WEBVTT
00:00:14.080 --> 00:00:17.839
Everyone, we are Rina and Dara, and welcome to Fertility Ford.
00:00:18.000 --> 00:00:24.399
We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City.
00:00:24.640 --> 00:00:36.159
Our Fertility Ford podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
00:00:36.640 --> 00:00:50.079
I'm really excited today to have Priyanka Jane on our podcast, who is the co-founder and CEO of EVI, a women's health technology company focused on closing the gender health gap by decoding the vaginal microbiome.
00:00:50.479 --> 00:01:01.520
Under her leadership, EVI provides at-home metagenomic testing to identify imbalances, aiming to move beyond traditional limited testing for better diagnostics.
00:01:01.840 --> 00:01:03.679
Bianca, I'm so happy to have you today.
00:01:04.079 --> 00:01:05.359
Thank you so much for having me.
00:01:05.439 --> 00:01:07.040
I'm so excited to be here.
00:01:07.439 --> 00:01:08.480
It's amazing.
00:01:08.640 --> 00:01:25.680
I was at my favorite or one of my favorite health conferences, IHS Integrative Health Symposium, a couple months back, and I was walking around looking at all the different booths, and I came across your company and learned a lot about it.
00:01:25.760 --> 00:01:30.480
And I'm so happy today for you to share with our listeners all about EV.
00:01:30.799 --> 00:01:37.680
So I'm I'm super curious of how you came up with the idea, how you got started with this company.
00:01:38.000 --> 00:01:38.959
Of course, yes.
00:01:39.120 --> 00:01:44.959
As I think probably most founders in women's health will say, it came from my own personal journey.
00:01:45.120 --> 00:01:49.599
And for me, it was very much feeling like I could just never get answers at the doctor's office.
00:01:49.680 --> 00:01:55.280
I mean, I think any woman who's listening to this probably has some version of this story at some point in their lives.
00:01:55.519 --> 00:02:01.920
But for me, it was I was in my late 20s and I was dealing with just an onslaught of mysterious health problems.
00:02:02.079 --> 00:02:04.159
And I went to doctor after doctor.
00:02:04.239 --> 00:02:05.760
I drew 20 tubes of blood.
00:02:05.920 --> 00:02:09.520
I did every test that anyone could, you know, tell me to do.
00:02:09.599 --> 00:02:14.879
And I get constantly we got the call of like, all of your results look perfect and nothing seems wrong.
00:02:15.120 --> 00:02:19.599
And maybe you're stressed, or maybe you're dehydrated, or maybe you don't sleep enough.
00:02:19.759 --> 00:02:25.280
And I was like, in what, you know, my background is actually in data science and machine learning, not in healthcare.
00:02:25.439 --> 00:02:31.439
And I was sitting in my data science job being like, wow, we can predict anything and it's the age of AI and machine learning.
00:02:31.599 --> 00:02:36.879
And then I was going to the doctor and constantly being told, we don't know, there's no data, there's no signal, whatever.
00:02:37.039 --> 00:02:40.479
And so I was incredibly frustrated, as I think so many patients are.
00:02:40.639 --> 00:02:55.840
And I started doing my own research, which is when I found out that women in the US were not in clinical research until 1993, and that to this day, women are diagnosed on average four years later than men across over 700 of the same diseases.
00:02:56.000 --> 00:02:59.599
And to me, that really screamed that we actually have a data problem, right?
00:02:59.680 --> 00:03:06.560
Like fundamentally, we have defined health and disease based on whatever predicts health and disease in middle-aged, mid-sized white men.
00:03:06.800 --> 00:03:09.759
And the female body is different down to the cellular level.
00:03:09.919 --> 00:03:15.439
There are so many signals that our bodies are trying to give us, telling us what's going well, where do we need help?
00:03:15.599 --> 00:03:20.639
But we just do a terrible job measuring and tracking those things because we just never studied women.
00:03:20.879 --> 00:03:26.080
And so I really wanted to focus on these overlooked biomarkers in the female body, right?
00:03:26.159 --> 00:03:30.000
Could we do a better job measuring and tracking these female specific signals?
00:03:30.080 --> 00:03:33.120
And could that actually help us improve outcomes in women's health?
00:03:33.280 --> 00:03:35.840
And so that was kind of the original impetus for EV.
00:03:36.080 --> 00:03:40.479
And obviously, we've now focused on the vaginal microbiome, which I'm sure I'll get to tell you more about.
00:03:40.800 --> 00:03:41.280
Wow.
00:03:41.439 --> 00:03:42.400
So it's great.
00:03:42.560 --> 00:03:46.960
See, finding a gap in healthcare and trying to fill that gap.
00:03:47.120 --> 00:03:48.800
It's it's very frustrating.
00:03:49.039 --> 00:03:49.919
I agree with you.
00:03:50.240 --> 00:03:57.599
The limited research or the research that has been done for so many years really focuses on white middle-aged men.
00:03:57.840 --> 00:04:03.039
Yes, we're more complicated, but that's not a reason that we, you know, not to study us.
00:04:03.360 --> 00:04:03.840
Totally.
00:04:04.000 --> 00:04:05.520
We should be able to find signal, right?
00:04:05.599 --> 00:04:09.520
There's so many signals and we should be able to better measure them and track them.
00:04:09.759 --> 00:04:15.120
And it's just crazy that we've like reduced female biology to the parts that overlap with male biology, right?
00:04:15.199 --> 00:04:16.639
And there's so much more to us.
00:04:16.720 --> 00:04:22.160
And could we be leveraging that additional amazing biology to actually have better health outcomes, right?
00:04:22.240 --> 00:04:24.480
I think there's so much opportunity there.
00:04:24.879 --> 00:04:25.360
Good for you.
00:04:25.439 --> 00:04:29.519
Like the idea of hearing that you're okay, that everything looks good.
00:04:29.839 --> 00:04:32.720
Good for you for saying, you know what, I'm not taking this answer.
00:04:32.879 --> 00:04:35.920
There's something else that I could look at.
00:04:36.319 --> 00:04:36.639
Totally.
00:04:36.879 --> 00:04:40.000
So it's I mean everyone's had that happen to them, I think.
00:04:40.480 --> 00:04:42.160
I think it's it's super common.
00:04:42.560 --> 00:04:43.279
Microbiome.
00:04:43.519 --> 00:04:58.240
Like I I love in school, in nutrition school, you learn a little bit about the gut, but even the gut microbiome has become a little bit more spoken about, definitely in the medical world, but even to the general population.
00:04:58.399 --> 00:05:01.839
But vaginal microbiome, let's talk about that.
00:05:02.160 --> 00:05:03.680
We're in the early innings, girl.
00:05:04.800 --> 00:05:08.000
No, I mean it's so interesting because most people have heard the term microbiome, right?
00:05:08.160 --> 00:05:11.040
Your gut, there's one in your mouth, there's one on your skin.
00:05:11.199 --> 00:05:16.079
But most of us are just totally unaware unless you're dealing with the problems that we solve for.
00:05:16.240 --> 00:05:19.439
A lot of people are unaware of the microbiome that exists in the vagina.
00:05:19.600 --> 00:05:23.680
And really, microbiome is just a fancy word for a community of microbes.
00:05:23.839 --> 00:05:26.480
So bacteria, fungi, viruses, you name it.
00:05:26.639 --> 00:05:36.000
And those microbes, we've actually co-evolved with the community in our vaginas to play this really important immune-like role for our entire reproductive system.
00:05:36.240 --> 00:05:51.839
And so what I found when I was at the beginning of starting EVI was that vaginal discomfort, meaning symptoms of odor, discharge, itching, bacterial vaginosis, yeast infections, recurrent UTIs, these are the leading reason women seek healthcare advice in America.
00:05:52.160 --> 00:06:00.319
And when we go to the doctor, we are more likely to be misdiagnosed than correctly diagnosed, and we are more likely not to get better than to get better.
00:06:00.560 --> 00:06:04.800
I mean, in my opinion, that's offensive and embarrassing for the healthcare system.
00:06:04.959 --> 00:06:09.040
And so understandably, we as patients end up online the same way I did.
00:06:09.120 --> 00:06:19.519
We're buying God only knows what wipe, wash, depository, is going to make your vagina smell like a flower because the healthcare system doesn't actually know what's going on and doesn't have the tools to actually understand it.
00:06:19.759 --> 00:06:28.959
And what was so interesting to me about the vaginal microbiome is like, okay, yes, when there are these pathogenic bacteria in the vagina, you often experience these symptoms and infections.
00:06:29.120 --> 00:06:44.079
But what the research shows time and time again, there are hundreds of studies on this now, is that when you have those pathogens in the vagina, you not only are getting these symptoms and infections, but you now also have infection and inflammation of the reproductive tract.
00:06:44.240 --> 00:07:06.800
And all of these studies are showing that inflammation and infection plays a critical role in fertility outcomes, whether it's idiopathic infertility, unexplained infertility, IVF failure, recurrent pregnancy loss, pregnancy outcomes, whether it's preterm birth or preeclampsia, but then goes down the line to cervical cancer progression and STI acquisition, endometriosis relapse and menopause symptoms.
00:07:06.879 --> 00:07:11.040
And I was like, oh my God, this is such an important set of information.
00:07:11.199 --> 00:07:18.720
And frankly, these markers in the vaginal microbiome are playing this incredibly important role in our overall health, and we're entirely ignoring it, right?
00:07:18.879 --> 00:07:20.000
Which blew my mind.
00:07:20.160 --> 00:07:35.600
And when I describe these pathogens in the vagina that create these symptoms, what's interesting is that 80% of the time that women have a completely disrupted vaginal microbiome, they have no symptoms, which means that actually a lot of women don't even know that this is happening.
00:07:35.680 --> 00:07:39.120
And it's not something that we're routinely checking or improving.
00:07:39.279 --> 00:07:46.639
And you're then leaving all of these women with these inflamed reproductive tracts that might be then affecting our health outcomes throughout our lives.
00:07:46.959 --> 00:07:48.000
Yeah, it's interesting.
00:07:48.240 --> 00:07:54.160
It's interesting to hear that a lot of times you actually don't get any outward signs, so to speak.
00:07:54.240 --> 00:08:03.360
And it's often when you go to the doctor for a checkup or you're going for something specific, that's when sometimes it may be uncovered, perhaps.
00:08:03.600 --> 00:08:04.000
Totally.
00:08:04.319 --> 00:08:04.800
Totally.
00:08:05.040 --> 00:08:10.079
And I mean, the other thing that I didn't explain is kind of how it works, which I think kind of relates back to all of this.
00:08:10.319 --> 00:08:13.040
So what's interesting is if you think about the gut microbiome, right?
00:08:13.120 --> 00:08:14.639
People talk about diversity, right?
00:08:14.720 --> 00:08:17.040
You want high diversity, you want lots of different things.
00:08:17.199 --> 00:08:20.240
What's interesting is that in the vagina, you actually want the opposite.
00:08:20.399 --> 00:08:24.800
You want dominance by a couple of species of specific bacteria.
00:08:24.959 --> 00:08:30.720
So there are certain species of lactobacilli, I'm sure you've heard of those, it's in certain probiotics or yogurt.
00:08:31.040 --> 00:08:37.600
There's vaginal specific strains of lactobacilli that play a really important role in reproductive health.
00:08:37.679 --> 00:08:45.279
And more specifically, they produce lactic acid, they produce hydrogen peroxide, and they take up space on the vaginal wall.
00:08:45.360 --> 00:08:54.559
And they basically make it so that when pathogens inevitably get into the vagina, I mean, it is literally an open gateway, when they get there, they can't survive.
00:08:54.639 --> 00:08:57.519
They can't thrive, it's too acidic, there's no space for them.
00:08:57.600 --> 00:09:06.399
And so when we say the vagina is a self-cleaning oven, it's really actually that the vaginal microbiome is keeping out those bad bacteria from moving up the tract, right?
00:09:06.559 --> 00:09:12.960
But God forbid you live your life, you have sex with someone new, you sit in your swimsuit for too long, you have a long period.
00:09:13.120 --> 00:09:19.279
All of those things can increase the vaginal pH and allow those pathogenic bacteria to start to replicate.
00:09:19.440 --> 00:09:24.000
And when that happens, that's when, you know, sometimes we go to the doctor with those symptoms.
00:09:24.159 --> 00:09:28.159
But also now you've lost that protective barrier for the rest of the reproductive tract.
00:09:28.240 --> 00:09:32.399
And that's what's then associated with all of these health outcomes across the lifespan.
00:09:32.720 --> 00:09:33.759
Oh, wow.
00:09:34.080 --> 00:09:38.559
So from one little thing, it can actually snowball into something a lot greater.
00:09:38.879 --> 00:09:39.279
Totally.
00:09:39.360 --> 00:09:42.720
And I think it's this is where it's like knowing what's going on.
00:09:42.879 --> 00:09:46.399
And frankly, like this is a very accessible sample.
00:09:46.559 --> 00:09:50.720
You don't have to draw your blood, you don't have to like prick, prot, you don't do anything.
00:09:50.799 --> 00:09:52.240
I mean, it's a swab of your vagina.
00:09:52.320 --> 00:09:54.399
I joke that it's easier than putting in a tampon.
00:09:54.639 --> 00:10:01.840
And there's so much valuable information right there of just like, what does your immune barrier for the reproductive tract look like?
00:10:02.000 --> 00:10:02.720
Is it intact?
00:10:02.879 --> 00:10:03.519
Is it not?
00:10:03.679 --> 00:10:10.000
And what's amazing about the vaginal microbiome to me, especially in the case of fertility, is that it's modifiable, right?
00:10:10.159 --> 00:10:14.480
Unlike so many things you can be told in the fertility journey that you can't change.
00:10:14.639 --> 00:10:16.000
Like, I can't change how old I am.
00:10:16.159 --> 00:10:19.200
I can't change, you know, a lot of the parts of the journey.
00:10:19.360 --> 00:10:21.039
I can change my vaginal microbiome, right?
00:10:21.120 --> 00:10:24.080
And Evi's actually really good at improving the vaginal microbiome.
00:10:24.240 --> 00:10:25.759
We published a lot of studies on that.
00:10:26.000 --> 00:10:33.759
So I think it's really exciting to be an accessible biomarker that patients can manage at home, that's affordable, and that also you can improve.
00:10:33.840 --> 00:10:37.039
And that that improvement is then associated with improved outcomes.
00:10:37.360 --> 00:10:41.200
So, yeah, let's talk about exactly this at home kit, how it works.
00:10:41.279 --> 00:10:42.879
It kind of sounds so it sounds easy.
00:10:42.960 --> 00:10:44.559
It's just a you said a swab.
00:10:44.879 --> 00:10:46.720
Yeah, it's incredibly easy.
00:10:46.879 --> 00:10:51.840
Patients can order it themselves at ev and it comes to your house.
00:10:51.919 --> 00:10:53.200
It's literally what it sounds like.
00:10:53.279 --> 00:10:55.360
It's like a little Q-tip swab of the vagina.
00:10:55.519 --> 00:10:58.480
You put it back in the tube, you mail it back to the lab.
00:10:58.639 --> 00:11:02.159
We do what's called shotgun metagenomic sequencing on the sample.
00:11:02.240 --> 00:11:08.000
It's a fancy way of saying that we sequence all the bacteria and fungi, the whole genome of everything in the sample.
00:11:08.240 --> 00:11:12.480
And it's the first time that you can actually get a comprehensive picture of everything going on.
00:11:12.639 --> 00:11:21.600
What's good, what's bad, how much of everything, what type of bad, what specific genes are present, how are those associated with different types of inflammation.
00:11:21.759 --> 00:11:27.200
And then we take all of that comprehensive molecular data and we put it in the context of you, right?
00:11:27.279 --> 00:11:35.919
So we'll say, okay, you have no symptoms, or you do have symptoms, or you're trying to conceive, or you're in perimenopause, or you're on this specific birth control.
00:11:36.159 --> 00:11:48.080
We'll combine all of that personalized data and we'll predict the specific treatments and ingredients that are most likely to help your vaginal microbiome get back to a state of health, dominated by that good bacteria.
00:11:48.240 --> 00:11:49.120
What do we need to treat?
00:11:49.200 --> 00:11:50.799
What biofilms do we need to break?
00:11:50.960 --> 00:11:53.039
How do we get the good lactobacilli in there?
00:11:53.120 --> 00:11:54.080
How do we feed them?
00:11:54.320 --> 00:12:03.919
We'll actually prescribe, we have the clinicians on our platform to prescribe custom compounded vaginal suppositories with exactly what the patient needs and send it to their journey.
00:12:04.559 --> 00:12:08.879
So we're able to enable patients to kind of manage the entire process at home.
00:12:09.039 --> 00:12:19.679
And for a lot of the patients who are on some version of a fertility journey, whether they're before getting to an IVF clinic or they're working with a fertility doctor, it's something that they don't have to go into the clinic for.
00:12:19.759 --> 00:12:25.120
It's something that doesn't require any more tricks and trotting and shots, but it's actually quite easy to manage.
00:12:25.200 --> 00:12:30.879
And again, it's a modifiable factor that we think is a really exciting opportunity to improve outcomes.
00:12:31.200 --> 00:12:33.360
So the kit comes, I'm assuming.
00:12:33.440 --> 00:12:40.399
So you said the kit with a combined with like a questionnaire and in-depth of how old you are, do you have any symptoms?
00:12:40.720 --> 00:12:55.120
Are you seeking fertility support and all of that combined with the results from that swab can kind of give you a better picture of where you are and how you, if need be, can improve your vaginal microbiome.
00:12:55.679 --> 00:12:56.159
Exactly.
00:12:56.399 --> 00:12:56.879
Exactly.
00:12:57.039 --> 00:13:18.960
And the the research in fertility is just so robust and it's so interesting, where there's study after study after study that has shown that being in that state of dominance by this healthy bacteria, low levels of the pathogenic bacteria, low levels of inflammation, all of that being highly associated with positive outcomes in, again, natural fertility as well as IVF.
00:13:19.120 --> 00:13:24.960
And so I think it's one of those things where if you're not there, it's totally fine because we know how to get you there, right?
00:13:25.120 --> 00:13:26.639
And if you are there, amazing.
00:13:26.720 --> 00:13:30.320
Now you know that this is actually really supporting you in your fertility journey.
00:13:30.480 --> 00:13:36.960
And so we're really excited to be able to bring that research and make it kind of clinically accessible to patients.
00:13:37.120 --> 00:13:41.759
And then we're also building on the research with a lot of our partners at RMA and otherwise.
00:13:41.840 --> 00:13:45.360
And we're really excited to kind of bring some of this novelty to patients.
00:13:45.679 --> 00:13:55.759
Yeah, I would love to hear if you're able to share with us the research that you have been doing and perhaps the research that you are going to be ongoing with RMA.
00:13:55.919 --> 00:13:56.000
Yeah.
00:13:57.759 --> 00:14:01.200
We're so excited to have such a great partnership with the team.
00:14:01.279 --> 00:14:05.200
And I mean, just to give everyone a little bit of a sense of the company.
00:14:05.440 --> 00:14:08.320
So we have the test product, we have the care offering.
00:14:08.480 --> 00:14:17.519
And today we work with over 100,000 patients across the country, and we work with over 2,000 doctors who use us for vaginal health as well as fertility.
00:14:17.759 --> 00:14:24.480
And we've been looking, so we've now built by miles the world's largest data set that's ever existed on the vaginal microbiome.
00:14:24.720 --> 00:14:42.879
96% of our patients have consented to research, which means that we can finally actually use that data to find these patterns and understand what's related to infertility and are there specific genes and enzymes and markers and really get to the answers that, frankly, we just haven't funded that research historically in this country.
00:14:42.960 --> 00:14:45.679
So we're very excited to kind of be pushing that forward.
00:14:45.840 --> 00:14:50.000
And in addition to the retrospective data, we are also running prospective studies.
00:14:50.159 --> 00:15:00.240
And so we, well, I'm trying to remember, we did an abstract with RMA last year at ASRM, which is the big American Society of Reproductive Medicine conference.
00:15:00.399 --> 00:15:17.039
And I think in that one, we were looking retrospectively at patients who reported infertility, and we found very specific signatures that were uniquely different in that cohort versus patients who didn't have infertility, which was very interesting and kind of builds on the existing published research in that space.
00:15:17.279 --> 00:15:41.200
And the prospective study that we've been so grateful to have such amazing guidance from the RMA team in the design and execution of the study, we're doing a study where we are taking EV tests very explicitly during IVF cycles to see if within the IBF journey, we can pinpoint specific markers in the vaginal microbiome that predict implantation success and failure in an IBF cycle.
00:15:41.360 --> 00:15:46.080
And so we actually now have the data from the first 170 patients in that study.
00:15:46.240 --> 00:15:55.600
And we're incredibly excited about what the data is showing us in terms of very clear signatures in the vaginal microbiome that are highly predictive of outcomes.
00:15:55.679 --> 00:16:01.679
And what's exciting is that those same markers are ones that we know how to modulate in our care programs already.
00:16:01.840 --> 00:16:04.320
And so we're really excited to put all of that together.
00:16:04.480 --> 00:16:14.960
We're finishing and rolling into that study now, and then we're hoping to publish it later this year so that we can actually get this new algorithm that we're training out to patients to help improve outcomes as fast as we can.
00:16:15.279 --> 00:16:16.000
That's wild.
00:16:16.080 --> 00:16:28.720
It's so interesting to see, you know, I've been in RV for 15 years, and we have is we've always been, I think, at the forefront of research, but to see just the evolution and, you know, even things, this was not even on my mind.
00:16:28.879 --> 00:16:30.080
The idea, it's interesting.
00:16:30.240 --> 00:16:37.759
I learned for many years about the gut microbiome and you know, the brain microbiome and the vaginal, but just and then also the interconnection.
00:16:37.840 --> 00:16:43.120
I think that's something that I'm curious to see vaginal health and mental health.
00:16:43.279 --> 00:16:43.519
Yeah.
00:16:43.679 --> 00:16:46.080
And the interplay between the two.
00:16:46.399 --> 00:16:46.879
Totally.
00:16:47.039 --> 00:16:50.799
I mean, we haven't done our own study on that, although we do collect some data.
00:16:51.039 --> 00:16:55.840
One of the things that I know is that the most commonly reported other diagnosis, right?
00:16:55.919 --> 00:17:02.559
So we ask about PCOS and endometriosis and autoimmune disease and cancer history and infertility and you name it.
00:17:02.799 --> 00:17:10.799
The most common answer, unfortunately, for our patients who have recurrent vaginal infections is anxiety and depression.
00:17:11.039 --> 00:17:21.359
And that matches, unfortunately, the published literature that shows that patients with recurrent yeast infections have like double the rate of mental health issues compared to people who don't.
00:17:21.519 --> 00:17:25.279
And so I think, as my co-founder always says, vaginal health is mental health.
00:17:25.359 --> 00:17:29.759
I think that it affects if you're, and I think very similar to fertility, right?
00:17:29.839 --> 00:17:33.119
If you're dealing with these challenges, it's not just physical, right?
00:17:33.200 --> 00:17:34.799
It's emotional, it's relational.
00:17:35.039 --> 00:17:43.920
And so I think what we have seen is that the importance of taking care of patients mentally is equally as important as actually changing their vaginal microbiome.
00:17:44.079 --> 00:17:45.759
Yeah, it goes hand in hand for sure.
00:17:46.079 --> 00:17:59.119
But it's great that you said because I think when I'm speaking with my patients, when they think of the microbiome and they think of all, you know, the organisms, the microbes in their body, they often think of like the yucky not good and not recognizing that we need.
00:17:59.279 --> 00:18:00.880
There's a lot of goodies out there.
00:18:01.119 --> 00:18:12.640
But it's fascinating because you know, when I was doing research myself, I did see certain microbes like the lactopacilli strains repeatedly coming up, and then maybe one or two other ones that were there.
00:18:12.880 --> 00:18:13.680
But it's interesting.
00:18:13.759 --> 00:18:17.440
Now it makes sense that now that you're saying we do not want the diversity.
00:18:17.519 --> 00:18:24.880
So when I speak about gut health and having a diverse amount of fruits and vegetables and grains and proteins, your gut likes that diversity.
00:18:25.039 --> 00:18:30.400
It's fascinating to hear that your vaginal microbiome actually does not want the diversity.
00:18:30.720 --> 00:18:31.200
100%.
00:18:31.519 --> 00:18:32.799
You want it to be dominated.
00:18:32.880 --> 00:18:36.079
You want those bacteria to be your protective shields.
00:18:36.240 --> 00:18:45.599
They can handle a little bit of, you know, here and there and whatever, but you do not want those guys taking over because that's when you start to have that infection, inflammation, symptoms, you need it.
00:18:46.079 --> 00:18:57.839
And one other thing I wanted to say on the mental health thing that I think is so important is I think that so much of where this all comes back to is also just the stigma and the taboos and the shame around these topics, right?
00:18:57.920 --> 00:19:07.839
And I think that's why I'm so glad you are doing these podcasts where you are talking about these things, you know, out in the world, because the reality is these are the leading reason women go to the doctor, right?
00:19:07.920 --> 00:19:12.799
These are incredibly, incredibly prevalent conditions, but people feel so alone in them.
00:19:12.960 --> 00:19:17.359
And unfortunately, like so many patients feel incredibly dismissed at the doctor's office, right?
00:19:17.519 --> 00:19:19.519
You're fine, your result is normal.
00:19:19.759 --> 00:19:20.400
We don't know.
00:19:20.559 --> 00:19:23.279
Oh, it's it doesn't really matter, just take this antibiotic.
00:19:23.440 --> 00:19:29.759
And I think that feeling of dismissal over and over again can be so harmful to your own mental health.
00:19:29.920 --> 00:19:38.160
And so I think the compounding nature of stigmatized and taboo topics that are often dismissed then lead to so many women struggling with these problems alone.
00:19:38.319 --> 00:19:44.319
And I hope that platforms like yours and platforms like ours really together are trying to break down both of those pieces.
00:19:44.880 --> 00:19:45.839
Amen to that.
00:19:46.000 --> 00:19:46.880
Yeah, it's interesting.
00:19:46.960 --> 00:19:52.720
I'm happy you mentioned PCOS because I was thinking that could be another, you know, I I work with a lot of PCOS patients.
00:19:52.799 --> 00:19:56.240
And I think testing for that population group, I think can be really great.
00:19:56.400 --> 00:20:00.160
I'm curious to see like when is the best time to test?
00:20:00.400 --> 00:20:03.440
Is it like when people are at first trying to conceive?
00:20:03.599 --> 00:20:05.200
Is it when they're struggling?
00:20:05.359 --> 00:20:10.799
Is it when they get that diagnosis of like unexplained infertility or or maybe all of the above?
00:20:11.119 --> 00:20:11.440
Yeah.
00:20:11.680 --> 00:20:18.240
I mean, what we see is that there's kind of four distinct patient profiles we see on the fertility side.
00:20:18.480 --> 00:20:22.000
The first is what I would say is like planning to conceive, right?
00:20:22.160 --> 00:20:27.599
My friends who are starting to take prenatal vitamins and are doing their blood work and making sure things are okay.
00:20:27.759 --> 00:20:32.960
I mean, it's such an easy thing to check to see like, oh, is this something I need to improve?
00:20:33.119 --> 00:20:35.039
Is this something that could stand in my way?
00:20:35.200 --> 00:20:40.400
And we definitely see a subset of our patients kind of in that early planning phase.
00:20:40.720 --> 00:20:43.359
Then we see patients who are struggling, right?
00:20:43.519 --> 00:20:45.200
Whether that's three months, six months.
00:20:45.440 --> 00:20:46.880
I mean, you know as well as I do.
00:20:47.119 --> 00:20:50.880
A lot of people just hate that feeling of being out of control, not knowing what's going on.
00:20:51.039 --> 00:20:52.480
It hasn't been 12 months yet.
00:20:52.640 --> 00:20:54.160
They don't know what doctor to go to.
00:20:54.319 --> 00:21:03.119
And we see a lot of patients coming to us then saying, you know, is there any testing that I didn't do that maybe actually could be pointing to why this feels harder than I thought it should be?
00:21:03.359 --> 00:21:14.160
And a lot of times we'll partner with amazing dietitians and acupuncturists and naturopaths, the places that those patients tend to end up to kind of make sure that we are a part of that overall journey.
00:21:14.400 --> 00:21:18.480
The third and fourth patients are often with the IVF clinics, right?
00:21:18.640 --> 00:21:24.240
So some patients, before they even do their first transfer, they want to make sure their highest likelihood of success.
00:21:24.400 --> 00:21:32.240
And we'll see them testing before they schedule the appointment or right after their egg retrieval to make sure that they're in an optimal condition before a transfer.
00:21:32.480 --> 00:21:39.119
And some patients will see after their first transfer fails and they're looking for what might be a reason for that, we'll see them coming back to us then.
00:21:39.279 --> 00:21:44.799
And so I would say those are kind of the four most common places in the journey that we see patients engage with EVI.
00:21:44.880 --> 00:21:52.000
But we're really excited that, you know, we often can support them before they have a doctor when they're at home and they're just thinking about it and we can educate them.
00:21:52.160 --> 00:21:58.160
We have amazing health coaches that can explain the vaginal microbiome, talk to them about its role in their health.
00:21:58.240 --> 00:22:05.039
But then we're also able to work with so Many amazing doctors and practitioners to be a part of kind of their broader care journey.
00:22:05.519 --> 00:22:06.160
I think that's great.
00:22:06.240 --> 00:22:12.480
Yeah, I for me the idea of being proactive, but of course it starts with people knowing that it's out there.
00:22:12.880 --> 00:22:20.720
Yeah, I think it should be, you know, you go to your OBGYN, you know, before you start trying to conceive, and that should be like a discussion.
00:22:20.799 --> 00:22:24.480
I think it it should be part of, you know, normal practice.
00:22:24.720 --> 00:22:34.559
But the fact that it can be helpful throughout is great for our audience to hear that there's not necessarily one specific time that is best, it can help throughout.
00:22:35.039 --> 00:22:35.519
Totally.
00:22:35.680 --> 00:22:36.720
I completely agree.
00:22:37.119 --> 00:22:47.359
And the fact that you could even, so you said you often uh Sonic will recommend a repeat to see if the changes that you recommended from your company after this changes to see if it's made a difference.
00:22:47.440 --> 00:22:47.680
Yeah.
00:22:47.839 --> 00:22:48.079
Yeah.
00:22:48.319 --> 00:22:50.400
Because look, some patients it takes longer.
00:22:50.559 --> 00:22:52.160
Some patients it happens really fast.
00:22:52.240 --> 00:22:54.480
And some, like, look, everyone's different.
00:22:54.559 --> 00:22:57.119
And I would never tell anyone how to do their journey.
00:22:57.359 --> 00:23:01.519
Some patients really want to know that they're in an optimal place before they do a transfer, right?
00:23:01.599 --> 00:23:06.400
Maybe you only have one embryo, or maybe, you know, you just don't want to spend the money to do it again.
00:23:06.559 --> 00:23:11.839
I think we often will see those patients doing a retest before they do a transfer.
00:23:12.000 --> 00:23:14.799
But other patients, you know, they just take the test, they don't even get the results.
00:23:14.880 --> 00:23:15.519
They do the transfer.
00:23:15.599 --> 00:23:19.839
And if it doesn't work, they're like, okay, now let me go back and look if that could have been a contributing factor.
00:23:20.000 --> 00:23:27.920
And so I think all of those decisions are always best made by the patient who's in that body and making those decisions and in partnership with their clinician.
00:23:28.000 --> 00:23:31.680
And we're just there to support and plug in in whatever way makes the most sense.
00:23:32.000 --> 00:23:34.640
I think you've created something phenomenal.
00:23:34.799 --> 00:23:36.160
Like I'm really impressed.
00:23:36.240 --> 00:23:41.279
I wish I knew about you when I was going through my fertility struggles, just to get some more insight.
00:23:41.359 --> 00:23:48.319
It's again amazing to see the evolution of things being created, of the research that's out there and the research that you're doing.
00:23:48.400 --> 00:23:55.039
It's I really can't wait to see where the company continues to go and how it evolves and changes over time.
00:23:55.200 --> 00:24:01.519
And I'm really like, I would love to have you back on to hear some of the research, like the future research that you conduct.
00:24:01.839 --> 00:24:08.640
Well, when we publish our study in a in a few short months here, I would love to come on and tell everyone about it because the results are incredibly exciting.
00:24:08.720 --> 00:24:11.279
And I think just a really amazing new tool for us to have.
00:24:11.359 --> 00:24:14.799
I think that like at the end of the day, I am two things.
00:24:14.960 --> 00:24:16.799
I am a data nerd and I'm a patient, right?
00:24:16.880 --> 00:24:21.279
And I believe that patients should have access to tools and best in class technology.
00:24:21.440 --> 00:24:28.400
I mean, nothing drives me more crazy than just the dearth of good technology and women's health and the dearth of good data and research, right?
00:24:28.480 --> 00:24:39.440
And so I really hope that by bringing better technology to this problem, we can finally gather the data that finally allows us to understand the female bodies so that we don't have to hear unexplained everywhere we go.
00:24:39.759 --> 00:24:42.319
Oh man, I think that's great.
00:24:42.799 --> 00:24:47.119
How do our listeners find you, your company?
00:24:47.279 --> 00:24:50.720
What's the best way for them to get to see your product?
00:24:50.960 --> 00:24:51.279
Yeah.
00:24:51.519 --> 00:24:55.440
So we're online at evie.com, it's just ebvy.com.
00:24:55.680 --> 00:24:59.519
We are on Instagram at Evi and we are on TikTok at EviBio.
00:24:59.759 --> 00:25:02.160
And I will shamelessly plug our TikTok.
00:25:02.240 --> 00:25:04.319
It is so amazing, so hilarious.
00:25:04.480 --> 00:25:08.160
I think we get 200 million views a year across all of our content.
00:25:08.319 --> 00:25:15.599
It's a phenomenal place to just be a woman and laugh about all the things that we should have learned, that we don't understand, that we want to understand.
00:25:15.759 --> 00:25:24.240
It's such a great community and so much amazing educational content, but also just humor about what it's like to have a female body in 2026.
00:25:24.640 --> 00:25:30.400
You made my day because I am newish to TikTok, but your Instagram account, I think, is phenomenal too.
00:25:30.480 --> 00:25:31.759
I see I love the research.
00:25:31.920 --> 00:25:36.079
There's humor, there's videos, but good to know TikTok's even more fun.
00:25:36.319 --> 00:25:37.200
That's amazing.
00:25:37.359 --> 00:25:43.839
Well, we're so happy to have you, Priyanka, on our podcast and to share with our listeners the great work that you're doing.
00:25:44.000 --> 00:25:48.160
And how we always end our podcast is with words of gratitude.
00:25:48.400 --> 00:25:51.279
So what are you grateful for today?
00:25:51.680 --> 00:25:52.079
Wow.
00:25:52.240 --> 00:26:03.839
Honestly, this conversation makes me so grateful for all of the incredible fertility doctors that sit with their patients through some of the hardest, most emotional times in our lives.
00:26:04.000 --> 00:26:06.160
I mean, we see those patients all day, every day.
00:26:06.240 --> 00:26:16.559
And I feel so grateful they're in the hands of these incredibly competent superhero providers who are doing their absolute best to make patients and families' dreams come true.
00:26:16.720 --> 00:26:24.480
And I've truly loved getting to know the fertility doctor community, how curious they are, how much they want to see the data, they want to innovate.
00:26:24.640 --> 00:26:27.039
And I think it's such a unique field of medicine, right?
00:26:27.119 --> 00:26:36.559
Where everyone is so aligned towards the goal of improving outcomes in a way that I don't think is, I think there's a lot of kind of run-of-the-mill status quo elsewhere in medicine.
00:26:36.640 --> 00:26:40.559
And I think in fertility medicine, you really see a push towards let's do better.
00:26:40.640 --> 00:26:43.440
And I think that's really driven by the amazing doctors.
00:26:43.759 --> 00:26:44.079
Yeah.
00:26:44.240 --> 00:26:46.480
Again, the evolution is pretty wild.
00:26:46.720 --> 00:26:48.240
I'm gonna piggyback on that.
00:26:48.480 --> 00:26:51.359
I'm grateful that we can normalize vaginal health.
00:26:51.519 --> 00:26:57.039
I think, you know, back in my mother's day, my grandmother's day, it was such a taboo topic.
00:26:57.440 --> 00:27:00.319
And A, now we're much more informed.
00:27:00.720 --> 00:27:03.279
And B, we can also have the humor with it too.
00:27:03.359 --> 00:27:06.079
Like it doesn't need to be something shameful.
00:27:06.240 --> 00:27:11.359
And it is part of our body, and it's something that we need to continue to learn about.
00:27:11.519 --> 00:27:13.599
And you guys are doing great work in this field.
00:27:13.680 --> 00:27:19.200
So I'm very happy that we had you on and can't wait to see what's to come.
00:27:19.519 --> 00:27:21.279
Yeah, no, I so appreciate you having me.
00:27:21.359 --> 00:27:25.119
Thank you so much again, and for the amazing work that you are doing with this platform.
00:27:25.440 --> 00:27:25.839
Thanks.
00:27:26.079 --> 00:27:27.119
Appreciate it.
00:27:27.440 --> 00:27:29.440
Thank you so much for listening today.
00:27:29.599 --> 00:27:38.240
And always remember, practice gratitude, give a little love to someone else and yourself, and remember, you are not alone.
00:27:38.480 --> 00:27:42.400
Find us on Instagram at fertility underscore forward.
00:27:42.559 --> 00:27:52.240
And if you're looking for more support, visit us at www.rmany.com and tune in next week for more fertility forward.
00:00:14.080 --> 00:00:17.839
Everyone, we are Rina and Dara, and welcome to Fertility Ford.
00:00:18.000 --> 00:00:24.399
We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City.
00:00:24.640 --> 00:00:36.159
Our Fertility Ford podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
00:00:36.640 --> 00:00:50.079
I'm really excited today to have Priyanka Jane on our podcast, who is the co-founder and CEO of EVI, a women's health technology company focused on closing the gender health gap by decoding the vaginal microbiome.
00:00:50.479 --> 00:01:01.520
Under her leadership, EVI provides at-home metagenomic testing to identify imbalances, aiming to move beyond traditional limited testing for better diagnostics.
00:01:01.840 --> 00:01:03.679
Bianca, I'm so happy to have you today.
00:01:04.079 --> 00:01:05.359
Thank you so much for having me.
00:01:05.439 --> 00:01:07.040
I'm so excited to be here.
00:01:07.439 --> 00:01:08.480
It's amazing.
00:01:08.640 --> 00:01:25.680
I was at my favorite or one of my favorite health conferences, IHS Integrative Health Symposium, a couple months back, and I was walking around looking at all the different booths, and I came across your company and learned a lot about it.
00:01:25.760 --> 00:01:30.480
And I'm so happy today for you to share with our listeners all about EV.
00:01:30.799 --> 00:01:37.680
So I'm I'm super curious of how you came up with the idea, how you got started with this company.
00:01:38.000 --> 00:01:38.959
Of course, yes.
00:01:39.120 --> 00:01:44.959
As I think probably most founders in women's health will say, it came from my own personal journey.
00:01:45.120 --> 00:01:49.599
And for me, it was very much feeling like I could just never get answers at the doctor's office.
00:01:49.680 --> 00:01:55.280
I mean, I think any woman who's listening to this probably has some version of this story at some point in their lives.
00:01:55.519 --> 00:02:01.920
But for me, it was I was in my late 20s and I was dealing with just an onslaught of mysterious health problems.
00:02:02.079 --> 00:02:04.159
And I went to doctor after doctor.
00:02:04.239 --> 00:02:05.760
I drew 20 tubes of blood.
00:02:05.920 --> 00:02:09.520
I did every test that anyone could, you know, tell me to do.
00:02:09.599 --> 00:02:14.879
And I get constantly we got the call of like, all of your results look perfect and nothing seems wrong.
00:02:15.120 --> 00:02:19.599
And maybe you're stressed, or maybe you're dehydrated, or maybe you don't sleep enough.
00:02:19.759 --> 00:02:25.280
And I was like, in what, you know, my background is actually in data science and machine learning, not in healthcare.
00:02:25.439 --> 00:02:31.439
And I was sitting in my data science job being like, wow, we can predict anything and it's the age of AI and machine learning.
00:02:31.599 --> 00:02:36.879
And then I was going to the doctor and constantly being told, we don't know, there's no data, there's no signal, whatever.
00:02:37.039 --> 00:02:40.479
And so I was incredibly frustrated, as I think so many patients are.
00:02:40.639 --> 00:02:55.840
And I started doing my own research, which is when I found out that women in the US were not in clinical research until 1993, and that to this day, women are diagnosed on average four years later than men across over 700 of the same diseases.
00:02:56.000 --> 00:02:59.599
And to me, that really screamed that we actually have a data problem, right?
00:02:59.680 --> 00:03:06.560
Like fundamentally, we have defined health and disease based on whatever predicts health and disease in middle-aged, mid-sized white men.
00:03:06.800 --> 00:03:09.759
And the female body is different down to the cellular level.
00:03:09.919 --> 00:03:15.439
There are so many signals that our bodies are trying to give us, telling us what's going well, where do we need help?
00:03:15.599 --> 00:03:20.639
But we just do a terrible job measuring and tracking those things because we just never studied women.
00:03:20.879 --> 00:03:26.080
And so I really wanted to focus on these overlooked biomarkers in the female body, right?
00:03:26.159 --> 00:03:30.000
Could we do a better job measuring and tracking these female specific signals?
00:03:30.080 --> 00:03:33.120
And could that actually help us improve outcomes in women's health?
00:03:33.280 --> 00:03:35.840
And so that was kind of the original impetus for EV.
00:03:36.080 --> 00:03:40.479
And obviously, we've now focused on the vaginal microbiome, which I'm sure I'll get to tell you more about.
00:03:40.800 --> 00:03:41.280
Wow.
00:03:41.439 --> 00:03:42.400
So it's great.
00:03:42.560 --> 00:03:46.960
See, finding a gap in healthcare and trying to fill that gap.
00:03:47.120 --> 00:03:48.800
It's it's very frustrating.
00:03:49.039 --> 00:03:49.919
I agree with you.
00:03:50.240 --> 00:03:57.599
The limited research or the research that has been done for so many years really focuses on white middle-aged men.
00:03:57.840 --> 00:04:03.039
Yes, we're more complicated, but that's not a reason that we, you know, not to study us.
00:04:03.360 --> 00:04:03.840
Totally.
00:04:04.000 --> 00:04:05.520
We should be able to find signal, right?
00:04:05.599 --> 00:04:09.520
There's so many signals and we should be able to better measure them and track them.
00:04:09.759 --> 00:04:15.120
And it's just crazy that we've like reduced female biology to the parts that overlap with male biology, right?
00:04:15.199 --> 00:04:16.639
And there's so much more to us.
00:04:16.720 --> 00:04:22.160
And could we be leveraging that additional amazing biology to actually have better health outcomes, right?
00:04:22.240 --> 00:04:24.480
I think there's so much opportunity there.
00:04:24.879 --> 00:04:25.360
Good for you.
00:04:25.439 --> 00:04:29.519
Like the idea of hearing that you're okay, that everything looks good.
00:04:29.839 --> 00:04:32.720
Good for you for saying, you know what, I'm not taking this answer.
00:04:32.879 --> 00:04:35.920
There's something else that I could look at.
00:04:36.319 --> 00:04:36.639
Totally.
00:04:36.879 --> 00:04:40.000
So it's I mean everyone's had that happen to them, I think.
00:04:40.480 --> 00:04:42.160
I think it's it's super common.
00:04:42.560 --> 00:04:43.279
Microbiome.
00:04:43.519 --> 00:04:58.240
Like I I love in school, in nutrition school, you learn a little bit about the gut, but even the gut microbiome has become a little bit more spoken about, definitely in the medical world, but even to the general population.
00:04:58.399 --> 00:05:01.839
But vaginal microbiome, let's talk about that.
00:05:02.160 --> 00:05:03.680
We're in the early innings, girl.
00:05:04.800 --> 00:05:08.000
No, I mean it's so interesting because most people have heard the term microbiome, right?
00:05:08.160 --> 00:05:11.040
Your gut, there's one in your mouth, there's one on your skin.
00:05:11.199 --> 00:05:16.079
But most of us are just totally unaware unless you're dealing with the problems that we solve for.
00:05:16.240 --> 00:05:19.439
A lot of people are unaware of the microbiome that exists in the vagina.
00:05:19.600 --> 00:05:23.680
And really, microbiome is just a fancy word for a community of microbes.
00:05:23.839 --> 00:05:26.480
So bacteria, fungi, viruses, you name it.
00:05:26.639 --> 00:05:36.000
And those microbes, we've actually co-evolved with the community in our vaginas to play this really important immune-like role for our entire reproductive system.
00:05:36.240 --> 00:05:51.839
And so what I found when I was at the beginning of starting EVI was that vaginal discomfort, meaning symptoms of odor, discharge, itching, bacterial vaginosis, yeast infections, recurrent UTIs, these are the leading reason women seek healthcare advice in America.
00:05:52.160 --> 00:06:00.319
And when we go to the doctor, we are more likely to be misdiagnosed than correctly diagnosed, and we are more likely not to get better than to get better.
00:06:00.560 --> 00:06:04.800
I mean, in my opinion, that's offensive and embarrassing for the healthcare system.
00:06:04.959 --> 00:06:09.040
And so understandably, we as patients end up online the same way I did.
00:06:09.120 --> 00:06:19.519
We're buying God only knows what wipe, wash, depository, is going to make your vagina smell like a flower because the healthcare system doesn't actually know what's going on and doesn't have the tools to actually understand it.
00:06:19.759 --> 00:06:28.959
And what was so interesting to me about the vaginal microbiome is like, okay, yes, when there are these pathogenic bacteria in the vagina, you often experience these symptoms and infections.
00:06:29.120 --> 00:06:44.079
But what the research shows time and time again, there are hundreds of studies on this now, is that when you have those pathogens in the vagina, you not only are getting these symptoms and infections, but you now also have infection and inflammation of the reproductive tract.
00:06:44.240 --> 00:07:06.800
And all of these studies are showing that inflammation and infection plays a critical role in fertility outcomes, whether it's idiopathic infertility, unexplained infertility, IVF failure, recurrent pregnancy loss, pregnancy outcomes, whether it's preterm birth or preeclampsia, but then goes down the line to cervical cancer progression and STI acquisition, endometriosis relapse and menopause symptoms.
00:07:06.879 --> 00:07:11.040
And I was like, oh my God, this is such an important set of information.
00:07:11.199 --> 00:07:18.720
And frankly, these markers in the vaginal microbiome are playing this incredibly important role in our overall health, and we're entirely ignoring it, right?
00:07:18.879 --> 00:07:20.000
Which blew my mind.
00:07:20.160 --> 00:07:35.600
And when I describe these pathogens in the vagina that create these symptoms, what's interesting is that 80% of the time that women have a completely disrupted vaginal microbiome, they have no symptoms, which means that actually a lot of women don't even know that this is happening.
00:07:35.680 --> 00:07:39.120
And it's not something that we're routinely checking or improving.
00:07:39.279 --> 00:07:46.639
And you're then leaving all of these women with these inflamed reproductive tracts that might be then affecting our health outcomes throughout our lives.
00:07:46.959 --> 00:07:48.000
Yeah, it's interesting.
00:07:48.240 --> 00:07:54.160
It's interesting to hear that a lot of times you actually don't get any outward signs, so to speak.
00:07:54.240 --> 00:08:03.360
And it's often when you go to the doctor for a checkup or you're going for something specific, that's when sometimes it may be uncovered, perhaps.
00:08:03.600 --> 00:08:04.000
Totally.
00:08:04.319 --> 00:08:04.800
Totally.
00:08:05.040 --> 00:08:10.079
And I mean, the other thing that I didn't explain is kind of how it works, which I think kind of relates back to all of this.
00:08:10.319 --> 00:08:13.040
So what's interesting is if you think about the gut microbiome, right?
00:08:13.120 --> 00:08:14.639
People talk about diversity, right?
00:08:14.720 --> 00:08:17.040
You want high diversity, you want lots of different things.
00:08:17.199 --> 00:08:20.240
What's interesting is that in the vagina, you actually want the opposite.
00:08:20.399 --> 00:08:24.800
You want dominance by a couple of species of specific bacteria.
00:08:24.959 --> 00:08:30.720
So there are certain species of lactobacilli, I'm sure you've heard of those, it's in certain probiotics or yogurt.
00:08:31.040 --> 00:08:37.600
There's vaginal specific strains of lactobacilli that play a really important role in reproductive health.
00:08:37.679 --> 00:08:45.279
And more specifically, they produce lactic acid, they produce hydrogen peroxide, and they take up space on the vaginal wall.
00:08:45.360 --> 00:08:54.559
And they basically make it so that when pathogens inevitably get into the vagina, I mean, it is literally an open gateway, when they get there, they can't survive.
00:08:54.639 --> 00:08:57.519
They can't thrive, it's too acidic, there's no space for them.
00:08:57.600 --> 00:09:06.399
And so when we say the vagina is a self-cleaning oven, it's really actually that the vaginal microbiome is keeping out those bad bacteria from moving up the tract, right?
00:09:06.559 --> 00:09:12.960
But God forbid you live your life, you have sex with someone new, you sit in your swimsuit for too long, you have a long period.
00:09:13.120 --> 00:09:19.279
All of those things can increase the vaginal pH and allow those pathogenic bacteria to start to replicate.
00:09:19.440 --> 00:09:24.000
And when that happens, that's when, you know, sometimes we go to the doctor with those symptoms.
00:09:24.159 --> 00:09:28.159
But also now you've lost that protective barrier for the rest of the reproductive tract.
00:09:28.240 --> 00:09:32.399
And that's what's then associated with all of these health outcomes across the lifespan.
00:09:32.720 --> 00:09:33.759
Oh, wow.
00:09:34.080 --> 00:09:38.559
So from one little thing, it can actually snowball into something a lot greater.
00:09:38.879 --> 00:09:39.279
Totally.
00:09:39.360 --> 00:09:42.720
And I think it's this is where it's like knowing what's going on.
00:09:42.879 --> 00:09:46.399
And frankly, like this is a very accessible sample.
00:09:46.559 --> 00:09:50.720
You don't have to draw your blood, you don't have to like prick, prot, you don't do anything.
00:09:50.799 --> 00:09:52.240
I mean, it's a swab of your vagina.
00:09:52.320 --> 00:09:54.399
I joke that it's easier than putting in a tampon.
00:09:54.639 --> 00:10:01.840
And there's so much valuable information right there of just like, what does your immune barrier for the reproductive tract look like?
00:10:02.000 --> 00:10:02.720
Is it intact?
00:10:02.879 --> 00:10:03.519
Is it not?
00:10:03.679 --> 00:10:10.000
And what's amazing about the vaginal microbiome to me, especially in the case of fertility, is that it's modifiable, right?
00:10:10.159 --> 00:10:14.480
Unlike so many things you can be told in the fertility journey that you can't change.
00:10:14.639 --> 00:10:16.000
Like, I can't change how old I am.
00:10:16.159 --> 00:10:19.200
I can't change, you know, a lot of the parts of the journey.
00:10:19.360 --> 00:10:21.039
I can change my vaginal microbiome, right?
00:10:21.120 --> 00:10:24.080
And Evi's actually really good at improving the vaginal microbiome.
00:10:24.240 --> 00:10:25.759
We published a lot of studies on that.
00:10:26.000 --> 00:10:33.759
So I think it's really exciting to be an accessible biomarker that patients can manage at home, that's affordable, and that also you can improve.
00:10:33.840 --> 00:10:37.039
And that that improvement is then associated with improved outcomes.
00:10:37.360 --> 00:10:41.200
So, yeah, let's talk about exactly this at home kit, how it works.
00:10:41.279 --> 00:10:42.879
It kind of sounds so it sounds easy.
00:10:42.960 --> 00:10:44.559
It's just a you said a swab.
00:10:44.879 --> 00:10:46.720
Yeah, it's incredibly easy.
00:10:46.879 --> 00:10:51.840
Patients can order it themselves at ev and it comes to your house.
00:10:51.919 --> 00:10:53.200
It's literally what it sounds like.
00:10:53.279 --> 00:10:55.360
It's like a little Q-tip swab of the vagina.
00:10:55.519 --> 00:10:58.480
You put it back in the tube, you mail it back to the lab.
00:10:58.639 --> 00:11:02.159
We do what's called shotgun metagenomic sequencing on the sample.
00:11:02.240 --> 00:11:08.000
It's a fancy way of saying that we sequence all the bacteria and fungi, the whole genome of everything in the sample.
00:11:08.240 --> 00:11:12.480
And it's the first time that you can actually get a comprehensive picture of everything going on.
00:11:12.639 --> 00:11:21.600
What's good, what's bad, how much of everything, what type of bad, what specific genes are present, how are those associated with different types of inflammation.
00:11:21.759 --> 00:11:27.200
And then we take all of that comprehensive molecular data and we put it in the context of you, right?
00:11:27.279 --> 00:11:35.919
So we'll say, okay, you have no symptoms, or you do have symptoms, or you're trying to conceive, or you're in perimenopause, or you're on this specific birth control.
00:11:36.159 --> 00:11:48.080
We'll combine all of that personalized data and we'll predict the specific treatments and ingredients that are most likely to help your vaginal microbiome get back to a state of health, dominated by that good bacteria.
00:11:48.240 --> 00:11:49.120
What do we need to treat?
00:11:49.200 --> 00:11:50.799
What biofilms do we need to break?
00:11:50.960 --> 00:11:53.039
How do we get the good lactobacilli in there?
00:11:53.120 --> 00:11:54.080
How do we feed them?
00:11:54.320 --> 00:12:03.919
We'll actually prescribe, we have the clinicians on our platform to prescribe custom compounded vaginal suppositories with exactly what the patient needs and send it to their journey.
00:12:04.559 --> 00:12:08.879
So we're able to enable patients to kind of manage the entire process at home.
00:12:09.039 --> 00:12:19.679
And for a lot of the patients who are on some version of a fertility journey, whether they're before getting to an IVF clinic or they're working with a fertility doctor, it's something that they don't have to go into the clinic for.
00:12:19.759 --> 00:12:25.120
It's something that doesn't require any more tricks and trotting and shots, but it's actually quite easy to manage.
00:12:25.200 --> 00:12:30.879
And again, it's a modifiable factor that we think is a really exciting opportunity to improve outcomes.
00:12:31.200 --> 00:12:33.360
So the kit comes, I'm assuming.
00:12:33.440 --> 00:12:40.399
So you said the kit with a combined with like a questionnaire and in-depth of how old you are, do you have any symptoms?
00:12:40.720 --> 00:12:55.120
Are you seeking fertility support and all of that combined with the results from that swab can kind of give you a better picture of where you are and how you, if need be, can improve your vaginal microbiome.
00:12:55.679 --> 00:12:56.159
Exactly.
00:12:56.399 --> 00:12:56.879
Exactly.
00:12:57.039 --> 00:13:18.960
And the the research in fertility is just so robust and it's so interesting, where there's study after study after study that has shown that being in that state of dominance by this healthy bacteria, low levels of the pathogenic bacteria, low levels of inflammation, all of that being highly associated with positive outcomes in, again, natural fertility as well as IVF.
00:13:19.120 --> 00:13:24.960
And so I think it's one of those things where if you're not there, it's totally fine because we know how to get you there, right?
00:13:25.120 --> 00:13:26.639
And if you are there, amazing.
00:13:26.720 --> 00:13:30.320
Now you know that this is actually really supporting you in your fertility journey.
00:13:30.480 --> 00:13:36.960
And so we're really excited to be able to bring that research and make it kind of clinically accessible to patients.
00:13:37.120 --> 00:13:41.759
And then we're also building on the research with a lot of our partners at RMA and otherwise.
00:13:41.840 --> 00:13:45.360
And we're really excited to kind of bring some of this novelty to patients.
00:13:45.679 --> 00:13:55.759
Yeah, I would love to hear if you're able to share with us the research that you have been doing and perhaps the research that you are going to be ongoing with RMA.
00:13:55.919 --> 00:13:56.000
Yeah.
00:13:57.759 --> 00:14:01.200
We're so excited to have such a great partnership with the team.
00:14:01.279 --> 00:14:05.200
And I mean, just to give everyone a little bit of a sense of the company.
00:14:05.440 --> 00:14:08.320
So we have the test product, we have the care offering.
00:14:08.480 --> 00:14:17.519
And today we work with over 100,000 patients across the country, and we work with over 2,000 doctors who use us for vaginal health as well as fertility.
00:14:17.759 --> 00:14:24.480
And we've been looking, so we've now built by miles the world's largest data set that's ever existed on the vaginal microbiome.
00:14:24.720 --> 00:14:42.879
96% of our patients have consented to research, which means that we can finally actually use that data to find these patterns and understand what's related to infertility and are there specific genes and enzymes and markers and really get to the answers that, frankly, we just haven't funded that research historically in this country.
00:14:42.960 --> 00:14:45.679
So we're very excited to kind of be pushing that forward.
00:14:45.840 --> 00:14:50.000
And in addition to the retrospective data, we are also running prospective studies.
00:14:50.159 --> 00:15:00.240
And so we, well, I'm trying to remember, we did an abstract with RMA last year at ASRM, which is the big American Society of Reproductive Medicine conference.
00:15:00.399 --> 00:15:17.039
And I think in that one, we were looking retrospectively at patients who reported infertility, and we found very specific signatures that were uniquely different in that cohort versus patients who didn't have infertility, which was very interesting and kind of builds on the existing published research in that space.
00:15:17.279 --> 00:15:41.200
And the prospective study that we've been so grateful to have such amazing guidance from the RMA team in the design and execution of the study, we're doing a study where we are taking EV tests very explicitly during IVF cycles to see if within the IBF journey, we can pinpoint specific markers in the vaginal microbiome that predict implantation success and failure in an IBF cycle.
00:15:41.360 --> 00:15:46.080
And so we actually now have the data from the first 170 patients in that study.
00:15:46.240 --> 00:15:55.600
And we're incredibly excited about what the data is showing us in terms of very clear signatures in the vaginal microbiome that are highly predictive of outcomes.
00:15:55.679 --> 00:16:01.679
And what's exciting is that those same markers are ones that we know how to modulate in our care programs already.
00:16:01.840 --> 00:16:04.320
And so we're really excited to put all of that together.
00:16:04.480 --> 00:16:14.960
We're finishing and rolling into that study now, and then we're hoping to publish it later this year so that we can actually get this new algorithm that we're training out to patients to help improve outcomes as fast as we can.
00:16:15.279 --> 00:16:16.000
That's wild.
00:16:16.080 --> 00:16:28.720
It's so interesting to see, you know, I've been in RV for 15 years, and we have is we've always been, I think, at the forefront of research, but to see just the evolution and, you know, even things, this was not even on my mind.
00:16:28.879 --> 00:16:30.080
The idea, it's interesting.
00:16:30.240 --> 00:16:37.759
I learned for many years about the gut microbiome and you know, the brain microbiome and the vaginal, but just and then also the interconnection.
00:16:37.840 --> 00:16:43.120
I think that's something that I'm curious to see vaginal health and mental health.
00:16:43.279 --> 00:16:43.519
Yeah.
00:16:43.679 --> 00:16:46.080
And the interplay between the two.
00:16:46.399 --> 00:16:46.879
Totally.
00:16:47.039 --> 00:16:50.799
I mean, we haven't done our own study on that, although we do collect some data.
00:16:51.039 --> 00:16:55.840
One of the things that I know is that the most commonly reported other diagnosis, right?
00:16:55.919 --> 00:17:02.559
So we ask about PCOS and endometriosis and autoimmune disease and cancer history and infertility and you name it.
00:17:02.799 --> 00:17:10.799
The most common answer, unfortunately, for our patients who have recurrent vaginal infections is anxiety and depression.
00:17:11.039 --> 00:17:21.359
And that matches, unfortunately, the published literature that shows that patients with recurrent yeast infections have like double the rate of mental health issues compared to people who don't.
00:17:21.519 --> 00:17:25.279
And so I think, as my co-founder always says, vaginal health is mental health.
00:17:25.359 --> 00:17:29.759
I think that it affects if you're, and I think very similar to fertility, right?
00:17:29.839 --> 00:17:33.119
If you're dealing with these challenges, it's not just physical, right?
00:17:33.200 --> 00:17:34.799
It's emotional, it's relational.
00:17:35.039 --> 00:17:43.920
And so I think what we have seen is that the importance of taking care of patients mentally is equally as important as actually changing their vaginal microbiome.
00:17:44.079 --> 00:17:45.759
Yeah, it goes hand in hand for sure.
00:17:46.079 --> 00:17:59.119
But it's great that you said because I think when I'm speaking with my patients, when they think of the microbiome and they think of all, you know, the organisms, the microbes in their body, they often think of like the yucky not good and not recognizing that we need.
00:17:59.279 --> 00:18:00.880
There's a lot of goodies out there.
00:18:01.119 --> 00:18:12.640
But it's fascinating because you know, when I was doing research myself, I did see certain microbes like the lactopacilli strains repeatedly coming up, and then maybe one or two other ones that were there.
00:18:12.880 --> 00:18:13.680
But it's interesting.
00:18:13.759 --> 00:18:17.440
Now it makes sense that now that you're saying we do not want the diversity.
00:18:17.519 --> 00:18:24.880
So when I speak about gut health and having a diverse amount of fruits and vegetables and grains and proteins, your gut likes that diversity.
00:18:25.039 --> 00:18:30.400
It's fascinating to hear that your vaginal microbiome actually does not want the diversity.
00:18:30.720 --> 00:18:31.200
100%.
00:18:31.519 --> 00:18:32.799
You want it to be dominated.
00:18:32.880 --> 00:18:36.079
You want those bacteria to be your protective shields.
00:18:36.240 --> 00:18:45.599
They can handle a little bit of, you know, here and there and whatever, but you do not want those guys taking over because that's when you start to have that infection, inflammation, symptoms, you need it.
00:18:46.079 --> 00:18:57.839
And one other thing I wanted to say on the mental health thing that I think is so important is I think that so much of where this all comes back to is also just the stigma and the taboos and the shame around these topics, right?
00:18:57.920 --> 00:19:07.839
And I think that's why I'm so glad you are doing these podcasts where you are talking about these things, you know, out in the world, because the reality is these are the leading reason women go to the doctor, right?
00:19:07.920 --> 00:19:12.799
These are incredibly, incredibly prevalent conditions, but people feel so alone in them.
00:19:12.960 --> 00:19:17.359
And unfortunately, like so many patients feel incredibly dismissed at the doctor's office, right?
00:19:17.519 --> 00:19:19.519
You're fine, your result is normal.
00:19:19.759 --> 00:19:20.400
We don't know.
00:19:20.559 --> 00:19:23.279
Oh, it's it doesn't really matter, just take this antibiotic.
00:19:23.440 --> 00:19:29.759
And I think that feeling of dismissal over and over again can be so harmful to your own mental health.
00:19:29.920 --> 00:19:38.160
And so I think the compounding nature of stigmatized and taboo topics that are often dismissed then lead to so many women struggling with these problems alone.
00:19:38.319 --> 00:19:44.319
And I hope that platforms like yours and platforms like ours really together are trying to break down both of those pieces.
00:19:44.880 --> 00:19:45.839
Amen to that.
00:19:46.000 --> 00:19:46.880
Yeah, it's interesting.
00:19:46.960 --> 00:19:52.720
I'm happy you mentioned PCOS because I was thinking that could be another, you know, I I work with a lot of PCOS patients.
00:19:52.799 --> 00:19:56.240
And I think testing for that population group, I think can be really great.
00:19:56.400 --> 00:20:00.160
I'm curious to see like when is the best time to test?
00:20:00.400 --> 00:20:03.440
Is it like when people are at first trying to conceive?
00:20:03.599 --> 00:20:05.200
Is it when they're struggling?
00:20:05.359 --> 00:20:10.799
Is it when they get that diagnosis of like unexplained infertility or or maybe all of the above?
00:20:11.119 --> 00:20:11.440
Yeah.
00:20:11.680 --> 00:20:18.240
I mean, what we see is that there's kind of four distinct patient profiles we see on the fertility side.
00:20:18.480 --> 00:20:22.000
The first is what I would say is like planning to conceive, right?
00:20:22.160 --> 00:20:27.599
My friends who are starting to take prenatal vitamins and are doing their blood work and making sure things are okay.
00:20:27.759 --> 00:20:32.960
I mean, it's such an easy thing to check to see like, oh, is this something I need to improve?
00:20:33.119 --> 00:20:35.039
Is this something that could stand in my way?
00:20:35.200 --> 00:20:40.400
And we definitely see a subset of our patients kind of in that early planning phase.
00:20:40.720 --> 00:20:43.359
Then we see patients who are struggling, right?
00:20:43.519 --> 00:20:45.200
Whether that's three months, six months.
00:20:45.440 --> 00:20:46.880
I mean, you know as well as I do.
00:20:47.119 --> 00:20:50.880
A lot of people just hate that feeling of being out of control, not knowing what's going on.
00:20:51.039 --> 00:20:52.480
It hasn't been 12 months yet.
00:20:52.640 --> 00:20:54.160
They don't know what doctor to go to.
00:20:54.319 --> 00:21:03.119
And we see a lot of patients coming to us then saying, you know, is there any testing that I didn't do that maybe actually could be pointing to why this feels harder than I thought it should be?
00:21:03.359 --> 00:21:14.160
And a lot of times we'll partner with amazing dietitians and acupuncturists and naturopaths, the places that those patients tend to end up to kind of make sure that we are a part of that overall journey.
00:21:14.400 --> 00:21:18.480
The third and fourth patients are often with the IVF clinics, right?
00:21:18.640 --> 00:21:24.240
So some patients, before they even do their first transfer, they want to make sure their highest likelihood of success.
00:21:24.400 --> 00:21:32.240
And we'll see them testing before they schedule the appointment or right after their egg retrieval to make sure that they're in an optimal condition before a transfer.
00:21:32.480 --> 00:21:39.119
And some patients will see after their first transfer fails and they're looking for what might be a reason for that, we'll see them coming back to us then.
00:21:39.279 --> 00:21:44.799
And so I would say those are kind of the four most common places in the journey that we see patients engage with EVI.
00:21:44.880 --> 00:21:52.000
But we're really excited that, you know, we often can support them before they have a doctor when they're at home and they're just thinking about it and we can educate them.
00:21:52.160 --> 00:21:58.160
We have amazing health coaches that can explain the vaginal microbiome, talk to them about its role in their health.
00:21:58.240 --> 00:22:05.039
But then we're also able to work with so Many amazing doctors and practitioners to be a part of kind of their broader care journey.
00:22:05.519 --> 00:22:06.160
I think that's great.
00:22:06.240 --> 00:22:12.480
Yeah, I for me the idea of being proactive, but of course it starts with people knowing that it's out there.
00:22:12.880 --> 00:22:20.720
Yeah, I think it should be, you know, you go to your OBGYN, you know, before you start trying to conceive, and that should be like a discussion.
00:22:20.799 --> 00:22:24.480
I think it it should be part of, you know, normal practice.
00:22:24.720 --> 00:22:34.559
But the fact that it can be helpful throughout is great for our audience to hear that there's not necessarily one specific time that is best, it can help throughout.
00:22:35.039 --> 00:22:35.519
Totally.
00:22:35.680 --> 00:22:36.720
I completely agree.
00:22:37.119 --> 00:22:47.359
And the fact that you could even, so you said you often uh Sonic will recommend a repeat to see if the changes that you recommended from your company after this changes to see if it's made a difference.
00:22:47.440 --> 00:22:47.680
Yeah.
00:22:47.839 --> 00:22:48.079
Yeah.
00:22:48.319 --> 00:22:50.400
Because look, some patients it takes longer.
00:22:50.559 --> 00:22:52.160
Some patients it happens really fast.
00:22:52.240 --> 00:22:54.480
And some, like, look, everyone's different.
00:22:54.559 --> 00:22:57.119
And I would never tell anyone how to do their journey.
00:22:57.359 --> 00:23:01.519
Some patients really want to know that they're in an optimal place before they do a transfer, right?
00:23:01.599 --> 00:23:06.400
Maybe you only have one embryo, or maybe, you know, you just don't want to spend the money to do it again.
00:23:06.559 --> 00:23:11.839
I think we often will see those patients doing a retest before they do a transfer.
00:23:12.000 --> 00:23:14.799
But other patients, you know, they just take the test, they don't even get the results.
00:23:14.880 --> 00:23:15.519
They do the transfer.
00:23:15.599 --> 00:23:19.839
And if it doesn't work, they're like, okay, now let me go back and look if that could have been a contributing factor.
00:23:20.000 --> 00:23:27.920
And so I think all of those decisions are always best made by the patient who's in that body and making those decisions and in partnership with their clinician.
00:23:28.000 --> 00:23:31.680
And we're just there to support and plug in in whatever way makes the most sense.
00:23:32.000 --> 00:23:34.640
I think you've created something phenomenal.
00:23:34.799 --> 00:23:36.160
Like I'm really impressed.
00:23:36.240 --> 00:23:41.279
I wish I knew about you when I was going through my fertility struggles, just to get some more insight.
00:23:41.359 --> 00:23:48.319
It's again amazing to see the evolution of things being created, of the research that's out there and the research that you're doing.
00:23:48.400 --> 00:23:55.039
It's I really can't wait to see where the company continues to go and how it evolves and changes over time.
00:23:55.200 --> 00:24:01.519
And I'm really like, I would love to have you back on to hear some of the research, like the future research that you conduct.
00:24:01.839 --> 00:24:08.640
Well, when we publish our study in a in a few short months here, I would love to come on and tell everyone about it because the results are incredibly exciting.
00:24:08.720 --> 00:24:11.279
And I think just a really amazing new tool for us to have.
00:24:11.359 --> 00:24:14.799
I think that like at the end of the day, I am two things.
00:24:14.960 --> 00:24:16.799
I am a data nerd and I'm a patient, right?
00:24:16.880 --> 00:24:21.279
And I believe that patients should have access to tools and best in class technology.
00:24:21.440 --> 00:24:28.400
I mean, nothing drives me more crazy than just the dearth of good technology and women's health and the dearth of good data and research, right?
00:24:28.480 --> 00:24:39.440
And so I really hope that by bringing better technology to this problem, we can finally gather the data that finally allows us to understand the female bodies so that we don't have to hear unexplained everywhere we go.
00:24:39.759 --> 00:24:42.319
Oh man, I think that's great.
00:24:42.799 --> 00:24:47.119
How do our listeners find you, your company?
00:24:47.279 --> 00:24:50.720
What's the best way for them to get to see your product?
00:24:50.960 --> 00:24:51.279
Yeah.
00:24:51.519 --> 00:24:55.440
So we're online at evie.com, it's just ebvy.com.
00:24:55.680 --> 00:24:59.519
We are on Instagram at Evi and we are on TikTok at EviBio.
00:24:59.759 --> 00:25:02.160
And I will shamelessly plug our TikTok.
00:25:02.240 --> 00:25:04.319
It is so amazing, so hilarious.
00:25:04.480 --> 00:25:08.160
I think we get 200 million views a year across all of our content.
00:25:08.319 --> 00:25:15.599
It's a phenomenal place to just be a woman and laugh about all the things that we should have learned, that we don't understand, that we want to understand.
00:25:15.759 --> 00:25:24.240
It's such a great community and so much amazing educational content, but also just humor about what it's like to have a female body in 2026.
00:25:24.640 --> 00:25:30.400
You made my day because I am newish to TikTok, but your Instagram account, I think, is phenomenal too.
00:25:30.480 --> 00:25:31.759
I see I love the research.
00:25:31.920 --> 00:25:36.079
There's humor, there's videos, but good to know TikTok's even more fun.
00:25:36.319 --> 00:25:37.200
That's amazing.
00:25:37.359 --> 00:25:43.839
Well, we're so happy to have you, Priyanka, on our podcast and to share with our listeners the great work that you're doing.
00:25:44.000 --> 00:25:48.160
And how we always end our podcast is with words of gratitude.
00:25:48.400 --> 00:25:51.279
So what are you grateful for today?
00:25:51.680 --> 00:25:52.079
Wow.
00:25:52.240 --> 00:26:03.839
Honestly, this conversation makes me so grateful for all of the incredible fertility doctors that sit with their patients through some of the hardest, most emotional times in our lives.
00:26:04.000 --> 00:26:06.160
I mean, we see those patients all day, every day.
00:26:06.240 --> 00:26:16.559
And I feel so grateful they're in the hands of these incredibly competent superhero providers who are doing their absolute best to make patients and families' dreams come true.
00:26:16.720 --> 00:26:24.480
And I've truly loved getting to know the fertility doctor community, how curious they are, how much they want to see the data, they want to innovate.
00:26:24.640 --> 00:26:27.039
And I think it's such a unique field of medicine, right?
00:26:27.119 --> 00:26:36.559
Where everyone is so aligned towards the goal of improving outcomes in a way that I don't think is, I think there's a lot of kind of run-of-the-mill status quo elsewhere in medicine.
00:26:36.640 --> 00:26:40.559
And I think in fertility medicine, you really see a push towards let's do better.
00:26:40.640 --> 00:26:43.440
And I think that's really driven by the amazing doctors.
00:26:43.759 --> 00:26:44.079
Yeah.
00:26:44.240 --> 00:26:46.480
Again, the evolution is pretty wild.
00:26:46.720 --> 00:26:48.240
I'm gonna piggyback on that.
00:26:48.480 --> 00:26:51.359
I'm grateful that we can normalize vaginal health.
00:26:51.519 --> 00:26:57.039
I think, you know, back in my mother's day, my grandmother's day, it was such a taboo topic.
00:26:57.440 --> 00:27:00.319
And A, now we're much more informed.
00:27:00.720 --> 00:27:03.279
And B, we can also have the humor with it too.
00:27:03.359 --> 00:27:06.079
Like it doesn't need to be something shameful.
00:27:06.240 --> 00:27:11.359
And it is part of our body, and it's something that we need to continue to learn about.
00:27:11.519 --> 00:27:13.599
And you guys are doing great work in this field.
00:27:13.680 --> 00:27:19.200
So I'm very happy that we had you on and can't wait to see what's to come.
00:27:19.519 --> 00:27:21.279
Yeah, no, I so appreciate you having me.
00:27:21.359 --> 00:27:25.119
Thank you so much again, and for the amazing work that you are doing with this platform.
00:27:25.440 --> 00:27:25.839
Thanks.
00:27:26.079 --> 00:27:27.119
Appreciate it.
00:27:27.440 --> 00:27:29.440
Thank you so much for listening today.
00:27:29.599 --> 00:27:38.240
And always remember, practice gratitude, give a little love to someone else and yourself, and remember, you are not alone.
00:27:38.480 --> 00:27:42.400
Find us on Instagram at fertility underscore forward.
00:27:42.559 --> 00:27:52.240
And if you're looking for more support, visit us at www.rmany.com and tune in next week for more fertility forward.
