Rethinking TTC: Recognizing When To Change Your Approach

Introduction to Dr. Marc Sklar 0:00

Hey, I'm Dr. Aumatma, the host of the Beyond Infertility Summit. And I want to introduce you today to my friend Dr. Marc Sklar, who is known as the fertility expert. He is a natural fertility specialist helping couples get pregnant for over 20 years. He's on a mission to help you feel hopeful and confident about your fertility journey again. He's achieved so many things. His background is in acupuncture and oriental medicine, but he also integrates functional fertility in to the way that he approaches things.

What you will find in our conversation today is, I really hit him with the hard questions. I hit him with questions that are often asked of me. And because Dr. Marc and I have been doing this for a really long time, we get similar questions. So we really got into what are the things that are blocking our fertility from the mindset perspective. And I'm not talking things like, Are you feeling hopeful? Are you feeling happy? Are you? No, I'm talking about mindset that are crucial and fundamental to whether or not you're going to have a positive fertility outcome or not.

We're breaking down some real shit today, and I hope that you will join us because this was a phenomenal conversation with Dr. Marc Sklar. I look forward to seeing you there. Enroll talk soon. Welcome Dr. Marc. I'm so excited to have you here today and we've just you're just so dear

What Beyond Infertility Means 1:51

and like our approaches to fertility are so similar. So I'm going to start with a question that I unusual, which is what does beyond infertility mean to you? Oh, well, first, thanks for having me. I'm excited to be here. And and I always love our time together and find that we actually don't do this enough. So it's nice to nice to connect. Yeah. Look, that's an interest. A really interesting question. First and foremost, I like to just start off by saying that I really don't like the word infertility.

I think it it preconditions our brain and mind to think that something's not possible, to think that something's inherently broken about us or our reproductive systems. And because I believe and I know you feel the same way that so much about our reproductive health and fertility is so much more than our endocrine system or our hormones or our uterus or our ovaries. And there's so many things that can impact it that I really think that that word really does a disservice to couples and what we need.

I understand why we use it. It's a term that makes it easy for people to relate to and connect with and understand kind of the help that they need. But with that being said, I feel like, okay, after the first time somebody hears it and they and they've been told like, oh, you know, you you might be infertile or have infertility issues. Like, I feel like that word never needs to be used again. And I tend to be someone who tends to focus on the positive. And so I like to use the word fertility, fertility support, you know, fertility issues because it's focusing on the thing that's more positive in that word.

And I think in a culture and reproductive medical model or system that we live in today where everything is so negative and really fear based and beating down on these couples and individuals, I really want to focus on the positive, but I also feel like that word inherently make no couples ever said this to me, but I just get the impression it makes them feel like nothing could be done. Like there's no option. There's no way for them to make changes as with their struggles and the difficulties that they're having.

And I think that's just inherently not true overall. So you know, so, you know, to me, to answer that question in a long way, in a long winded way, is like I really just I don't like the word infertility and I think it really just does everyone a big disservice. But beyond infertility, I think, you know, definitely has a place here because we want to first and foremost move beyond that word. Right. So I think moving beyond that, that little word or phrase that we put so much weight into, I think is really, really important.

So it's there. We've been told it. Now let's go beyond that. Like, what else can we how else can we reframe this for ourselves? What else can we look at to get to a different place? And that's where that other part of the word beyond comes into place for me, into play for me, which is how do we get to the other end of this in a positive way? And I think there's that's a huge place and I think really should be the main focus for everyone who's tuning in to your interviews and and who's dealing with fertility issues is how do we get beyond these difficulties to the successes that we want and those successes look or can look very different?

Or that path, I should say, to that final successful outcome can look very different for each individual couple and could also look different, you know, obviously to the way we intended. You know, most know no one goes into trying to have a child and says or I should say almost no one, because I do unfortunately know a couple of people that have done this. But like no one goes into their their trying to conceive journey and says, okay, we're going to we want to grow a family. Okay, here we go. IVF, it is.

Right? Like no one typically starts there or I would hope that they don't. So, you know, I think the moving beyond this term for me, first and foremost, I want everyone listening to know that you can have a successful outcome. You can have the pregnancy and family and children of your dreams. The path to get there might not be what you originally thought it would be. And I think that's also something that we need to move beyond, right? We have these assumptions and preconceived ideas and notions about this ideal, like storybook fairy tale endings sort of speak.

And, you know, life, unfortunately, is just not a fairy tale. It just doesn't typically work out that way. And and I think that's very purposeful. Right? Like, we all have things to learn and and hurdles to jump over and cross. And if life was always so easy in every aspect of everything we did, we really wouldn't grow as individuals. So, you know, I really want to look at the fertility journey for all of us as a process and something that will make us stronger and better in the end of it, regardless of what that outcome is.

And that's another way that we can look at beyond. So I think that that word beyond could really serve a lot of purposes for all of us, but to let to allow us to break beyond those preconceived ideas of like, okay, I get married, we go on vacation, we get pregnant, we have a family, I have two kids or three kids, and they grow up and everyone's healthy and I'm like, World is not like that, right? So let's move beyond our fairy tale ideas of what things should be like. And let's also move beyond feeling sorry for ourselves or being angry about the fact that you have fertility issues or frustrated those things don't really do us any service when we're trying to get to the end result. And let's let's get to a place where we can all get the help and support that we truly need, move beyond the struggles that we're in and get the results that we are so striving for.

Yeah, absolutely. So in summary, I would say you like highlighted a few things that I just want to like reflect back on. One is the word infertility and how we can like reframe it to the positive, which is fertility. How do we support fertility rather than how do we not be infertile? Right. And then the other piece of like just getting beyond the challenges to the vision that we have for our lives and that it may not be looking the way that you planned, but that's okay because we're you still have the ability to get to that vision

Stress and Fertility 9:26

regardless of the path that your life took to get you there. Yeah, 100%. I think those those two reframing and and, you know, summarizing what I said, because I know I went in a bunch of places is a beautiful way to do that. And and I hopefully that rings true to those who are listening. Yeah. Yeah. And I like I hope that that's exactly the audience that we are hoping to have. And the community that we want to nurture is the community that's asking those questions like, how do I go past this? Like, Yes, this is the label that I was given, but I choose not to be kind of giving my power away to this label or this the doctor that gave me the label, but then like go past it and really figure out what can I do to have the family that I envision?

So great. Let's get a little bit deeper into that. Like the path to getting to our end goal in your experience and you've been doing this a long time. What is the what are the things that are making people's fertility more struggled then than it should be? Yeah, I mean, that's a loaded question, right? Like because there's so many reasons why this can happen. And but but asking that question is the first step to moving beyond where we're at and getting to that end goal. So that's an absolute necessary question that we all need to ask once we've made the decision to move beyond it.

Right. To be like, okay, well, this is the this the issue that I have and now we need to figure out what I'm going to do and how to be successful. So my first thought when it comes to that question is that you ask it. And the first thing that came to mind was stress and I know that this word gets thrown around quite a bit and gets, you know, so someone might hear that and be like, I'm going to tune out that because like before stress, I know I got to manage my stress, but I want to go beyond just that superficial notion of of stress, because I think that that word can really encompass a lot and a lot more than just, you know, I had a hard day at work today, and it really got to me, it was a stressful day.

And now I just need to, like, de-stress or decompress. Yes. Obviously, that is a piece. And that's the that's the emotional side of what we're talking about. And as much as I'm going to move past that in just a second, I don't want to minimize that either. There are hundreds of thousands of research studies that show how impactful stress is in a negative way to almost any health condition. And fertility is no different. And about I want to say at least 20 years ago, I could be off by some years when there was a research study done by Alice Douma about, you know, comparing the stress that a couple is under who go through fertility treatments and comparing that to someone who's been given a life threatening disease or given the diagnosis of cancer or anything in the equivalent.

And I want to highlight that for just a moment, because that shows how damaging stress can be for us. And just this label of infertility can you know what it can cause? So that alone can be so damaging on a stressful on a in a stressful sense. And then just the struggles of going through the fertility journey and trying to manage everything and all the different appointments and trying to figure it all out. And all of that can be stressful and difficult with our regular profession and, you know, a family and relationships and, and whatnot.

That alone is difficult. But moving beyond that emotional piece, I believe stress comes in a myriad of other ways as well, that we don't really we might talk about them in a different way, but not in terms of a stressful way, but all the things that we do to our body can cause more stress on our body. Maybe not always emotionally, but it can cause stress physically and physiologically. And those are things that I think do not get discussed enough. So, you know, you may have heard that, oh, we need you need to get better sleep.

We need to manage our sleep better. We need to it, you know, roughly 8 hours of sleep. It needs to be good, good sleep hygiene, go to sleep at a good time. All those things are true. But the reason why we need to do that is because if we don't, it will cause a reaction in our body, which is the equivalent of stress physically. Like I know when I don't have a good night's sleep and I wake up and I've got to perform that next day, I feel like crap. I can't think properly. I've got a foggy mind. I don't have enough energy.

I am not as quick or sharp in terms of how I need to perform. I actually all I want to do is go back to sleep and then I'm looking for things to help me get through this. Oh, you know, I need more caffeine. Or is there a supplement I can take that's going to give me more and right. Like we're trying to combat this in a different way. All that is stress. That's stressful. Our body is responding to all of that in a different way. You might have just been hurt, heard it in the past. It Oh, our sleep is off.

While all of this is impacting our body in a negative way. And I would interpret that as it's causing stress on our body physically. If we're not exercising enough, that causes stress. If we exercise too much, that certainly causes stress physically on our body. You know, the type of food or the quality of the food that we eat. If we're not eating that, the good quality of food, we're not taking care of our diet properly. Maybe we're not getting enough calories in a day while we're undernourished.

All of that is stressful for our body because it causes a stress response internally that the body needs to manage. And any time we cause a fight or flight response in our body, the last thing it wants to do is reproduce. So that's why when we have stressful instances in our body, it's so common for hormones to be dysregulated. It's so common for our home, for our cycles to be irregular, might be too short, might be too long. You might not ovulate at all. These are all real reasons why we see that.

And again, I would interpret that as a stress response on the body. I also think that in today's time that the the impact of chemicals and toxins in our environment, in our home, outside our home that we consume, that we touch, that we breathe, all of these things are causing stress on our body because our body needs to account for that and it has to adjust to those chemicals. And it doesn't do it in an easy way. And that causes stress. It puts stress on different organs, different systems that now have to account for these toxins and chemicals and at the same time keep everything functioning properly and regularly.

So these are all different forms of stress, let alone like just like, you know, where we in some traumatic event that also caused some stress for us. So I think stress is that big word that came to mind when you asked that question. But it means so much more than what we originally think about when we hear it. Yeah. And I think you hit on all of the different areas that are really inducing a stress response in the body in some physiological way that that they're they're the kind of like lowest hanging fruit, I call it is.

Hey, if you sleep better, you eat better, you exercise better or get some movement in your body. Your body has now a better ability to adapt to the stressors that are being thrown at us. Yeah, you said that. And the first thing I thought it was like everyone who I coach and speak to and like often their first question is, okay, so like what pill can I take? What's the like, what's the one thing I can take? And typically my response is, well, I don't even think we should be having a conversation about pills or supplements or medication or anything else until we've done all these foundational things that you kind of just alluded to, right?

Like, so these things have to be done first and ongoing. Li To create a solid foundation. Then we can build on that. Yeah. Yeah, I completely agree. I think it's especially in the fertility world. I don't know how this came about, but you don't see people with heart conditions going out and like, what supplement do I take? Right? They're not researching like, oh, I have this heart condition. What supplement can I take to fix it? Fertility is one of these things that I just feel like has become the the collect all collect all the cabinet solo supplements and take all of this abundance that's going to make for me.

And I, I don't understand how that came about, but I do see the people that come in with the garbage bags full of supplements. They're like, what are what's the thing that I'm not taking? And I'm like, Well, did you consider that maybe it's one of the things you're taking. It's already on your list is a lot of good things, but you're taking way too many things. Oh yeah. I have a I have a couple that I just started working with like two or three weeks ago and there's so many good things about their fertility situation, like hormones don't look look fine, like hormones look okay, manageable for their age.

I think she's showing I think she's like 43 or 44 and her it it the things are regular. Like there's a lot of really positive things. But when I started digging a little bit deeper, you know, I come to find out they both smoke Cigarets Oh, they both right. Like they have been under a lot of stress on their lifestyles a little bit off. A lot of this, by the way, started during COVID. And so, you know, you see these key things and it's not like in the same breath as she said, oh, yes.

Foundational Lifestyle Changes 20:38

You know, we like to drink wine on the balcony and and smoke cigarets. I know that. I know I shouldn't. We know we shouldn't be doing that. But but we love it so much. It's our time to connect, right? And sure, she knows it's bad. It's not like I have to say something, you know, earth shattering to be like, yeah, you shouldn't be doing this right? Like, you know, she really knows. But we can't get out of our own way sometimes. And and in their case, it's because that's the time after a long day that they find to connect.

That's the way they find to connect. Right. So if that is somebody listening, you know, I think we need to take a step back. We already know that that's not good. And especially habits like that, where it encompasses multiple things that are very habitual or how are we going to break that cycle yet still allow us to connect as a couple so that we feel connected, right? Because that's why they're doing it. Because they feel connected at that time. Well, can we find other things that we can do that don't require us to go out to the balcony, have a glass of wine and smoke a cigaret?

I would I would venture to say yes. Right. Like, so maybe we can go for a walk down the street. Maybe we can go for a walk on the beach or we can just hang out at the like let's find something different, especially with those things that we know, because often we know what's not good for us, yet we do not change it. We don't have the capacity or willingness to move beyond it. Yeah. Yeah, absolutely. And that's I think that's why people need coaches. Mm hmm. Hundred percent literally going to be like, you already know the things to do.

You have a whole list of things that you could do. You've heard a million times that alcohol is detrimental to fertility, yet you have taken the step to change that behavior because you haven't found a way to help that behavior change. Right. So let's let's talk about that a little bit, because I think it's really intriguing. What is like what do you find is a great way to motivate behavior change? Yeah. So so that's a great question. And I'm going to use this couple as an example again because one of the one of the things, by the way, that they wanted to do to get pregnant because they didn't want to change their habits was go to IVF.

Right? So we're going to spend tens of thousands of dollars, but we're not going to work on the one or two little habits that are changeable. So habits are hard to change. That's why they're called habits. So the first, first most important thing is that we need to feel supported and we need to have someone or multiple people that are that we can lean on when it gets difficult because invariably it will. Right? Quitting those habits, especially Cigarets, is not an easy thing to do. So one your partner needs to be on board and you need to be supportive of one another, right?

Because if, if you're going to stop smoking cigarets, for instance, and your partner's not oh, that's not a good recipe. That's going to be challenging for all of us to accomplish. And we need to both be have the same goal in mind, right? Like we need to be working in the same direction. So that's your first partner. And I would even say like Coach as part of this, because you guys are going to need to be doing it together, then you need to have an outside person who's going to be someone that you can lean on as a coach to pick you up and to motivate you when things get difficult because they absolutely will.

And I think a coach, a real coach is essential for something like this because that someone you can reach out to when things get difficult, they're also someone you have to hold yourself accountable to. It's really easy to not hold yourself accountable to your partner because for whatever reason, we dismiss the things that our family members and the people who love us the most say to us like, We're very quick to be like, Yeah, forget it. They're just saying it again. What does it matter? It's easy for me to ignore them.

I know them so well, but it's much harder for us to ignore somebody else who is there that is there to hold us accountable. So I think that's really important. And then we need to start to change our habits, right? Like so if you're always going out to the balcony to have a glass of wine and, and cigaret, the balcony is off limits. Like, unfortunately, it might be a nice place to spend time, but you can't spend time there until you break this habit. So I would put like a big red X on the window and be like, You can't go out this door, right?

Like you're not allowed to go there. You need to go do something else. And that's very much the case with all habitual things because we, we very much do these things subconsciously. Like I speak to people all the time about this and they'll say, well, all of a sudden I just found myself, you know, on the balcony or the cigaret was in my hand. I didn't even think about it. Like I wasn't consciously thinking about it. Right. Well, it's because you know that when you get to this exit on the when you're entering the exit on the highway, that's when you typically reach for the pack.

So you don't even have to think about anymore. Your body just does it when you get there. It's like Pavlov's dog, right? Like the bell rings and you just do it. So you have to change those things. You've got to drive a different way to work. You've got you can't drive in the same lane. You've got to do all the things that actually allows you to be consciously aware of what you're doing so your subconscious can't put you in those situations. And that goes with anything that we're talking about when it comes to a habit, whether it's alcohol or anything else.

You know, it's the same thing with habits, with our phones habits, with nighttime routines. We can't do the same thing, right? So if you go into bed and your phone is there and you're trying to change your sleeping habits and you're going to be on your phone for the last hour before you close your eyes like that's not helping you. So the phone can't be by your bed. It's got to be left outside, let's say in the kitchen. You charge it there, it's nowhere near you so that once you go into your bedroom, that's like sacred space, right?

That's two things happen there, lovemaking and sleeping, and that is it. Like that's what it's for. So, you know, it's about changing those things. If we don't take an active role in changing some of our daily routines consciously, then habitually those things will never, never shift. And it's been said that it takes 21 days to change a habit. Is that what you find to be true? At minimum, I would say I don't know if it's like exactly 21 days. I would say we need at least 21 days to break those habits.

And, you know, whether that's dietary changes or lifestyle or whatever, it's going to be like, we need at least three weeks. Yeah. Yeah, yeah, yeah. Awesome. I love that we talked about this because I think that it is one of those like things that people know to do but yet are doing it. And I think that it goes to everything. It's cigarets, alcohol, marijuana, food habits, right? Like, yeah, every night I just sit on the couch and like Netflix and eat potato chips like, okay, well, maybe we should stop the Netflix then.

You will definitely either. Jess So yeah, like typing, I think what you're saying and, and what I've seen to be true is like finding the things that you're pairing together in your brain that then become habitual. You got to break both of the things that you're grouping together or like two, three, three, four or five, whatever, number of things that are all grouped together and instead create a new pattern of like,

Breaking Habits and Building Support 28:38

Oh, when I get into my bed instead of the phone, I now have a different habit that I'm associating with bed. Yeah. 100, 100%. I think that's really important. And I think we have to be really regimented initially about these things. So much so that like we're going to create a new schedule for ourselves and we're going to put these schedules in our calendar. And when it says to do these things, we're going to actually do them right, like we can't stray from them. So if you want to be in bed by 930 or whatever it is, then like 930 comes around your alarm, rings, it says it's time for bed.

Awesome. I'm going to brush my teeth. I'm going to make whatever I'm doing stops, right? Like we're no longer staying up till midnight just to catch up on a pointless Netflix video that really doesn't nourish our soul, right? Like it's wasting time, and it makes us feel accomplished because we can have the Netflix conversations with our friends and family members, but like, it really does it nourish our soul. And in the end, we're more tired in the morning, right? So all of this is a vicious cycle.

So if we want to have more energy, we want to have better habits. If we want to have better sleeping routines and exercise time for exercise and so forth, like we have to create the space in our schedule to accomplish those things so we can set those foundational core pieces. So we're not always asking ourselves like, Well, what's the next vitamin that I can take where you've got like this bag? We're like, Okay, what's the next lifestyle thing that I can do to really set my foundational core in place?

Then I can see how my body is responding and decide, Do I need anything else to get me beyond this piece of it? This is a question I get a lot, so I'm going to ask it to you. I the number of times I hear women or couples say, we're already doing all of the natural things right? Like I'm already doing all that. I'm doing the supplements, I'm doing the food I eat amazing. I, you know, do the right amount of exercise. And yet I'm not pregnant. So what do you what is your response to that? So my initial response is always, well, just because you're you one, just because you feel like you're doing all the natural things, all the right things, first of all, doesn't mean that you are like, I'm sure there are things that you're not doing or not doing consistently enough.

Number two, and potentially even more importantly, is like, are these the right things for you? Right? Like just because you've read that you should be taking X supplements and just because you read that you should be walking or exercising or whatever. Like I'm at a loss for for whatever reason, of all the right things to be doing doesn't mean they're actually the right things for you as an individual. And I think that's such an important piece when we're talking about fertility or any health related issue.

Is, you know, fertility is very, very different then. And you brought up the example of like cardiovascular disease, right? I think it's a great example because we could look at cardiovascular disease and say like, okay, well, most people need to do X, Y and Z because it's it's a relatively like straightforward process in terms of making changes and seeing outcomes that's not as individualized as fertility is because there are so many different things that can impact your endocrine system and your reproductive function that it really needs to be individualized.

And so if you're just reading an article or watching something that's a group Facebook. Group of things to take, this is what works for me. You know, talk to a friend, a family member, a Facebook friend who said, Oh, these are the things that I did. And I see that actually quite a bit in my private group is oh, oh, I have I have the same thing you said that worked for you. What did you do and what did you do for it to work through? Doesn't mean it's going to work for me as an individual. And I think that my favorite example of this is that we make this assumption that all fertility related issues are equality related issues, that the core and root cause of all fertility issues is equality.

And I'm here to tell you, it's 100% not the case. And so most of the supplements out there, most of the things that are recommended are to improve specifically egg quality. That's what they are there to do. Well, but if you're issue is not egg quality, regardless of what your ages are, somebody told you if you don't know for sure that your issues egg quality, then you're just taking a shot in the dark. You don't even know if that's going to help. And so it really needs to be individualized. So when you're saying or when someone saying, you know, I'm doing all the right things or I've done all the things and I'm still not getting pregnant again, my response is, are you doing the right things for you as an individual?

That's going to get you the results that we're looking for. And I think that's a very different question with potentially very different results and recommendations for each person who asks it. And and even if there are certain things that are similar, it doesn't mean all of it's the same and we're all doing the same thing. So I really think that we need to be mindful of that. And the other thing that I would say, as kind of part of that is we have to give things time to work. You know, everything that you're doing from a natural perspective.

It's not like I've got a headache. I'm going to take some Tylenol and in an hour I'll feel way better. It doesn't work that quickly. It doesn't work like that. And we need to these things time for your body to react to them and to see the change and then to respond again. And that takes cycles cycle. So if we're constantly questioning every every cycle, every week, every month, what can I do more what else is there to do is this is I'm not seeing a change. You're actually just causing more stress for yourself and you're not allowing your body to respond to to what you're asking it to do.

And that, unfortunately, is something I see all the time. And so we have to give a little bit of trust to the process. I'm not saying that we don't reevaluate, but we need to give time for that to happen. And it's not healthy for us to constantly ask ourselves, what else can we be doing? Like I actually encourage all of you who are listening to say to set markers for yourself, to set lines in the sand when you can reach, when you can ask yourself this question again, right? So like, okay, I'm going to start on this path with so-and-so and they put me on this plan.

We're not sitting down to ask ourselves this question after every menstrual cycle. I'm not pregnant yet. What can I change and what can I do? Because you're not giving anything an opportunity. I'm going to give myself a chance at this time. This is when I ask myself that question again and there's the line. And until then, I'm just going to do what was asked of me unless something major changes. That's that's not right. And I'm going to enjoy life a little bit. And then when I get to that time, my calendar will tell me time to ask the question.

We reevaluate, reassess. And I think that piece is really important in this process because if not, you're just causing more stress, more anxiety and more frustration. I like that. I think that you're absolutely right in terms of the number of times women are like, Oh, my God, but I should be pregnant already.

Why Fertility Plans Must Be Personalized 36:38

And it's not working. And, and I like, but you started with a 23 day cycle and now you're at 27 days and you actually have a little phase and your your temperatures look so much better. We retested your hormones. Your hormones look better, right? Like there is proof that things are incrementally improving. But I think when people especially when the bar is am I pregnant or am I not right? That's the only thing that I'm looking at. Pregnant or not pregnant instead of like, what are all the things that are under this surface that I like?

I actually have to, like, climb up this mountain and then I'm going to be pregnant. What are all the the steps along the way that are going to get me to that point of being pregnant and being able to, like, evaluate and and just like take a step back, slow down. And I, I know that it goes against everything that they're being told, right? There are these are in their ear like you're not pregnant yet, you're not pregnant yet. You've got to move this along. This has got to go faster. And then just like that, internal pressure of like, I need to do this drive drives us mad sometimes and we lose sight of like, how do we how do we have reassurance that we're on the right path?

And because the default isn't to find a functional fertility person that can support people. Right. The default. Right. I'm going to do this on my own until I walk into an IVF clinic and they're doing this on my own, actually prolongs the journey for so many people. I've seen this over and over again. Yeah. And there you don't know that the things that you're doing are getting you any closer to the goal because you're just willy nilly like, yeah, that worked for some person. So yeah, I'll do that.

And yeah, I'll do that thing because the research papers said so and I'll do that thing because some doctor wrote a blog about it, and then you have all these things and you're like, But what am I supposed to know? This is anything supposed to change if I do these things right, how will I know? So I think really like asking better questions along this path and saying, and this is for anybody that you're working with, you can say, I'm curious if you also do this is like at what point should we reevaluate?

At what point should we hit a certain bar that becomes like, okay, this is your new baseline and your next marker of like now we can test your hormones and see if something has changed. Yeah. For me, I, I always tell everyone we need 3 to 4 months before I even want to reevaluate anything. You know, it's fine to, like, check in in between and it's fine to, especially if something is really off because, you know, sometimes those things happen, you know, then then we need to evaluate, you know, more, more quickly than that.

But in general, I don't even want to look at that. And my first question is, is how are you feeling? How are you doing? What changes have you noticed? I like for couples to feel healthier. Like the goal for me is that you live a healthier life, that you feel healthier across the board in every system. That to me tells me you've created a more fertile environment for conception to occur and for a healthy pregnancy. And then as a result of that, we will achieve pregnancy at some point. So that's really the that's really the first goal when it when we're trying to accomplish things and reevaluate things.

The only piece that I find that might change that approach is potentially just time, you know, time in terms of age, time in terms of family planning, just just time, right? Like so even though, as you said, maybe they wasted a few years trying on their own and trying to figure out on their own, you and I might not think of that as time because we haven't been accomplishing much during that time. We might think of it as wasted time, but but the reality is, is they still view it as time. And that's time that's passed where they're getting more anxious and more concerned about, you know, when can I get pregnant?

And I wanted three children and now I don't even have one yet. And right. So I think that's that piece really can speed some things up. And that might be really the thing that pushes me to recommend IVF more than anything else, more than any other one thing would really be time for for those individuals. If I have someone who comes to work with me and they're 40 or above, we just inherently have to approach that situation differently than we would someone who's 30 or 35. So, you know that that piece, I do think, can compress time and allow us to make decisions a little bit faster.

But outside of that, you know, that's how I would approach things. And you mentioned something earlier that got me thinking about creating space for me. I think so often one of the difficult challenges we have is that we want something so badly. We want to have a child so badly that we we strangle the opportunity, so much like we want to hold on more, we want to control more, we want to do more in a shorter period of time. And all of a sudden we are doing this to ourselves. We're just creating less space, less opportunity for things to occur because everything is so tight.

And if there's one thing I've learned through my studies of both philosophy, religion, medicine, the world is that the most amazing things happen when we create space and opportunity, not when we create less space. So I want to encourage everyone to like let's all take a step back. Let's take a breath a little bit more. Let's breathe a little bit more. Let's create more opportunity and room for your body to respond to what you wanted to do and create space, an opportunity for a child to be born into.

And I think that's so important when we're talking about fertility, because it's everything is so especially when we get scared. And that fear based is like everything just closes in the walls, close in, everything gets tighter, more difficult. And we have to we make these decisions we wouldn't have otherwise made. So let's take a step back or a few steps back. Create more room for opportunity to happen. Yeah, yeah, absolutely. I think that that it's it's challenging to think about and it's challenging for a lot of people to wrap their head around.

Yeah. But when we're able to have a little bit of space a little bit more, a little lower anxiety around when this is going to happen versus how this is going to happen. That's beautifully said, actually. I love that. It really just creates so much, so much more like it's it's hard to put it into words, but I can feel it. Every time people have this shift, I'm like, Oh, I can feel like, how? How much less anxiety there is. Yeah. And it's palpable. It's just so like it. I love it when that happens because I'm like, I know you're going to get pregnant.

Like I can absolutely guarantee it. Whereas before it was like plausible, right now, again. The tension changed, the tension change. And it's just like things are more relaxed. They're more relaxed about the process and like it will happen. And I love that you said, you know, work on how it's going to happen versus when it's going to happen. Yeah, yeah, absolutely. I heard a few times this idea of personalization on this journey. Like, everyone needs a unique approach, a unique plan. They have things going on.

Can you just speak to that a little bit? Because I think that because infertility is such a big word, that means absolutely nothing. And people get attached to this word and they're like, I have this thing. Can't you just tell me what to do? Right? And I'm like, Well, what thing do you have? I actually did 40 or 50 things. What is actually happening? So can you just speak to like this idea that we don't there is not a one size fits all approach to fertility where so many other conditions are less, less needing, less customization, the same things that got you to the heart disease that every single person that has heart disease usually is going to benefit from the same things and the same lifestyle changes and the same supplements.

Whereas fertility is like probably the biggest diagnostic thing that just has a whole host of underlying things. Yeah. So I want us to move away from this concept and understanding that that infertility is a diagnosis. It is not okay. It doesn't mean anything. It doesn't tell you anything more than, Oh, I know, okay, I'm having trouble getting pregnant. And that's it. That's all it means, right? So we, we need to understand why we're not getting pregnant. And we could take any example of really any condition.

So I could say polycystic ovarian syndrome, I could say egg quality issues, and I can have ten women in the room with either one of those diagnoses. And I promise you, none of them would be given the exact same plan to address their issues. Okay. And that's because the root cause, the reason why each one of them is having that issue is different for each one of them. Maybe for one, it's similar to the next person, but it's different because of, you know, sleeping patterns or exercise patterns or whatever it might be.

But that's still different, right? And that still requires us to approach that in a different way. So the the I think polycystic ovary syndrome is a great way to explain this. About 50% of all PCOS women that we see are what we would label as atypical. I'm sure that's similar for you that they what that means is they don't fit the textbook classic presentation that you would find if you opened up a dictionary or medical texts that said polycystic ovarian syndrome. And it starts to list this out.

50% don't fall into that category. Okay. So the 50% that do fall into that category, great. We have a place to start. But even with that, we can't say that they're all the same. One of those individuals might have a secondary hypothyroidism in conjunction with PCOS, which I see all the time. Another one might have hypothyroidism and a huge amount of stress. You might go to that other 50%. That's atypical. And one might have a lot of blood sugar issues, but no androgen issues. The other one might have no blood sugar issues, but a lot of androgen issues.

Right. And so this starts to speak to the variety and there's two different ways to classify PCOS. I've read two different more recent definitions and classifications, and one separates them into four groups and one separates them into ten. That just starts to tell people who are listening, like how diverse that condition is, and that is the most common female endocrine disorder around. So even with that, we have variation, right? So I think that starts to show us that we're, we all have different issues, secondary, tertiary issues that will impact the primary issue that require us to approach it differently.

We also have cultural and genetic issues that will impact how that also needs to be approached and managed. So there's these layers upon layers upon layers of reasons that start to create this issue in this specific, unique individual that then needs to be addressed uniquely. So I often when I'm talking about diet with somebody and they say, Oh, should I be following a keto diet or a paleo diet or, you know, whatever diet someone wants to mention and. Oftentimes I say, you know, I'll tell people, okay, I want you to eat more like a paleo diet or whatever.

But even if I put ten people in the room and I said they all should be on a paleo diet, they're not all going to be on the exact same paleo diet. It's going to look a little bit different for this individual than it does for that individual for various reasons, based on their underlying issues, cultural needs, where they live like there's so much variation to that. So often I say, I want you to use this as a framework and then I want you to make it your own. Like we've got to find like, okay, this food might not work for you for various reasons, so we're going to find something else instead.

And how are you going to customize this diet to make it uniquely yours right? So these are all frameworks and outlines, and I think that's really the most important thing that we need to recognize is that, yes, we might be similar to somebody else, we might all we might have or I might have PCOS or egg quality issues like my friend does. But they live a different life than I do. They have different genetics that I do. They have different underlying issues in conjunction with that than I do. So my plan needs to be different for me than it is for them.

And that is really that's difficult to do for the common person out there. That's really challenging. And and, you know, I don't pretend to think that that's easy for them, but that's also why you need some guidance and a coach to help formulate that for you and help you understand why it's so important for you to have a unique plan and help you create that plan for yourself and over time modify it as you can continue to get results. Yeah. Yeah. Well, so I think that this has just been such a riveting conversation.

I love talking to you every time we talk about like, how are we? You're so similar, right? But I appreciate it because I feel like these are some of the questions that don't get talked about often and are really shaping the journey that people are on. So thank you for sharing your wisdom. Thank you for being who you are in this space, holding the space for so many couples on their fertility journeys. I appreciate you. Where can people find you and connect with you? Well, thanks so much for having me.

I love these conversations. So it's it's it's so much fun to have. The easiest place for someone to find me is on YouTube on my YouTube channel called Fertility TV. I typically put out new video every week. They're free, really useful information on really like almost every topic you could think of, you could probably find it there. So that's the most resourceful, I think that everyone should everyone can check out, but I'm on all the platforms, Facebook, Instagram, TikTok, and then you can always find me on my website at MarcSklar.com also.

Well, thank you for being here and sharing all of your wisdom. And just like helping educate our community on what they can do to support and optimize their fertility. So appreciate you. Thank you.