beneficial for fertility patients.

What aspects of this diet make it advantageous? How do you incorporate dietary recommendations for your patients that are going through IVF that maybe don't want to address diet and lifestyle?

How do you encourage them to incorporate a fertility friendly diet into their IVF journey and how important is it?

PRP, innovation, and advancing fertility treatments

I'm very. Curious. Anybody saying diet doesn't matter isn't reading right? Like there's there's no question that diet makes a huge difference in in multiple different ways.

So we know that an inadequate diet that doesn't have enough vitamins is going to increase your level of oxidation. And if you don't have a high level of oxidation and you don't have enough antioxidants, mainly vitamins in your diet, you're going to be more inflamed.

Inflammation, definitely not good for fertility. Likewise, if you're eating a pro-inflammatory diet, one high in sugar or one high in cholesterol, you're doing a lot of damage to your body.

And so that's not a good thing either. So there is no question that diet has a significant impact. There are many studies that have shown that an adequate diet does make a difference.

We focus a lot these days on the Mediterranean diet, and the Mediterranean diet can be quite helpful when you look at the epidemiol object studies, they say, you know, less red meat, lots of fresh vegetables, fish and poultry.

If you are going to have some type of animal based protein and then lots of, you know, whole grains, nuts, fruits, that kind of thing. So that diet appears to have the highest rate of success for fertility patients.

But there's no question I mean, if you're sitting there eating a bacon cheeseburger every day, you're going to compromise your fertility care. Yeah, absolutely. Agree.

The Mediterranean diet and in general eating whole foods, a variety of fruits and vegetables, prioritizing lighter meats and really adding in a component of protein and and variety, which I find to be so important, because the variety really adds to the vitamins and minerals that people are getting from the food that they eat.

How important is it really? Like is the Mediterranean diet or any diet for that matter going to make a significant impact on fertility outcomes and treatment outcomes?

Does it actually enhance and magnify their chances of success, at least from what you've seen with your patients? Yeah, and not doing it will prevent you potentially from getting pregnant.

So it's not that eating the Mediterranean diet is magically going to fix your blocked tubes or your negligible sperm count, but it's certainly going to facilitate an easier path to a pregnancy.

And so I think it's important to always remember fertility is like a puzzle and the more pieces we have, the closer we get to the whole rate. So, you know, it's not about I need the one and only thing, which is a big chunk of the puzzle.

You want all the pieces so that you get there as efficiently and as successfully as possible. Thank you. Yes, fertility is such a puzzle and sometimes it takes a skilled provider to get to the root of what's happening.

What are all the puzzle pieces that fit together and how do they fit together and how do they complement each other in the outcome that they, the patient, desires right.

Can you talk a little bit more about the natural empathic event interventions that are contributing to improving fertility outcomes for your patients?

Oh, tremendously. I mean, let's be honest here. Traditional medical Western training, which is what I've gone through, is completely ignorant of anything having to do with a holistic approach.

Right. It's here's the disease, either here's the medication or here's the scalpel that you need to cut it out. Right. So we are we are terrible at managing that kind of stuff.

And, and I've tried hard to educate myself, but I can't say I'm an expert in naturopathy, whereas a natural path knows all about the vitamins and knows you know how to manage things like thyroid antibodies, which are notoriously difficult to get rid of.

I learned from one of my natural paths that giving patients selenium and inositol will reduce their thyroid antibodies.

Nutrition, Mediterranean diet, and fertility outcomes

Reducing thyroid antibodies is important for patients who have miscarriages, who have recurrent failures, things like that. So we really try hard to listen to our naturopaths because they're so knowledgeable about a lot of different aspects of medicine.

And it is medicine that we are ignorant of and that we are just not trained to deal with. So in our practice, there's no question that we do better because of that teamwork with our naturopath.

And there's there is, you know, people are always like, well, it's not really science. There's lots of science behind this. I mean, we know about the impact of vitamin D, but I never got taught that even in my fertility training, no one in my training ever said, Hey, make sure you check vitamin D levels, vitamins, you know, things like that.

They're all so critical. So we make sure that we have really good relationships with our naturopaths everywhere that we work because they're integral to the process.

Yes. You mentioned so many important nutrients, vitamin D, super crucial getting or lowering antibodies of thyroid is so, so, so important. And absolutely research has shown that high thyroid antibodies are known to have an impact on pregnancy outcomes and potentially causing recurrent implantation failure as well as a recurrent miscarriage.

So I'm so glad that are these like yourself are really addressing some of these things before going into IVF treatments which tend to be just so expensive and they're going to have better outcomes when they actually address some of these underlying things first.

So really appreciate your approach to all of it. Yeah, I couldn't agree with you more. There's actually really good science to back up what you just said as well at the British Fertility Society meeting last year in Belfast, they introduced the fact that you can actually overdo it with supplements.

So we know that most people's bodies suffer from what's called oxidative damage, which as you are well aware, comes from low vitamin intake and a poor diet and so on and exposure.

And so you get all this oxidative damage, you take in off vitamins and you get some reduction in that. And so you have less oxidative damage. But if you take too many vitamins, they've actually shown both in sperm and now in the follicular fluid of egg retrievals that you can actually do what's called reductive damage, which is the opposite of the oxidative damage.

You're actually suppressing the cell's natural ability to function. And because of that, you can actually overdo it. And, you know, even for me, in the past, people would say, I'm taking this, that and the other thing, I was like, sure, it doesn't make any difference, but now I realize it actually does make a difference.

You can you can be on too many. And so when I get people that come in and they have the garbage bag, I tell them, like, you need to talk to a natural path because they're the experts in this and they can customize this for you.

You may not need 20 different supplements. You may only need four or five. And those are the right ones for you. So, so yeah, it is super important to do that because the people that are coming in with the garbage bag, they're actually probably harming their fertility.

It's also really important that at least from what I've seen, that patients are getting the right support and really like tailoring their supplement plans because it's really easy for people to scour the Internet or Dr.

Google and find just every supplement under the sun. And a lot of the patients that we see are taking garbage bags full of supplements that they don't know what they're for.

They went to five different practitioners and got five different suggestions. It's really, really important to kind of tailor this approach and tailor the protocol to each person instead of kind of piecemeal saying things together, which sometimes I feel like the overconsumption of supplements can be extremely dangerous.

Recent research has found that to be true, and there is. There is a cost. The cost to your liver is pretty extensive when your body has to process supplements that it doesn't necessarily need, but the supplements add to the burden on the liver.

Targeted supplements and avoiding overuse

There's just so much harm really that can be done by taking too many supplements. Taking the wrong supplements. What what are your thoughts on that? Yeah, no, I, I think that comes out of ignorance, to be honest with you.

Right. That's those are those are medical practitioners who are not either aware of the research and the literature on this or, you know, don't believe in it, which is erroneous, obviously.

Or, you know, I will tell you, as horrible as this sounds, and I hope your listeners and viewers don't panic on this one, but it is to the financial detriment of a clinic for the clinic to have higher success rates.

And I know of one clinic in particular in the Toronto area who obviously shall remain nameless, where the director actually tells the Embryology team, we don't want to have super high success rates because it reduces return business.

So, you know, when they're cutting off all your supplements and they're telling you not to do all of this, you got to ask yourself, why are they doing that right?

Is it ignorance? Is it a problem with, you know, a lack of knowledge? Is it previous experience that was negative and why was it negative or are they just self-serving?

Because if you don't succeed on the first try, you're forking out another X number of thousands of dollars to come back again for treatment number two.

And we don't want that. Right. We we don't like victory reproductive care. I don't want you to do it more than once to me. I failed you when I have to bring you back more than once.

So we want to optimize it for you every time. So I will never tell anybody go off of all your supplements because that that just makes no sense at all. Yeah.

I think there's just so many practitioners or endocrinologists, reproductive endocrinologist, OB-GYNs, even that really don't believe in the integrative approach.

They are very skeptical of supplements or herbs even, or really optimizing a person's lifestyle diet. I've I've had patients come back and say, oh my, a reproductive endocrinologist said, I don't need to work on my diet.

That's not going to make any difference in my fertility outcomes. I'm going to do IVF anyway, so I don't need all this. Just give me the supplements I need.

And it's unfortunate when people are getting mixed messages, right, like they are hearing one thing from their RE and then they come to someone like myself or my team and we say, well, this is going to make a huge impact on whether or not you get good quality eggs, whether or not you're able to have a positive IVF outcome.

It's going to make a difference whether or not this is going to work for you. And you could do five or six IVF treatments or you can do one and and get the benefit quicker and not spend thousands of dollars doing the treatments.

If I was going to be going through IVF treatment, I would definitely want you as part of my team because you have such an integrated approach. I want a doctor that is aiming for one cycle, not multiple rounds of IVF cycles.

I want to do a wand and be done. So definitely, definitely see the value in working with someone like yourself. Where can people find you? Sure, there's probably two or three ways to be honest.

So our website's pretty sophisticated. We have a lot of info there and pretty much on every page some pop up jumps up saying, Do you want to consult so you can sign up from there?

You can just email us at info@drvictory.com info@drvictory.com.

Finding the right fertility specialist and closing remarks

And then we do a weekly show on five different platforms YouTube, Instagram, Facebook, Twitter, which is now X and TikTok. And so people can come up there and we actually take questions live.

So we answer those questions all the time and we we see what we can do to help people. And I love it because it's a it's a mental challenge for me. I have to kind of know what I'm talking about and be able to answer questions.

And so it's really good practice because you got to stay on the ball or you don't answer people's questions. So I love the challenge of that because it keeps me on top of things and keeps me abreast of the latest and greatest all the time.

You mentioned earlier, which I totally agree with you, it's so important to find a fertility specialist who is the right one for you and to be able to work with someone who can personalize your treatment in fertility care, who care, who has a approach of a holistic perspective on what's happening and not just going in and assuming that every single person needs the same protocol.

It's so, so, so important. And I just wish there were more of you. Like, I wish there were more. Ari's just like you who wanted to personalize care and wanted to approach fertility and IVF from the holistic perspective, because IVF is just amazing technology it offers.

So much. And yet when we're missing that crucial component of optimizing the body before you get to IVF, the rates of IVF are a lot lower. So I absolutely appreciate you love that you're doing this work and I just wish there were more of you everywhere.

Well, I'm sure there are more of me somewhere, but I do I do encourage people to spend the time to make sure that they are finding a fertility specialist that they're genuinely comfortable with.

Make sure your fertility specialist is knowledgeable, make sure they're open to new things and and having complementary medicine involved and make sure that they are customizing the treatment for you.

If you're getting the exact same treatment, everybody else is getting, but you're not the exact same as everybody else. You've got to stand back for a second and say, is this a good fit for me?

And sometimes it is, but it is. Thank you so much for being with us today, Dr. Victory. Thank you. I appreciate that. That's very kind of you.

Rahi Victory, MD, FACOG, BS

The Power Of Personalized Fertility Care