S2 #Ep08 What We Actually Look At In Unexplained Infertility bölümünün tam dökümü

the puzzle. Yeah. That we can help an impact. That's why we're in that gap. Yes. You know, there's a ceiling to what medicine can do before RVF. Yeah. There's only so much. Yeah. You know, make sure everything's okay. You know, go back and listen to the pathology podcast if you haven't, but make sure everything's okay within their realm. And yeah, make sure you're not sick. Mm-hmm. And then you kind of go into medicated conceiving. I think as well, one more little caveat I'll put in there is. You want to make sure like physically there's all the capabilities are there. You don't have any block tubes, whether that's male or female, really. You want to make sure all the piping is fine, right? You want to make sure that there's like with your uterus that there isn't really big fibroids or really bad adenomiosis or something which could be like a physical limitation or polyps in the uterus. And I feel like medicine does that well for the most part. Yeah. But then there's this, yeah, this no man's land of How long do we keep trying without changing anything? We're eating really well. You know, we're exercising, like just say they're being good. Not that I don't think other people are good. but you know, we're not quite ready to go to that next level. That's where we come in. Yes. And like you said, two things. Let's check everything over. There could be things that we see differently, but let's also give you all the bits and pieces that we can to possibly try and improve all of that hard work you're doing. Because the other thing that has a ceiling is diet and lifestyle. But it's not medicine. It's not therapeutic. So that's what we can help with. Yeah, absolutely. Okay. So let's start with a few different sort of points that I think are really important when we talk to unexplained infertility that we want to dig into. So should we talk about implantation? Yeah. Or you want to start with something like more inflammation. No, no. When we do all of our content and all of our education right, we always have these buzzwords. Implantation, inflammation, immune system, thyroid function. And I think, yeah, what we need to do is take each one of those and really break it down for people because they're not in this world like us every day. And these are words that can sound really scary. and they don't really mean anything, you know, to the general public, like numbers. And my like my accountant, he speaks a different number language to me, but I speak fertility. So yes, let's start with implantation and let's start to break down some of these unexplained, you know, possibilities where these things might be kind of yeah, might help explain. Yeah. Really. So I think with implantation, I think the understanding that most people have is that the embryo, once it's been fertilized, that beautiful egg's been fertilized, it just nestles in the uterus and they call it a day. It makes us little home and that's it. But it's such a more complicated process. Do you want to explain a bit? We can kind of go into more detail. Yeah, yeah. So if we start from the start, we've got the sperm and we've got the egg. Just in case you haven't listened to me talk about this a million times. They find each other. You know, sperm swims up, egg is here. And this is very similar for IVF. You know, we try and maintain as much as we can of this. In some cases there's extra things we can do, but sperm swims, eggs there. She should be there. Getting released, you know, spermie should be there waiting. She's there, she gets released, she chooses the sperm that she determines to be the best, strongest, healthiest, amazing sperm. Again, in IVF, that can be done in a petri dish, which is so cool. Sometimes we will choose the sperm for the egg in IVF for for a random amount of reasons. But that's called Ixy, and sometimes that can help. But then if that all goes well, There's a million things that probably happen that we don't know about. What we think can happen is they could go for a coffee and not like each other. They don't go home together. They could, you know, go home together, really like each other and come together, hopefully. Find a comfy bed, you know, nice clean sheets. Have a good time. And that would make your embryo. You know, long story short. That embryo is then out on its own. You know, hopefully she's beautifully nice and strong. She has beautiful, you know, gooey, squishy, strong walls. She then needs to go and find a home for herself. You know, and that's really hard. Again, millions of processes probably going on here. So this would be your transfer back if we were talking IVF. This is something that is so complex physiologically. We have immune. you know, involvement. We have inflammation involvement. There we have hormonal involvement for sure. But she needs to go and find that beautiful home. For lots of reasons, that does not always happen. Lots of reasons. Yeah. So but that is implantation. This is aside from sperm quality, egg quality, swimming, releasing. You know, this is aside from all of that. We've got our embryo. You've got all your graded embryos on ice, you know? We still need to get it back. We still need to find a home. So this is what we mean by implantation. So what do you think are some of the things that impact someone's ability to be able to implant? I have endo, endometriosis. That is literally an inflammation of the environment that an embryo needs to implant in. It causes all kinds of immune malfunctioning. So, you know, sometimes the woman's body might see that embryo as an issue, like it was a bug that that it wants to attack, unfortunately. Sometimes E the, you know, instead of being all that beautiful gooey home, nice clean sheets there as well. I just always I'm gonna relate everything back to sex. It them they might be all crumpled. They might be all dirty, you know. You like go to the hotel and the sheets aren't clean. You're not gonna want to sleep in that bed. And that is how I

picture my uterus. You know, when I was trying to conceive. Sure. So I want to do everything I can to go in and like, you know, I want to wash the sheets, I'm gonna clean up the bedroom, you know, I'm gonna make it a nice place for her to have a home. so inflammation, immune activity, it could be it could be histamine stuff, which kind of comes back to the immune stuff. So all your allergy stuff as well. Yep. So your immune system's like hyper vigilant. So if you're someone that is like you feel like you're allergic to everything, you know, you're like, it's dust, it's the pollen, it's everything. I'm constantly like having an antihistamine every day. Yeah. These are the kind of people that we really want to try and calm down and support your immune system. For sure. Cause I always bring it back to the fact that with my clients, I'm like, if your body is sensing an attack. It's the same as when your body's in a stressful state and that final flight. When you're fighting the battles, it's not the time to conceive. Yeah. Same at same thing, right? If your body is fighting an immune battle, it's gonna be like, hang on, I can't do that right now. I am fighting a battle on multiple fronts right now. Yeah. That's my focus. Well, that's the case with any comorbidities, really. If you think about it as energy, yeah. I think about it as we each have this beautiful ball of energy that makes us. us and that energy needs to be shared and spread throughout the body. So if it's like all in your immune system because it's flipping out, then you know, there's not going to be a whole lot left for everything else. So I guess then the other things that could impact are hormonal imbalance, you know. Sometimes if we can get that egg transfer back right at the right time, I think that makes a big difference for women. If we just try and put an egg in any old time of the cycle. might not be as successful. So hormones, for sure. Yeah. And you want to make sure I do think that your hormones are operating as they should because it's so important. Yeah, yeah, yeah. Yeah. You're going through a whole different hormone phase as soon as you're pregnant. Right. And it's been implanted. Definitely. So if your body, especially if you're someone and this is where like I think I really want to support these women before we get to this point. If you're having one period every four or five months and your hormones are really low, I really I know you would be the same. We want to get in there and see if we can actually get all that beautiful roller coaster to really kind of get reved up in a beautiful, natural way before we get you pregnant, if we can. Definitely. Yeah. Cause this, you know, other comorbidities, or autoimmune disease is huge. We've got things like diabetes, we've got metabolic factors, so on and so forth. The list goes on. Obviously, the thing about working in fertility is you want people to be the most vital, the most healthiest, their best self, as much as we can.

So having a disease, unfortunately, and I, you know, speak from experience, does make it harder sometimes. But you know, the the other part of that is what were you saying just before? vitality. We're talking about fertility. I got it. The other part of it is. There's necessary things that like need to happen beyond implantation too. So you know, we've got these phases. We've got them coming together. We've got the making of the embryo. We've got the implantation, but then we need it to stay. So making that home as good as we can means that hopefully they're gonna stick around. You know, they're not gonna be short-term renters. We want the long-term meant. We wanna get to the mortgage, you know. Million dollar mortgage, we've got to stick around. Pay that interest down. Yeah, like you want you want it to stick. You want it to stay. And I think with that, this is a really big area where we can support women with as well. 100%. Yeah. You know, we have beautiful herbs that we use in our clinic that can really support implantation. And they have beautiful historical data around you know preventing miscarriages. Thousands of years. Yeah. Like that's not nothing. No. You and I are evidence-based. We always look for that clinical research and stuff. But how can you ignore thousands of years of use for the same thing? I just think this is how women have been supporting women for that long as well. And like I just think there is just something so cool about that, you know. And so we do work with IVF clinics. We do work with doctors and specialists and we do all of that, but Really think it's great when we work together. Definitely. That's I think there's just such a part in that. Okay. So if that our we're talking about implantation. So then do we need to talk about inflammation? Yeah, I think it's part of that story, but it can be beyond it as well. So inflammation can affect our ability to conceive. Mm-hmm. So if we bring it back, you know, yes, it can affect affect the inf implantation, like I just said, but It can affect our ability to to conceive and it can change the quality of our egg. Mm-hmm. It can change the quality of the sperm. Mm. Yeah. The biggest inflammatory kind of stuff I see in men is often metabolically related. So if they do have extra pressure on those organs, high blood pressure, high cholesterol, maybe there's a little bit extra weight, maybe there's sugar dysregulation, you know? High blood pressure. Yeah. Yeah. All of that plays into not a great environment for our spermies. Yeah. And it's the same for women. Hmm. Except we just have even more reasons to be inflamed. Yeah, totally. Yeah. Even with like inflammation, you know, one thing that we often look at on a blood test is what we call a CRP, which is a C reactive protein, which is a marker of inflammation. I can't tell you how many times I've seen it raised. Yeah. And with that marker, just on that, you want it to be zero. You want zero inflammation. That's That's the goal. Yeah. But I'll see two, five, ten, fifteen. yeah. And I'm like, whoa. So if it's showing on pathology, like if we're at that point that it's showing on pathology, that is your body waving a flag to say, we are fighting a battle here right now. And the result of that battle is as inflammation showing. And it there might be people listening who don't know what inflammation is, because it's a it is a buzzy word that we use a lot. I always think if you picture banging your knee on something like really hard and then it swells and it goes red and it gets sore. Yep. That's what we're kind of talking about. But inflammation can present in all different parts of the body. And you might not see the redness. You might not see the swelling, but it's all still kind of, you know, your immune system's gone there to try and help. Yeah. Your body's sending all that extra energy there. Things aren't going to be working as well. I've got a really good example I want to Yeah, yeah, yeah. So Unrelated but related, right? So this is a case that Jess had a couple of weeks ago and I just think this is brilliant. So she had a little girl who was three years old, right, who had juvenile arthritis. And so she was on pretty hardcore medication for it. She's seeing her hematologist and everything. The parents decided, I think they'd seen some of my TikToks, they decided to book in. so I put them in to see Jess. And when Jess went and kind of went through the girl's little symptoms, she also had a really funny tummy. Yeah. Right. So Jess is like, this is weird. so she went to do a stool test. Now we can do them on little kids now. It's amazing, right? So this is where we they do a sample of their poo, they send it off and it gets tested, and we see everything that's in it. Now, when the parents had told the doctor that they were the specialist that they were going to see you know, naturopath, the doctor was like, You're wasting your money, you know, blah, blah, blah. Which and sadly we do hear a lot. Anyway, Jess got the results back. And said to the parents, here's your waste of money. Your daughter has two different parasites in crazy high levels. Now, because of those parasites, her little body was throwing off inflammation everywhere, and that's what was hurting your joints. It wasn't arthritis, it was the parasite. Now Jess was able to get rid of that parasite and all the pain went away. And the little girl's fine. So cool. And it started to happen really quickly because kids respond really well to that stuff and fast. Yeah. So what they thought was something really serious going on with the joint pain, we were able to look deeper and go, that's not as you think it is. Yeah. It's a result of inflammation. Because the thing about inflammation is it doesn't always present where the thing is going on as well. And we see that with our endo girls. Yeah. You know? Pain is not always pelvic. It's not always uterine. No. It can be anywhere, really. But that's so cool. I know.

She was able to do that. You know, if that little girl would have continued on with her doctors, she would have been specialist rest of her life. Medicated for life. Medicated for life. Horrible things for someone that's three years old. But now she's gonna be great. The poor parent, they were so happy. They were like, I'm gonna take Jess's cards and give them to everybody. That's so cute. Yeah, that's beautiful. I think it's worth noting too that our still test is not like a doctor's still test. It's completely different. Yeah. Yeah. Yeah. It tests everything. Yep. Everything is in there. Yeah. Basically. Yeah. Which is fabulous and really, really helpful information. So yeah, I just want to kind of demonstrate that that's a really good example of like absolutely where you could have inflammation in the body, but it's not what because there was a problem there. Yeah. It's where your body was throwing it. Right. So it's really interesting to sort of talk about that. I think it's really important. Actually, no, we've talked about endo. Let's talk about endo. Because we've briefly sort of touched on it. Yeah. Right. And I think it's really important to talk about endo and the impact on fertility. Yeah. We will also do a pretty decent episode on endo, so look for that. Yeah. But in context in the context of today, we, you know, we know that endo that inflammation can go anywhere, present anyway. I I think that even though we're talking about it so much, it still is just not understood. Like it's yeah, chronic migraines, chronic joint pain, fatigue through the roof, random six month pregnant bloating episodes. I've had endo girls who have, you know, th like feel like they've got broken toes. Like, you know, pain can be anywhere. Yeah. And also, like we said, not just pain. Not just pain. Yeah, so like you mentioned about migraines, you know, my own story before I was an atropath is one of my episodes of endo coming back, I bled for like 18 months. Yeah. You know, like you can have weird stuff going on. And if your body is doing that, there's a good chance there's going to be a whole bunch of inflammation driving. Yeah, that's behind the scenes. So the how that it kind of affects fertility, I think, you know, if we join the dots to what we spoke about before with implantation, there's that. There is the possibility that having all that inflammation may affect your egg quality as well. If we talk about AMH just as a slide briefly, we are looking at AMH anti-malarial hormone, not egg count. It's a hormone dynamic can change beautifully. it's you know it's not an indicator even of quality. We look at other factors in combination with that now. But sometimes You know, as an as an endo woman, our AMH may be lower. Yeah. It may not. endocan affect fertility, it can not. Like so there's, you know, cases that I've seen for women with endometriosis with no pain who just couldn't conceive. And so they started down the road of investigation. Huge amount of endometriosis, no pain. Yeah, well, that's the thing with endo, right? Is they have shown that you can have someone with any tremendous pain and heavy bleeding, tiny little spots of endo. Or you can have someone like Mel said with no symptoms whatsoever, and they just happen to have, yeah, gone down that path or happen to do some other random test or scan and then gone, my God, there's endo everywhere. Yeah. And they had no idea. So it's really, it can be like a real like silent disease when it comes to its impact on fertility. Definitely. And then, you know, I think it's worth talking about the endopregnancy as well. Because it can be really different for women. Yeah. I find for myself, for my family, for my a lot of my patients, there's not a lot of joy in an endopregnancy. You get pregnant, amazing. You're stoked. Then you have nine months of hell. Not for everyone. Don't wish it on anyone. But you you by having any kind of chronic disease, if you go into a pregnancy with diabetes, it's gonna be harder, you know? If there's the physicality of it, like the stretching of your adhesions, it it hurts to grow a baby. a lot of women with endo also are hyper hypermobile, hyperflexible. a lot of us have EDS, uhless Dallas syndrome. So sometimes that can be really painful and we can stretch too much, we can stretch in the wrong places, our hips can pop out of place, you know, the back goes really easily. It's really difficult for a stretchy body to carry something heavy. Like picture a watermelon in a stretchy bag. Yeah. It's like you know there's not a lot of structural integrity when you have endometriosis. And you know, there there could be other complications along the way that hopefully We'll be fine, but we are prone to more. yeah. So I think that's worth mentioning as well. In terms of fertility, it doesn't always affect it. What can we do? If it is, we reduce inflammation mostly. Yeah. Like for the most part, improve egg quality where we can reduce inflammation, modulate the immune system, settle the immune system down. Yes. To help. Yeah, definitely. And also sometimes the hormones are doing their own little field day. That's behind the scenes. Yeah, we look if we can balance out those hormones as best we can. This is not a case of low progesterone, high estrogen, anything like that. It is just a orchestra with no man to do this. And it's so like the trombones like and then the drums are like bang, bang, bang, bang. It's just everywhere. That's how I pitch for my hormones. Yeah. I mean, I think an orchestra is a pretty valid explanation. Yes. So we need to b rebalance all of all of that. Like j just those few things, but all of that. Did you get all that? Yes, I did. Thank you. let's talk about men. Yes. Right. Fertility. Yeah, in terms of fertility and the unexplained fertility component to do with men. So my guess is about eighty percent of women come to us and they have had quite a bit of testing. Yeah. Quite a few investigations. They've

been poked and prodded. It can be pretty invasive. And the man, this is best case scenario, has had one semen analysis and they said, Yeah, they're they're okay. Super sperm. You and I hate that term. Yeah. So there's lots of stuff here. And things that we may have already spoken about in season one. It's worth going back and listening to our fertility episode. One semen analysis is kind of like the testing of a woman's hormones randomly in her cycle. I really like three. But also, I hate when the one that I'm looking at was like three years ago. yes, yes, yes, yes. All the time. Yeah. I'm like, buddy, like you're a different human than you were three years ago. Yep. It's a big factor to take into consideration. And always, and we've mentioned this before, but mention it again, we don't have DNA fragmentation on Pretty much every test we're seeing. Yeah. there's so much there. So if your sperm turns over seventy-two days, every seventy-two days, imagine how many turnovers it's had since that semen analysis three years ago. I don't know maths. I told you. Not good with numbers, but someone with a calculator listening, you know, could probably write below the episode how many different. sperm turnovers are there. There's that. Like that's insane. We can't use a three-year-old semen analysis. No. Interesting that you said it was three years old because I really do like to have three. But I like to have them close together. Yes. And really I'm only gonna go down that route if we're having trouble conceiving. Yeah. But saying that there's unexplained infertility when you've done one semen analysis maybe three years ago is probably a huge gap. Absolutely. Yeah. Absolutely. And I want to know more. I think it's really important. Definitely. But then I think the male stuff with male infertility, well, couple infertility looking at men, I love to look and think about toxin exposure with men. Mm-hmm. And I don't think we talked on much on that in the season one, in that episode we spoke about. Because there's often I see men in trades. Men in doing all sorts of like you know, exposed to toxins and stuff that could be having an impact on that as well. Yeah. Again, whole episode coming on that. Yeah. Because it's big. Yeah. And if that woman is doing 80% of the lifting in a 50-50 job, you know, that needs to be reassessed. Like you've got to talk to HR. get that sorted. Absolutely unfair omband ombudsman. Yeah. Fair orchestra. Yeah. yes. So beyond the semen analysis, I want some blood tests. Yeah. You know? And also just from the beginning, I want to talk to them. Mm. I really want to meet that man and talk to him. Yes. I find it very frustrating when I'm going through the woman about the man's health. Yeah. I want to know. Because often like they'll start to reveal stuff to us that maybe the partner doesn't know. I think that's really important to go through. It's also just like patient care. It's like 101, you know, like I need to see that person. I need to talk to them. I really would like to, you know, have a conversation with this person who I've You know, I know all their results and stuff like that, maybe, but I haven't even met them. So yeah, please guys, book your appointments. But Yeah. And then I think if we're thinking about the missing conversations when it comes to unexplained infertility, I think a lot of that is the stuff that we do really routinely where we're checking in with, like we said, metabolic health, but it's their sleep, it's their stress, it's the lifestyle stuff that we said. Yeah. You know, because sometimes there'll be these little gaps. You know, I had a woman, actually, yes, this is I had a woman who came and saw me. She was 41, 42. She had done 10 rounds of IVF, right? And she'd done nothing had happened with all of that 10 rounds of IVF. She'd spent $200,000 on IVF and fertility treatments, right? Which is just crazy. And then I we were having a conversation, and I was asking her different questions and we I was talking about what she eating, you know, blah, blah, blah. And the topic of caffeine came up. And she was like, well, I love my coffee. And I said, well, I love my coffee too. But like, how many a day are you having? And she said, probably twelve. I was like, twelve. Twelve, you say. Every day? Yeah, every day. Wow. I'm like, did anyone ever tell you maybe that's a little bit too much? She was like, No, never. I was like, okay, really important. Right? Especially when she's done 10 rounds of IVF. Definitely. The next thing that was also really big red flag that jumped out at me is this woman works like seven days a week. So she works nine to five. She also does tutoring. She also works on the weekend, helps her husband's books. She is always working. And again, when you're going through all that IVF stuff, it is not the time to be hustling. You know, you've got to give your body a break. So if she's pounding like 12 coffees a day. And she's working seven days a week. These are big things where I would kind of go, Well, that's not unexplained. That's potentially There's some stuff there. That's there's some stuff to sort. There's some things we've got to work on. Yeah. I had a twenty-seven year old seven rounds in. Wow. No testing for general pathology. Lots of hormones, lots of STEM cycles, lots of all no vitamin D, no iron. I said, So it's like Are you sure? Can you just check that They hadn't done it? Do you think you can just no, no, I've checked. She liked what watched one of our TikToks or saw something and then was like, Well, I'd never seen my vitamin D get tested. And, you know, had asked them and then came to see me and nothing. Nothing had been tested. And this is a really young girl. No other reason why they weren't conceiving. Her AMH was fine, you know. really beautifully regular periods, like no endo. They've done all the hycoses, all of the, you know, scans, no PCOS, like really young, healthy, fit. That, you know, that seems unexplained.

But then when you go, well, there's this whole gap in basic testing. Just basic, you know, because we do get to the point where there can be quite extensive testing that They may not be ready for, or you know, it's not our call, or you know, all of those things. but yeah. It's just crazy. one thing I think is also really interesting, and I often like to, I always ask my clients this, especially, you know, when they're coming and talking about unexplained infertility. Well, ask everybody, generally. I say to them, you know, do you ever get UTIs? And do you ever get Candida or Thrush? Right? Now, there's two big There's big reasons why I ask this in terms of fertility. If you're someone that gets reoccurring candida, the presence of candida in your vaginal canal will make it acidic and sperm won't survive. So if you've been trying to conceive and it hasn't happened and you've had low-grade candida lurking in the background, you potentially are creating an environment, your body is where it's this it's killing the sperm. Yeah. The vaginal microbiome is so important for fertility. Yes. And we can now test that. Yeah, absolutely. Rarely, like obviously I'm only testing the people who I'm concerned about, but rarely would that pH come back within the range that we would see to be optimal for sperm to survive. So your vagina's literally killing the sperm. Yeah. Like that's, you know, it's like anaconda style. It's wild. And you know, and then talking about UTIs, I know was that? Two or three years ago. That's all a bit of a blur. they started recently doing some testing in early miscarriages, trying to figure out what was going on. And one thing they found is one of the things that did increase early miscarriages was UTIs. So, like if I ever get a woman in front of me that has been trying to conceive and she does have a history of UTIs, because there's a lot of UTI girlies out there, firstly, we can help. But if you are a UTI girly, right, what I say to everybody is the second you get a positive pregnancy test, shut up, shop. No more sexual intercourse. Nope. Nope. I don't want any sexual intercourse for the first six weeks. And really from six to twelve, I'd rather he wrap it up. Use protection. Yeah. You don't want to have any risk of anything entering that pathogenic that could be upsetting that really delicate environment because it's all still still so new. Yeah. You don't want to have anything risking upsetting it. You know, and it's so interesting because I remember I did it was a few years ago now, I did a discovery call with a girl and then she couldn't see me for a while. But I happened we we had the UTI conversation came up. So I was like, hey, heads up, this is what my advice I give everybody. When I finally saw her, I think she'd then gotten pregnant, but she remembered what I said. And she was like, my God, the second I got a positive pregnancy test, I just stopped. I was like, get away from me. And those women, it's so funny. I don't have

to tell them twice. They are like, it is, don't even worry about it. There's no way he'll go anywhere near me. Yeah. And which is, you know, fine and and great. But it was so interesting. Right. So this is where again we're looking at stuff. Yeah. That, you know, potentially these are reasons. And with with that, often the the guy will have it as well. And he will be asymptomatic. Yes. And so the passing back and forth, you know, can be really common. Yeah. And then the you know, she goes, antibiotics or beautiful herbal medicine, which works really well, and then cleans herself up, that vaginal microbiome's trying to repair. And then we go back in, you know, for the hanky panky and unfortunately, you know, we get it back. So I will often treat both of them. Yes. If she's getting recurrent UTIs, I just You know what? If you have to take this, yeah. If you have to take this, you're gonna take it too, because it tastes really bad. But it works really well. And I'll put them on a couple of courses of herbal medicine for it. And then that's gonna help out with both of their genital urinary kind of health and conceiving. And you know, these bugs can come up later. I think that's the other thing. You can get through that initial phase. Yeah. And we see, unfortunately, like later loss. with things like E. coli coming up. Yeah. sadly. Which is devastating. Yeah. So again, this is where like it's not unexplained. You know, I just honestly think it just means that there's just more of that story still for us to uncover. Yeah. is there any more clinical gems that you've seen recently that you think would be good to mention? What are you seeing? Well I I did have that loss unfortunately. Yeah. Yeah, twenty two weeks. Yeah. So what happens is the infection causes the cervix to start shortening because the the the body kind of panics. Yeah. And it almost, you know, will essentially put it into labor. So we do unfortunately God, it was awful see that happen. Yeah. so clearing it up, you know, beforehand, if we know, if we can, throughout this beautiful woman was completely asymptomatic. So it's not one symptom at any point that there was an issue. but obviously, you know, we'll get that very special and unique care moving forward. we do see I think we haven't mentioned I do see secondary unexplained infertility of being in clinic. Yeah. So this I don't know if I find it even more frustrating. But so conceived fine the first time, had baby, you know, doing their thing, want to go for a second and just nothing. I think there's lots in that. But for the most part, completely not unexplained. Just because you've had one pregnancy doesn't mean that you will have another. Do you think with that though, that there's an element where now the woman is a mother? Hundred percent and she's That's why it's not unexplained. Sleep depri deprivation, you know, mineral and nutrient depletion. Big time. Not feeding yourself. Cause you don't. Breastfeeding. The caloric amount of like, you know, food that we need to make breast milk is insane. Not only are we not eating that much, we're not really eating. Like you've got this human, this your very first little human to try and keep alive. That's huge. Yeah, and then, you know, often there's the pressures of going back to work for us now, for both, you know, my husband d he would have loved more time off with our kids. all of those things for sure impact. But I also I reckon every pregnancy is I just basically treat that couple as different people, like that woman as a different person. I think that there's there's differences in egg, sperm, metabolic. inflammation, you've literally like pushed out a human or got a human cut out of you or however you want to do it. You're a different you've got a different body. Like you can physically feel and see that. So some things might have changed. Yeah. So maybe not unexplained. It's not nothing. It's definitely not nothing. not to mention the possibility that you're breastfeeding, you've got a little baby, your periods come back, you're trying to go back to work. That baby doesn't love to sleep. Yeah, all of that. Yeah. So any more takeaways, last takeaways for today? I think that what we do every day is try and explain it. Yeah. You and I are both naturally curious. I was gonna say pains in the arse, but yeah, sure. Yeah. We wanna fix it. We wanna get to the bottom of it. It bugs us with you know, I'm often like thinking about it after work. I know. What what what is missing there? Like what didn't they do? Or what could we do more or better? Or yeah. We're actually invested. Like truly invested. We're on your team. Yeah. Yeah. Yeah. Yeah. So if you've been told unexplained infertility, then maybe it just means you we just need to look a bit deeper. Or differently. Yeah. And maybe you need someone like us on your team who's going to be like batting for you. Yeah. To really kind of Put all the pieces of the puzzle together. Because advo advocacy can be a really big part of it as well. You know, it's hard to do that when you don't know what you're trying to advocate for. Yeah. Yeah. Yeah. So there's so much more to be able to unpack and then things that can be done to improve your fertility. So please don't just accept that and go, well, I've got unexplained infertility. No. Just means we need to learn a bit more. Definitely. So thank you, Mel and thanks everyone for joining us today. Thanks, guys. See you next time. See you then.