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The IVF Blueprint: What Every Intended Parent, Surrogate & Egg Donor Needs to Know with Dr. Carrie Bedient
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If you’ve ever felt lost in the world of IVF, surrogacy, or egg donation—this is the guide you’ve been waiting for.
Joining Whitney is Dr. Carrie Bedient, one of the three renowned fertility specialists behind the hit podcast Fertility Docs Uncensored and now co-author of their new book The IVF Blueprint—the very first comprehensive guide to IVF. Alongside Dr. Abby Eblen and Dr. Susan Hudson, she’s transformed years of clinical expertise and countless patient questions into an accessible, step-by-step roadmap for navigating fertility treatment.
You’ll hear why IVF isn’t linear—it’s a marathon of science and emotions—and why emotional support is just as critical as medical expertise. Dr. Bedient shares how the book feels like sitting at your kitchen table with three fertility doctor friends, ready to guide you through everything from IVF protocols and lifestyle choices to trending medications like GLP-1s.
Whether you’re considering egg donation, surrogacy, or IVF for yourself, this episode and book will give you the clarity, confidence, and community you need to take the next step.
Recommended
Transcript
Introduction to the IVF Blueprint
00:00:00
Speaker
If you've ever felt lost in the world of IVF, surrogacy, or egg donation, this is the guide you've been waiting for. Fertility treatment is not linear like that. You have to be able to get through the the marathon of everything that we do with the emotions that go with it in order to hit your end objective.
00:00:20
Speaker
That's Dr. Kari Bediant, one of the three renowned fertility specialists who co-hosts the hit podcast, Fertility Docs Uncensored. And now, along with Dr. Abby Eblen and Dr. Susan Hudson, they have co-authored the IVF Blueprint, the very first authoritative guide to IVF. yeah It's everything you love about the podcast, real talk, clear answers, and even a little humor now in book form.
00:00:46
Speaker
This book gets you the experience of sitting at your kitchen table with a cup of coffee or a glass of wine with your three best friends who all happen to be fertility doctors who are going to make sure you get through this process because you are their girl or boy.
00:01:07
Speaker
or person, however you want define it.
Emotional and Medical Insights into IVF
00:01:09
Speaker
Inside the book and in this conversation, you'll learn how to navigate a process that can feel overwhelming and what actually matters.
00:01:17
Speaker
IVF protocols, increasing your success rate, and even trending medications like GLP-1s and why emotional support matters just as much as medical expertise.
00:01:28
Speaker
So if you want clarity, confidence, and the step-by-step roadmap to make IVF less overwhelming, let's dive in. Enjoy. Okay, Dr. Harry, I am so excited that we get to talk again. And this time we're talking about your book.
00:01:47
Speaker
Look at it. Oh my gosh. um First of all, congratulations. Thank you. i just got a huge box of these last night and, uh, was dancing around kitchen. Yes, you were.
00:02:00
Speaker
Because I was super excited. As should. As you should. I love it. I love it. Okay. Well, um, I was lucky enough, thank you, to get an advanced copy. Um, and first of all, um Like right off the bat, you guys hit us in the feels because we go with Maya Angelou, who like queen, and she said in the very beginning, you may encounter many defeats, but you must not be defeated.
00:02:27
Speaker
Okay, instant tears. And like, how does this quote just sit with y'all when you decided to like do this?
00:02:40
Speaker
it i actually have not thought about that in context with us at all i have just always thought about it in terms of patience because you know as as fertility docs like our and really any fertility professional one of your main jobs is as a cheerleader and encouraging people to keep going and to continue on even when the process is just
Origin and Development of the Book
00:03:04
Speaker
ah misery on a stick.
00:03:06
Speaker
And so, so I hadn't even thought about it in in terms of us. And this project was two years in the making of doing all of the prep work and deciding on the chapters and who is going to write it and getting three physicians to agree on anything.
00:03:27
Speaker
We're gonna touch on that in a second. Yeah, yeah. And that's actually a really good reminder right now as we're going through this final push before it it hits the shelves and it's widely available and and all of those things, because we're there, right there.
00:03:45
Speaker
right there Yes. Oh, my gosh. Well, yeah. No, I mean, it really um I feel like it's such a great premise to to what this book is. But before we kind of break it down, obviously, most of you most of us know you um from the Fertility Docs Uncensored podcast.
00:04:03
Speaker
Can you take us back to you said this was two years in and in the making. Take us back when the idea of the IVF blueprint was even born. So when we first got together as podcasters, it was at at a meeting, at a dinner at this particular meeting, and a couple glasses of wine later, it was the best idea ever to do this podcast.
00:04:26
Speaker
Well, if COVID hadn't shut the entire world down, I don't know how we would have continued because it forced us to figure out how to do this over Zoom and all of the online platforms and recording that way.
00:04:36
Speaker
And so once we realized, oh, this is going to be a thing. We're going to be able to do this. um We started to say, okay, let's open up to listener questions because there's the whole goal of everything we're doing is how do we make this information accessible to normal people who aren't necessarily sitting in our kitchens with us or you know in our office after hours with their feet up on the desk or actually on the small drawer that I pull out that is right at footstool level.
00:05:09
Speaker
and and how do we make this accessible? and so i would say relatively early on, once Once we decided, hey, this is going to fly, we put on the bucket list, we're going to write a book.
00:05:21
Speaker
and And fast forward two, three years later, Abby, Evelyn, who's from Nashville, was like, I'm just going to write the proposal and I'm going to write up you know one chapter. you guys are going to edit it.
00:05:35
Speaker
She put together the whole proposal. She found us an agent. and And then the whole thing took off and it and it just happened.
00:05:46
Speaker
It just happened. Wow. That's amazing. For listeners who already tune into the show, what's something new that they'll get from the book versus listening to the show?
00:06:01
Speaker
it's in one place and they don't have to search around, they don't have to find it. Because in the show, we release an episode every single week. And typically the way that we choose our episodes is what is trending in our clinics?
00:06:14
Speaker
What are we hearing the most about? And what questions did we get just hammered with that week? Because I don't know if you notice this in in your world of surrogacy, but I feel like my clinic follows a theme of the week.
00:06:28
Speaker
And it's, I won't hear about fibroids forever. And then all of a sudden it's six patients in a row. And then I won't hear about, you know, using donor sperm for a same sex couple where they have already had one child together. Like it's very weird how specific some of these themes can get.
00:06:46
Speaker
And and so we're just talking about that on the show. Well, this book is a condensed, organized approach to it because we go from the very beginning all the way through the IVF process. And so with a podcast, you can find all of that. It's just it's not linear because our clinics aren't linear and right you've got everybody from the very beginning to bringing back a baby for a visit.
00:07:11
Speaker
And so this is a very organized, condensed book that you can shove in your pocket, you can stick a bookmark in. And as much as I love technology, yes, you technically can do that with podcasts and online reading and all those things.
Navigating the Emotional Challenges of IVF
00:07:25
Speaker
It's a hell of a lot easier to just do with a hard copy book that you shove in your purse and you can say, okay, I need to flip to this because this is where I am right now.
00:07:37
Speaker
Yeah, no, I completely agree. You guys do such a great job. I mean, IVF Blueprint, like, I mean, truly hit the nose on the head. Like, I mean, you really did a great job of just, it's a roadmap. I mean, it's all part one, part two, part three, part four. Like, I mean, it's all there and there's no mystery about, you know, what the chapters are. You really can just flip to it. It's it's perfect.
00:08:02
Speaker
As far as, i mean, I think... Yes, it's so informational, but you guys do touch on kind of the emotional rollercoaster that is IVF. And you even share, um you know, some personal experiences within that.
00:08:19
Speaker
Why was it important to be so candid rather than keeping it strictly clinical? because one of the biggest reasons that people bail on fertility treatment is not the money.
00:08:33
Speaker
It's not the complexity. It's the emotions. It's that it is as overwhelming as a cancer diagnosis. And there is, there is a study to show that that is not just lip service to anything.
00:08:45
Speaker
And, and so if you cannot manage the emotions, it doesn't matter how amazing you are in every other respect. you're not going to be able to get through.
00:08:56
Speaker
And so you need that support group. You need to know I'm not alone in this. You need to know I'm not crazy. You need to know all of those things and that the feelings you're going to have about your significant other of everything from the intense adoration to the I hate you. Why are we doing this?
00:09:14
Speaker
And all of the things that happen in between that is all normal, because if you can validate the emotions and you can ground somebody in i'm I'm not insane.
00:09:25
Speaker
this is This is really happening. i have this range of emotions and you can validate their there experience as they're going through zero to 100. Then they can get through everything because I don't know if you notice this with your patients, but my patients are type a organized go-getters and yeah giving them an objective.
00:09:47
Speaker
That's not the problem. It's having them deal with all these feelings and emotions that they feel like, I don't have time for this. This is not who I am. This is not what I do. see the goal. I get the goal.
00:09:59
Speaker
And fertility treatment is not
Lifestyle and Health Considerations for IVF
00:10:01
Speaker
linear like that. You have to be able to get through the the marathon of everything that we do with the emotions that go with it in order to, to hit your end objective.
00:10:12
Speaker
And frankly, I think it's good training for parenthood because people say, Oh, fertility treatment's so emotional. Well, dude, parenthood.
00:10:21
Speaker
Amen to that. Yeah. For sure. For sure. You, you've touched on, I mean, yes, I, you know, IVF patients, third party intended parents or just starting out across the board. all of them I feel like it's one of the most motivated, you know, just groups of people.
00:10:40
Speaker
um And so you have a lot of individuals who are, you know, okay, let's, how, how can we, and How can we have the highest success rate? What can we do? What are the things that I can, you know, be in control of? That's, you know, a big one right there.
00:10:57
Speaker
And honestly, you know, in the world of IVF, like we all love our good luck charms and we all love our, you know, socks and our pineapples and our pomegranate juice and all of the things. um And I love that it was chapter third.
00:11:11
Speaker
No, it was chapter six, chapter six. You guys touched on just the lifestyle. in preparation for IVF. And obviously, you know, most of our audience is third party.
00:11:23
Speaker
And one of the things that I think you do a great job in addressing is the supplement category. And I know this is such a specific question, but can, you know, what should patients and intended parents really look for when it comes to those vitamins and supplements? Because again, you address like companies make these big promises and you know, not they're not, there's not a lot of backup behind that.
00:11:51
Speaker
Yeah. What, how, how can we avoid getting taken advantage of? Because there was this really great breakdown of companies that I had not heard of before. So looking at the third party verification is a third party in the same sense of third party reproduction, ah but a third party in terms of having someone outside the company validate what they're doing.
00:12:13
Speaker
And the USP and NSF, I'm pretty sure I'm getting those, those initials, right? we i look at them every single time I say them just to make sure I'm getting the right set. But making sure that there's those two validations on whatever supplement you're buying. And you don't need both. One is fine.
00:12:30
Speaker
Or there's something equivalent. For example, I know with a set of vitamins from... luminary, they actually use an independent British, like a European approval system, which is in some ways stricter than what we see in the US. And so as long as there is a third party verification that what you're getting is actually what you're getting, because what most people don't realize is if you get a blood pressure medication that's approved by the FDA, there are very strict rules of if you test 10 bottles of that exact same medication,
00:13:05
Speaker
you are going to get very close to the exact same thing in every single bottle and every single pill. Supplements don't have to play by those rules. So you can have the same bottle ah two next to each other. And one's got a much higher content than the other one because of the variations of the manufacturing process.
00:13:22
Speaker
And so getting that independent verification is really helpful. And also actually talking with your doc because supplement fatigue is real. And when you start, you think, oh, I'm totally going to take ABC XYZ, LMN, OQP, the whole alphabet of them.
00:13:40
Speaker
And the first week you're doing it, you're like, I'm doing things. I'm doing things for myself. I'm going to make this process more successful. By the time you're a month in, that's a lot of pills. and it's very expensive.
00:13:51
Speaker
And it's mentally weighing because to wake up every morning and be staring at a pill box of 12 different horse pills that you need to take. is hard and there's enough hard with what we're doing.
00:14:05
Speaker
We don't need to add to it. And so really knowing some of the data, knowing what is worth my time and what's not can be really helpful. Yeah, for sure. No, I love that. We'll get right back to the show, but I wanted to take a quick moment to speak directly to those of you dreaming of growing your family.
00:14:22
Speaker
For the past 18 years, we at Egg Donor and Surrogate Solutions have had the privilege of walking alongside hopeful parents, guiding them through egg donation and surrogacy with empathy, expertise, and personal experience.
00:14:37
Speaker
Many of us on the team have been intended parents or surrogates or egg donors ourselves, so we understand just how important this journey is. Whether you're just starting to explore your options or ready to take the next step, we're here to help.
00:14:51
Speaker
You can schedule a free 15 minute call with our team at create a happy family.com to get your questions answered and see if we're the right fit for your journey. You don't have to figure this out alone.
00:15:02
Speaker
This is your invitation to learn more and take the next step toward the family you've been dreaming of. All right, let's get back to the show. Okay. I want to break down some of you know the fun that was in here.
00:15:16
Speaker
and i love this was This has always been a big thing for me, but I love that you address just right off the bat the imperfection of BMI. and like you But you have you know some doctors and IPs who really, really focus on BMI and will have gestational carriers and donors who have had perfectly healthy pregnancies or lead perfectly healthy you know lives.
00:15:43
Speaker
And we have to say, I'm sorry, you're ineligible right now. Do you see the possibility of a different measure of health in the near future?
GLP-1 Medications and Fertility Concerns
00:15:53
Speaker
And really, why is BMI so important?
00:15:57
Speaker
BMI is a measurement for anyone who doesn't know. It's a measurement of height and weight taken in relation to each other. Because, for example, you can have someone who is... I had a woman yesterday that I saw for a physical exam, and she was 220 pounds. Well, was so...
00:16:12
Speaker
well she was six two and so She hurts two under 20 pounds are very appropriate for the frame of her body. If you find that same 220 pounds on someone who is five foot one that is a very different distribution.
00:16:27
Speaker
And and so BMI helps to take into account what height does to weight. Now, it doesn't necessarily take into account what muscle mass does, what your vascular health is, all of those things. And so it is an imperfect measure, but I think it's a much better measure than just straight weight is.
00:16:48
Speaker
And most of us don't have the resources to say, okay, we're going to check your blood sugar for a week after every meal. And we're going to have you run a cardiac fitness test. And we're going to have you get, I mean we do have a ton of labs that we get, but labs are only a portion of the story.
00:17:05
Speaker
you know We're not going to see how much you sleep. And I don't know how much in the future things like the aura ring or other Apple watches, other body biometrics that you can get. I don't know how much that's going to play a part, but right now we're still very much in the information data gathering phase with those types of things and figuring out what information is just information and what information is actionable.
00:17:32
Speaker
and And so I think there may be a point in the future where we are able to rely on that and and use data that is instead of one height and one weight, it's
00:17:46
Speaker
25 different categories of what's your heartbeat and what's your temperature and what's your restfulness and how well do you sleep and all of those things, what's your cycle like those types of things. And so right now BMI is kind of what we have to go on. Now, if someone is a weightlifter,
00:18:01
Speaker
That is a very different thing than if you're a couch potato. yeah Someone who's 6'2 is very different than someone who is five two in in the same weight category, but their BMI hopefully evens that out a little bit. and so
00:18:17
Speaker
Every clinic is different. There are definitely components of just physicality that no matter how hell healthy someone is, the more weight they have, it can be very physically challenging to get their eggs.
00:18:29
Speaker
And they do have higher risks for when we put them under anesthesia. And so some of these things are not going anywhere independent of BMI because Whether you're, it doesn't matter what your BMI is, if you have a ton of extra weight and tissue around your neck, around your chest, that makes getting oxygen into you much more difficult.
00:18:48
Speaker
And when we're doing a procedure like an egg retrieval, that is a big deal because apparently you need oxygen to live. know. no but yeah No, I appreciate that. Because again, you know, I think, I think weight in general, particularly in women, it's a hot button, you know, topic for sure. But you guys do a great job of breaking down the why.
00:19:08
Speaker
And you even do it later on in the chapters, which I really appreciate how you guys go back and forth between here's the groundwork and then how you see the groundwork later. Okay.
00:19:18
Speaker
Still on the subject of, you know, again, another hot topic in chapter five, you guys bring up those GLP ones that I feel like are everywhere right now.
00:19:29
Speaker
Yes. Can you walk us through what we know about them when it comes to fertility and are there specific concerns when it comes to gestational carriers using them?
00:19:40
Speaker
Yeah. So we actually did. We partnered with Form Health and this was in, want to say January of 2024. It might have been January of 2023. And we did three separate episodes on the podcast about this because it is such a big, important topic.
00:19:56
Speaker
And these medications are revolutionary. And the funny thing is that they're revolutionary after they've been in existence for a decade or more. And so these these medications have been around for a while in the context of treating diabetes because they are very helpful in moderating blood sugar by impacting what you what you take into your body.
00:20:16
Speaker
And one of the really valuable things about these medications is that you can take them once a week because many medications, we actually, we have the the structure of the compound that that needs to be ingested for whatever whatever medical thing you're treating, but it's the delivery system and it's the length of time that it sticks around because it's only been relatively recently that we have been able to get long acting medication like the semaglutides, like the
00:20:51
Speaker
tur appetides all of that class of medications. And so it makes it much more attainable of you take this injection once a week and then you just take keep taking it weekly as opposed to having to give continuous injections like you would see with someone who is a type one diabetic who requires insulin, having to wear a pump all the time,
00:21:12
Speaker
all of the the measures that you may need to do to control your blood sugar as a diabetic or really any other chronic medical condition. And so the semaglutides have been around for quite some time. It's just,
00:21:26
Speaker
Once a medication has been around for a while, you have the original purpose that it was created for. And then you figure out what side effects are actually effects that you want to capitalize on.
00:21:40
Speaker
and And we see this a lot. you know A good example of this is Welbutrin. It's an antidepressant, but used in different doses. It helps people stop smoking. um the Another use for the antidepressants is to treat hot flashes.
00:21:56
Speaker
It's not gonna be in the same dose as what you would need to have the antidepressant effect, but if you take it in a really low dose, it can control your hot flashes. And so the longer something's been around, the longer we've had the opportunity to figure out what other effects does it have? And in the case of the GLP-1s, what you find is that it really changes the hormonal perception of fullness and, and it changes some of those neurotransmitters.
00:22:26
Speaker
And so it decreases the cravings. It decreases the, I call it food shatter that happens in your brain. And so those of us who constantly think about food of you get up in the morning. You're like, okay, well what am I going to take for my lunch today?
00:22:42
Speaker
What am I going to have for dinner tonight? I'm having friends over on Friday. What am I going to make them? What am I going to bring to the potluck where your your thoughts are just constantly inundated with food chatter?
00:22:53
Speaker
it helps to cut that. And I think that there will probably be a future of these medications in addiction as well with alcohol, with other drugs.
00:23:04
Speaker
I think that it's it's not the full story, but I think there's a component of that that we are just learning more and more about. So we we nailed the GLPs with diabetes relatively early on.
00:23:16
Speaker
Now we're finding out the weight loss side effects. And I think that will continue on as we get more and more information about these and have more people on them. You'll figure out both the the good side effects and the bad side effects.
00:23:29
Speaker
Yeah, for sure. i mean, we've already seen, you know, i I feel like it was it was two years ago where it was, you know, i woman on People Magazine, I, you know, started taking Ozempic and now I'm, you know, pregnant and I had been trying for three years and, you know, things like that. So you're seeing kind of, you know, the residual effects of, you know, just, just that alone.
00:23:54
Speaker
You made mention, you know, yes, totally great to be on them, but you do need to be off of them during, during a cycle and really, yeah. Is there, is there concern about them? Is it a,
00:24:09
Speaker
nu I'm assuming it's just a nutrition issue. there's There's a couple of different concerns. So if someone's going through a donor cycle, we want them off two weeks prior to having anesthesia because it slows down your gut motility.
00:24:20
Speaker
And you don't want to put someone to sleep with a completely full stomach that maybe they, they maybe they followed all the and directions. They didn't eat after midnight the night before, but if you're on a GLP your gut motility is slowed. And so your stomach is still highly likely to be full.
00:24:34
Speaker
And we don't want that fluid coming back up into your lungs because that is a very bad day for everyone involved. And so, so that's one of the concerns. And that's part of the reason why egg donors, we have to have you come off of them so that we can,
00:24:48
Speaker
safely put you to sleep or anyone who's going through an egg retrieval for whatever reason. For gestational carriers, the half-life of these medications is quite long. That's what makes them so valuable in that you can take a medication dose once a week and have it work all the way all the way through.
00:25:06
Speaker
Typically, we want a medication to have gone through five half-lives, before we consider it generally out of the system. And a half-life is the time that it takes for 50% of the drug in your body to go away.
00:25:19
Speaker
And so for the GLPs, their half-life is easily a week or longer. And so you really need to be off for a minimum of a month. And the recommendation is actually two months to have it fully out of your system.
00:25:32
Speaker
When you have someone who's getting pregnant, part of the concern is we just don't know what it's gonna do to the baby. and that information will come as more and more people are on these medications. More and more people will get accidentally pregnant on them, you know not intending to, but they're taking the medication.
00:25:48
Speaker
And so we'll get more of that data. But right now we don't want to mess with any of the blood sugar metabolism as as you're growing a baby, because we want to make sure that there's no negative impact down
Understanding IVF Protocols and Reproduction Complexities
00:26:02
Speaker
the line. And so what you find with most medications, no matter what they are, women and children,
00:26:07
Speaker
ah women of childbearing age, pregnant women and children are the last people to get approved. There's very few pediatric, relatively medications that are fully approved because no drug company is going to run the study on kids.
00:26:20
Speaker
That is, that is a losing proposition. because if anything happens to those kids, they're liable for it. And the same thing happens with pregnant women. And so the way that we will get that data is through decades of use where we just follow them and say, okay, you happened to get pregnant while you were taking this medication. What was the outcome? Was your kid okay? Was there a smaller birth size? Was there any compromise in their growth? was there Was there anything that happened during this that really made an impact that we need to know about and that's gonna go on the black box mornings?
00:26:53
Speaker
Okay, no, that makes a lot of sense. And again, i just the way that you talk about these things is exactly how this book is written. It is such a great breakdown of these big, huge topics that feel overwhelming.
00:27:06
Speaker
And you even said it in the introduction, everybody first goes to Dr. Google. This is that great breakdown of Dr. Google can have a lot of this information And even when you get there and you try and find a reputable site, you can't read it unless you have a medical degree.
00:27:20
Speaker
So, you know, again, these are great things to know about. And you guys do such a great job of breaking it down. One of the things it made me smile, because when when I would educate, um you know, women who were coming in to surrogates, I would always say,
00:27:38
Speaker
every clinic has their own secret sauce. Every doctor has their own protocol. And you even said, i love it. It was, you know, get get five doctors in a room and particularly with progesterone, I guarantee you everybody will, you know, be fighting about, you just the proper way or, you know, ah how it's gonna get transferred, all of that.
00:27:57
Speaker
Can you break down just maybe why, you know, why does everybody have their own secret sauce? If there was one right way to do it, we would all be doing it.
00:28:10
Speaker
she there was If there was one proven way, if you do this and this and this, you will have a 100% success rate. Whatever the highest is, there is no question we wouldnt we would all be doing it. I mean, there's there is no question when you're doing a programmed and embryo transfer cycle, everybody uses progesterone because that is a right answer.
00:28:34
Speaker
you have to use progesterone when you're doing a program cycle, you have to have progesterone on board. Now, how you give it, when you give it, the dose you give, all of that's up for debate.
00:28:44
Speaker
It is not up for debate that you need progesterone for an embryo to implant. And so there are things that are very concrete that we know, but because of all of the difficulties in doing studies on women of reproductive age,
00:28:58
Speaker
And when someone is pregnant, especially in the early first trimester where that's when everything about the baby is forming, that's when you're getting organogenesis. That's when you are getting some of your biggest growth. That's when all of those external substances really have the potential to make a huge difference.
00:29:16
Speaker
People are very, very wary of giving anything that doesn't have a lot of data behind it. And there will be in every new drug's life, there will always be a point when there is no data behind it.
00:29:27
Speaker
And it's just logic. Does this make sense? Yes, it does. Okay, let's give it a shot with with all of the appropriate counseling, of course. But if there was one right way to do it, we would all be doing it.
00:29:40
Speaker
And there isn't. Every person is different. Every body is different. Every lab is different. There are things that, you know, when, um, for example, Susan and I, Susan Hudson, one of the other authors and I are talking, she does all program cycles because a lot of her patients are coming from.
00:29:58
Speaker
Corpus Christi, Texas, three hours away from San Antonio where or her lab is. And so she has to do program cycles because that's how they're going to work in terms of timing for a lot of my patients, when they are coming from China, when they are coming from France, when they're coming from Australia,
00:30:15
Speaker
we have to use a birth control pill to help get their cycle regulated because that's a really large plane ticket to have to organize by and go on the whim of your period.
00:30:26
Speaker
And so there's a lot of things that play into this, that aren't just the street medicine. It's the logistics of what we're doing and how we have to go about it.
00:30:37
Speaker
Someone who has all of their patients within a 30 mile range, can do very different types of cycles than someone whose patients are coming halfway around the world. And so I would say that most of us have have the assortment of of treatments at our fingertips. you know I can think of a handful of different treatments that I like to use for transfers, but it's going to be very different. Do I have a GC coming from across the country? Do I have an IP coming from another place in the world?
00:31:03
Speaker
Do I have someone who lives down the street from my clinic? And so that's why there's a lot of this variation because we're thinking about how do we get it for you? How do we nail your body's physiology, your experience, your travel, the big picture?
00:31:22
Speaker
Yeah. No, I feel you you guys wrote, when your physician recommends a particular protocol, there's usually a reason. And even in the intro, you said there's more than one way to accomplish the same result. And I thought that this was really such a helpful way of framing things.
00:31:41
Speaker
Do you, do you ever wish that there was an exact science or do you think the nuance is actually kind of part of the beauty of, of all of this?
00:31:53
Speaker
I think the answer to both of those questions is yes. ah Sure. Because ah cookbook medicine is easier. I mean, it is easier for me to to tell a patient, no, no, you have to do this.
00:32:04
Speaker
This is tried and true and proven. And this is what we are doing. Period. End of story. This is not a point up for discussion. but very few things in life actually work like that. And so as a result, part of the reason most of us go into this field is because we like the nuance. We like the art of ART of assisted reproductive technologies, because yeah, you get five doctors in a room and you're going to have at least eight opinions and being able to work through that and figuring out, okay, which patient deserves this protocol, which patient will be better served by that protocol, which clinic,
00:32:41
Speaker
which type of lab environment, which whatever it may be, that is part of what makes this job so much fun and so appealing because it's not a cookbook medicine. You know, you, you can't necessarily be monkey and and, do this again and again and again, you have to look at the person in front of you and go, okay, what do we have to work with here? Because some of those protocol changes have very little to do with the physiology and they have everything to do with the person who's sitting in front of you.
00:33:10
Speaker
Someone who's very, very anxious about timing and about unexpected events. You may do differently than someone who has an emphasis on, I want to do everything that is as quote unquote natural as possible.
00:33:22
Speaker
And you approach those two people differently and that's what makes it fun. And that's what helps them to get through it. And i I like those nuances because it keeps me entertained of how can I best serve this patient and get them through in a way that will not leave them going to therapy for an extra 10 years after this because the process was so damaging.
00:33:44
Speaker
For sure. How does that... how does that ideology transfer into third party reproduction, particularly with surrogates?
00:33:57
Speaker
Where I know if I know in my experience when there was a failed cycle, you sometimes have, you know, doctors that, you know, just say, okay, well, we're gonna, let's do it again. Let's try again.
00:34:11
Speaker
But then you have other doctors who are like, okay, hold on, let's throw the kitchen sink at it. Or you, you know, you have doctors are kind of like, well, okay, go find a different surrogate, which by the way, surrogates don't grow on trees. So let's not do that. But you know,
00:34:26
Speaker
um um yeah. It's with surrogacy in particular, there are so many more challenges because most the time when physicians are treating a patient, they are treating one patient in IVF by default, you have two patients because you usually have two halves of the equation, whether it's two moms, two dads, a mom and a dad, whatever it may be.
00:34:48
Speaker
When you add in surrogacy, you add not only a third party in the surrogate, but you usually add a fourth party in, in the agency or whoever's working with them. Sometimes you might have a donor as well. And so,
00:35:00
Speaker
you've gone from having just one person as a patient to two, because you're, you're talking about the, the adult person and the fetus in there.
00:35:10
Speaker
And then there's usually a partner and then a surrogate and, and there's this growing, weaned flower of people who are going to make this happen. and And so you have to figure out how do we adapt to this?
00:35:23
Speaker
And with surrogates, the other considerations in play are where is she coming from? How far away is she? How close is she in where she lives to a monitoring center?
00:35:35
Speaker
Because it's very different if I've got someone who lives in a big city versus someone who lives four hours outside of the nearest anything. And how, what kind of protocol do we use? Because a ah protocol that is a very natural cycle based protocol, that person has to be able to get to the monitoring much more quickly, has to be able to get on the plane with much less notice.
00:35:59
Speaker
And that's very different a program cycle where it's much, much easier to say, you're going to go in on this day you're going to go in on this day going to go in on this day and you're going to plane on this day to come to the, to get the transfer.
00:36:10
Speaker
what their home life is makes a difference. So if you've got a surrogate who's got amazing childcare at the drop of a hat, that's very different than someone who is going to have to fly her mom in from some other city to watch her kids while she goes for the transfer.
00:36:26
Speaker
And in all of those play into consideration, then you layer the intended parents on top of it because they're, they've got a huge emotional investment. They've got a huge financial investment.
00:36:38
Speaker
and they've got the time investment in all of this. And so they don't wanna wait second longer than they have to, to get this thing that they have been working for, for usually years by the time we get to the point of surrogacy.
00:36:50
Speaker
And so you have to layer all of those things on. And so a protocol that I'm much more willing to do on a patient who lives 15 minutes down the street, whether she's a surrogate or not, is very different than someone who,
00:37:03
Speaker
has all of these other things riding on them where, yeah, maybe I don't want to mess with the natural cycle quite so much. Maybe I do want to do at least a little bit of Lupron going in so that we can really line it up and make it as easy and as stress less as possible to get to the transfer, because it's not, it's not ever just about me and what's convenient for me to do as a physician.
00:37:29
Speaker
It's let's layer in all these other people and get to the best solution for everybody that's going to get us the highest success rate, but also is not going to do collateral damage in the process, at least that we can avoid.
00:37:42
Speaker
When do you make that decision as far as, okay, you've done XYZ protocol and this just isn't working and you have to break that match. And I know that's not taken lightly.
00:37:57
Speaker
Not at all. What are usually those kind of, i guess, checklist when you're having to make that? Yeah. Breaking a match is never done flippantly because we know full well how long it takes to find a surrogate, how hard it is to find one, how hard it is to find one who is a good match for whatever couple they're working with, where everything lines up. And so Nobody likes to break matches unless they have to.
00:38:27
Speaker
And so some of the things are very obvious. If you have a non-compliant surrogate, um hi gup absolutely. that's That's easy. If you have a medical condition that has changed. So for example, if you do a transfer and someone has, let's say they have a miscarriage, which in and of itself is not necessarily a a problem and a cause for match break, but you know let's say that while she's going through that, she has a blood clot.
00:38:52
Speaker
That's a medical reason where it's real easy to say, okay, you know I'm really sorry, we're done. You cannot be surrogate. The other reasons are much more nuanced because you have to look at and say, is this an embryo issue?
00:39:06
Speaker
When we thought, not only did we get PGT, not only did it become a blast, not only did it survive the thought, how did it look like when we put it in? because if you had a really gorgeous stellar embryo that comes from a donor that's PGT tested, that there's nothing lingering behind, that is a different story than when you put in an embryo that came from a 41 year old IP where there's no PGT testing and there's a really high chance that it's the embryo that was the problem.
00:39:35
Speaker
And so when we look at it, we look at the embryos that are going in. Were these gorgeous embryos that we think should have stuck? If so, you're a little more inclined to to match break. Were these really poor looking embryos that the surrogate did everything right?
00:39:50
Speaker
She did everything she was supposed to, her lining did everything it was supposed to We think that this is not really related to her. Many of us will give, i would say at least two, usually three attempts of transferring before we'll do a match break. Now, there's other reasons where sometimes no matter what you do with a surrogate, her lining just doesn't cooperate.
00:40:11
Speaker
And this is where having all those protocols at our fingertips is really helpful because I have a surrogate who we've been working with her for probably five months now. And every single time there's fluid in that lining.
00:40:22
Speaker
It doesn't matter what we do. We've tried natural cycles, program cycles, modified natural, every variation, every different type of medication you can you can go through and just her lining will not cooperate.
00:40:37
Speaker
And so there becomes a point where You just have to say, okay, this isn't working. I don't know why. i don't blame anybody involved. Like this is not someone's fault.
00:40:49
Speaker
It's just, this is what it is. And we need to match break and we need to find somebody else because of all of the things that pile onto a surrogacy journey, the time, the money, the emotions, the to goal that you're trying to reach.
00:41:01
Speaker
and And so that plays a role as well because most clinics, you know it's ah it's a lot of work to get a surrogate in. And that's just from our part. That's not even from your part where you have to find them and them.
00:41:15
Speaker
And so you know once I know I've got a surrogate who's medically cleared, we want to hang on to her as
Empowerment and Support for IVF Journeys
00:41:20
Speaker
much as possible. Now, you don't necessarily have to change the protocol every single time. you can You can give the exact same protocol one month that doesn't work, the next month it does. and There's no rhyme or reason to it. it's just the body changes month by month, which is the beauty of it.
00:41:35
Speaker
But it does make it more challenging as you're going through. No, for sure. For sure. I love that. If you could put a sticky note inside of every reader's copy, what would it say?
00:41:52
Speaker
You got this. o You can do this. I have faith in you. It's ah women are... and couples, parents who want to be parents are a force of nature.
00:42:07
Speaker
And there's not a doubt in my mind that you got this, you can do this. And in general, you know, we can, we can get everybody to a family. Now, sometimes it's prohibitively expensive or time consuming or things like that, but given enough time and money, we can figure out a way to get you a family.
00:42:26
Speaker
They take a donor, they take a surrogate, We will get you there. It's just, do you have the resilience to get through it? And i think the vast majority of people, when they decide to, they do.
00:42:38
Speaker
So you got this. I have no, I have faith in you. You totally got this. When you look back at writing the book, was there, was there a part that just feels maybe the most personal to you?
00:42:55
Speaker
I think the I wrote a lot of that fourth section. So the way that we wrote it going through is we divided it up equally. Each of us took a third and you would write that primary chapter and then you would run it through the other two.
00:43:09
Speaker
And we ran it through each other so many times that now there There are chapters where I have to go back and think, was I the primary on this? Or was it one of the other girls?
00:43:20
Speaker
um But the i I was the primary author for a lot of Section Four, which is gestational carriers, egg donors and sperm donors, LGBTQIA+, those chapters, the egg freezing chapter. And that i really enjoyed writing those chapters.
00:43:38
Speaker
because there's not that good information out there. And i don't see a whole lot of published information. You can find stuff on websites. You can find stuff by talking to people, by listening to podcasts, things like that.
00:43:50
Speaker
But there's not a whole lot of sanctioned by the establishment, I guess, information where you find it in in an actual book form where there's credibility behind it. And there's, you know,
00:44:04
Speaker
all three of us authors have MDs in our titles. We are all double boarded. We are all giving that weight to that material that, yes, this is important.
00:44:15
Speaker
Yes, people need to to do this to conceive their families. And that's true for populations that are considered non-mainstream, which is a whole other podcast in and of itself.
00:44:31
Speaker
a lot of four letter words that I can approach that. And heard, heard. Yeah, yeah. um but the But giving that weight to that and giving the way to the alternatives that even even heteronormative heterosexual couples face a lot of issues with getting an egg donor, getting a sperm donor, using a surrogate that I think it makes their journeys unnecessarily hard.
00:44:55
Speaker
And so I really appreciated writing those chapters because it meant that I got to share a lot of knowledge that is very specialized, that nobody taught me in fellowship, that I had to learn through experience and by working with my clinic and all of my amazing staff members and my partners. And I really enjoy pulling all of that together and and presenting that so that people have this resource that they otherwise don't have in such a concise, compact sanctioned, for lack of a better word, way.
00:45:27
Speaker
Because when you've got a big five publisher that says, yeah, this is important, it it lends credibility to it. And so I'm really glad that we can do that because it should. I completely agree because I mean, you know, exactly like you said, there's not, there's not a lot out there. And if it's out there, it's usually from, you know, a magazine, a headline or a, you know, really awful romance novel or something. so it's, you know, it's you, you do, you don't, you, you, there's books about IVF, sure. But, but there's not, well, what happens when it's not the reader doing, you know, the IVF and, you know, FET process. And so I, um, I love that it is
00:46:13
Speaker
very well addressed and is there for exactly like you said, and there's credibility, there's thoughts behind it, i you know, all of that. So thank you. No, I i really do appreciate that.
00:46:25
Speaker
If you could sum up the IVF blueprint in one sentence, or maybe I might make it easier on you, what would be like, what would be your one takeaway for a reader for this book?
Conclusion and Reflections on Collaboration
00:46:45
Speaker
The takeaway for this book is this book gets you the experience of sitting at your kitchen table with a cup of coffee or a glass of wine with your three best friends who all happen to be fertility doctors who are going to make sure you get through this process because you their girl or boy or person, however you want to define it.
00:47:12
Speaker
But that that's what I want people to take away from this is that this was written with the intent to get a normal non-medical person through this really intense time. It's highly technical, it's highly complex.
00:47:29
Speaker
There's a ton of research, there's a ton of data behind it. And and this is this is the approach that I, would give and frankly have given to my girlfriends who've gone through this.
00:47:41
Speaker
ah Okay, I'm going to sit you down and I'm going to tell you exactly what you're going to expect and what you're going to go through. And we're going to take it one chunk at a time. So it is manageable for what you're going through.
00:47:53
Speaker
and And that's what I want you to get. And that's what we really want to get from the book is we want our reader to feel like she's or he's sitting right there with us as we're just shooting the breeze on a Saturday afternoon talking about, hey, what's going on in your life?
00:48:13
Speaker
Perfect. Beautiful. And I i would say job well done and definitely accomplished for sure. Thank you. Okay, my last question, and you know it's coming.
00:48:25
Speaker
What filled your cup today as I sit here drinking my, I won't even say what number it is cup of coffee.
00:48:36
Speaker
What has filled cup this very early morning for you, Dr. Perry? I think that my answer this time is the exact same as my answer last time, which is getting to sit here and talk to you and have a lovely conversation. This is a beautiful way to start my day. It's very calm. It's it's like, it's it's what we shoot for in the podcast of the book. It's like, I'm sitting here talking with my best buddy and I'm really kind of annoyed that you live in Houston because that's far away from me.
00:49:05
Speaker
on I know, but we would get nothing done. We would accomplish absolutely nothing. Oh, we would. We would solve all the world's problems. Yes, yes. All of the above. All of the above. of the above.
00:49:16
Speaker
This is a very lovely way to start my day and is calm and is sweet and gives me energy to go into whatever chaos the day is going to bring. A hundred percent.
00:49:28
Speaker
Well, this is definitely a great way to start my day. um And again, I so appreciate you coming back on. um Okay. September 23rd. Yes. The IVF blueprint.
00:49:39
Speaker
You can get it at all of the big bookstores all online. i'm But yeah, everybody go, go check it out. It's, it's beautiful. It's absolutely, yeah. Job well done, you guys.
00:49:50
Speaker
Thank you so much. Thank you. Thank you. Thank you.