EP 326 How Stress Impacts Fertility and What You Can Do About It
On today’s episode of The Wholesome Fertility Podcast, I am joined by the incredible Dr. Alice Domar, a pioneer in the field of mind-body medicine and a leader in reproductive health psychology. Dr. Domar shares insights from her decades of research and work with patients experiencing infertility, diving deep into the emotional and physical toll of fertility challenges and how stress can impact reproductive outcomes.
We discuss the groundbreaking research that links stress reduction to increased fertility success rates, the importance of patient-centered care, and how mind-body practices can transform the fertility journey. Dr. Domar also shares her thoughts on spirituality, the power of connection, and how fostering a sense of belonging can help patients navigate the emotional rollercoaster of infertility. This episode is packed with valuable insights and hope for anyone on the fertility journey.
Be sure to tune in as you won’t want to miss this eye-opening and inspiring conversation!
Guest Bio:
Alice “Ali” Domar, Ph.D. is a pioneer in mind-body medicine, focusing on the relationship between stress, medical conditions, and lifestyle habits. She is Chief Compassion Officer at Inception Fertility, part-time associate professor at Harvard Medical School, and senior staff psychologist at Beth Israel Deaconess Medical Center. Dr. Domar is the author of Conquering Infertility and Finding Calm for the Expectant Mom and serves on advisory boards for Parents Magazine, Resolve, and Easy Eats. Her work has been featured in Redbook, Health, and BeWell.com.
Websites/Social Media Links:
Instagram: https://www.instagram.com/inceptionfertility/
Website: https://inceptionfertility.com/about-us/our-team/
Website: https://www.preludefertility.com/
For more information about Michelle, visit: www.michelleoravitz.com
Check out Michelle’s Latest Book: The Way of Fertility!
https://www.michelleoravitz.com/thewayoffertility
The Wholesome FertilityFacebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/
Instagram: @thewholesomelotusfertility
Facebook: https://www.facebook.com/thewholesomelotus/
-
[00:00:00] Michelle: Episode number 326 of the Wholesome Fertility Podcast. My guest today is Dr. Alice Domar. Dr. Domar is a pioneer in the field of mind body medicine. She conducts ongoing groundbreaking research, which focuses on the relationship between stress and various medical conditions, as well as the impact of lifestyle habits on mental and physical health.
[00:00:26] She 2022 as chief compassion officer. She is also an associate professor in obstetrics, gynecology, and reproductive biology part time at Harvard Medical School and a senior staff psychologist at Beth Israel Deaconess Medical Center. Dr. Domar is the author of numerous books including Conquering Infertility and her latest book, Finding Calm for the Expectant Mom.
[00:00:54] She's on the advisory board for Parents Magazine, Resolve, and Easy Eats. [00:01:00] She has been on the board of experts for Luminary and a columnist for Redbook and Health Magazines. She was also a featured expert on the online social network, BeWell. com.
[00:01:11]
[00:01:32] Michelle: /Welcome back to the podcast, Dr. Domar. I am so excited to have you back.
[00:01:38] Alice: I hear That just made my day, thank you.
[00:01:42] Michelle: Well, I really enjoyed our first talk and it was a while ago, but for people listening and haven't heard of you, which I think is actually very few, because I think a lot of people, most people that I talk to know who you are. but I would love for you to share your background and how you got into such [00:02:00] an important aspect of the work of the fertility journey.
[00:02:04] Alice: So it started with my parents, actually. So it took my parents, I think, seven years to get pregnant with my older sister and another five years to get pregnant with me. And there was almost nothing available in those days. I mean, literally my mom said that she had to go once a month to have air blown up her tubes, which just sounds disgusting.
[00:02:23] Anyway. So while I was growing up, she talked about it. How lonely she was. I mean, this was, you know, in the fifties and sixties when everybody was having five or six kids and how awful a period of her life it was. And so that just sort of permeated into my soul. And when I got a PhD in health psychology and I, I sort of, my focus was OBGYN and it just felt very natural.
[00:02:48] to go into the infertility field. And, you know, I have done a lot of research and it was funny because I just saw an interview was just published in Slate a couple of days ago, talking about one of the [00:03:00] first studies I did that showed that women with infertility had the same levels of anxiety and depression as women with cancer, AIDS, or heart disease.
[00:03:08] And people are still talking about that study and it was published in the New York Times. easily 25 years ago. And we, you know, and there's since been other research, which backs that up. Like, in fact, you know, you and I were just chatting about the pandemic. I was part of a study that, you know, Boston got hit really hard because there was a Biogen conference, must have been in early March, of international Employees and one of the employees was from China and infected all 70 people who was at that conference and it turned out that 300, 000 people ended up getting COVID from that one person.
[00:03:44] So Boston was hit very hard. Yeah, it was terrible. And the board of health shut down all the IVF programs. And so our patients were frantic. And so we thought, you know. Let's find out what's worse for our patients, infertility or the pandemic. And it was [00:04:00] infertility, which didn't surprise me at all because I've been working with infertility patients for almost 40 years, you know, it started out that I wanted to document how stressed our patients are, were, because. No one out there seems to get it, still, after 40 years. But I've also been trying my whole career, not only to figure out how stressed patients are, but also what are the best ways to relieve that stress.
[00:04:29] And if you relieve that stress, the pregnancy rates go up.
[00:04:32] So that's the whole bandwidth. And, you know, I took this new job two and a half years ago, which gives me the, Access and power to actually do the research and, change patient care the way I've always wanted to
[00:04:46] Michelle: mean, I just love that so much because I think that a lot of us do, I think people in general or society and also the systems, like they don't really take things seriously until you present them with proof. [00:05:00] Facts and research. and the thing is, you obviously had a feeling or hunch that it was so before you did the research, which is what caused you to do research, which I personally think is also an important aspect of all of this.
[00:05:13] But unfortunately we need the research. not unfortunate, fortunately, really to kind of make it more real
[00:05:19] in
[00:05:20] Alice: make, to make, doctors and patients believe in the mind body connection, you know, because, you know, I spent 17 years working with her Benson and all his research was trying to prove a mind body connection.
[00:05:33] And I want to,
[00:05:33] Michelle: the mindfulness based, uh, stress reduction.
[00:05:37] Alice: no, that was Jon Kabat Zinn.
[00:05:39] Her, her Benson was, he was, he died a couple of years ago. He was famous for the relaxation response. And I think he's kind of, he and Joan Borisenko sort of started the field of behavioral medicine. and anyway, I, I worked with them for 17 years and got fully entrenched in the whole mind body connection, not just in women's health, but in heart disease and cancer [00:06:00] and AIDS and pretty much everything, Any disease that's made worse by stress can be made better by different mind body strategies. So I just happen to want to focus on women's health, and again, when I think back, my mom said that when she was trying to get pregnant for the first time, they put her on the equivalent of Valium, and she got pregnant. So, clearly, I've had a bias, you know, my entire life that stress impacts fertility.
[00:06:28] Michelle: That's incredible. You know, it's interesting. My mom also, suffered with secondary infertility with me. So I always say I'm kind of like the proof that a woman knew in her heart that she was supposed to conceive. And she told me she, every time I ask her, she goes. Every single time I got my period, I cried, she would just tell me these stories.
[00:06:46] And it's like, as soon as I ask her, she's right back there, you know, remembering those moments just how fearful she was also throughout the pregnancy. And that's another thing. I know you wrote a book about that. And I think that that's kind of like a whole other chapter, which we'll [00:07:00] get to, you know, people's journeys really is that it doesn't necessarily end at the positive pregnancy stick.
[00:07:06] So
[00:07:07] Alice: it starts, it
[00:07:09] Michelle: yes, yes,
[00:07:10] Alice: You know, that's the surprise for my patients. I mean, I still have a small private practice, but, you know, for most infertility patients, they think all I need is a positive pregnancy test. But that's actually when the anxiety starts to really skyrocket.
[00:07:25] Michelle: Yeah, I see that a lot with my patients. I do acupuncture, it's very similar. And of course, just going through everything with them and every single, I mean, I have not yet met anybody who doesn't feel stressed or anxious during the pregnancy. And that's why I always reiterate it to them. Like, you are not alone.
[00:07:47] Like, I don't think I've met anybody that wasn't going through this. This is completely normal. And I, you know, it's just part of the process, but it's all about strategy. And I know you talked about just like tools and different things that you can do, but [00:08:00] before we even get to that, I would love for people to know, like, what is mind body, like, if you can really break it down, what are the components of mind body and like, what does it entail?
[00:08:09] Alice: So basically there's no division between our brain and our body. And so our thoughts affect our body and our body affects our thoughts or emotions. And, you know, they're researchers and, every system of the body, I just happened to have focused on women's health. And so, for example, we know that stress makes PMS worse.
[00:08:29] We know that stress makes menopause symptoms worse. We know I. believe that stress contributes to fertility issues. And so there's no division. I mean, there's, there's a constant communication between the brain and the body. And so to think that your thoughts and emotions and experiences and activities don't have an impact on your body is really naive.
[00:08:54] And, you know, I have spent my whole career trying to prove that stress [00:09:00] decreases fertility and that stress reduction increases fertility. And there are a lot of people who think I'm nuts and make fun of me and criticize me. And, you know, when I used to go to the fertility meetings, People would shun me, but I can tell you lately, since I've now been doing research that's showing, yeah, actually there is a connection.
[00:09:21] Now I get treated better.
[00:09:23] Michelle: Well, it's crazy because you can actually explain it. I mean, like, the more I dug into it, the more you can explain it. I mean, Your nervous system, it really, a lot of it comes down to the nervous system. And the nervous system doesn't feel safe. It gets into fight or flight. It takes away the blood from the organs to the limbs.
[00:09:40] And, and what does that do? It impacts also the blood that flows through the uterus and the ovaries. And so that's just one aspect of it. Then another thing is cortisol. Like when that increases, actually. It competes with progesterone, a very important hormone for pregnancy, for implantation, for uterine lining.
[00:09:58] So there's so many [00:10:00] actually explanations and then it can impact sleep, which also impacts hormones. So it's just like one after the next, it was like, you can really break it down.
[00:10:09] Alice: It's just, it's very hard to convince people because I think maybe not so much now, but 20 years ago, most physicians believed that the medication and the surgery and everything else they did could control all aspects of reproduction. And I remember. easily 25 years ago, a colleague and I were giving a talk to a group of infertility doctors about all the research, even then showing the impact of stress on the reproductive system and the impact of stress reduction on fertility rates.
[00:10:42] And one of the physicians actually said, I don't care how many studies you show me. I do not believe That the brain is more powerful than what we do with medications and surgery.
[00:10:52] Michelle: Hmm.
[00:10:52] it's interesting how people take a stance.
[00:10:55] Alice: and again, I think younger physicians, I mean, you know, I was a boss in IVF for 20 years and they had a [00:11:00] fellowship program and it was awesome for me because I got to have input on how they were trained and how they thought. And one of the fellows who's now a practicing infertility doctor actually did his big research study on the impact of.
[00:11:18] empathy on how patients felt. So, you know, the more impact or input one can have on young physicians or physicians in training, the better it's going to be for patients. Because I presented a study in October at ASRM showing that what patients want, In terms of patient centered care is really quite different from what physicians want.
[00:11:44] I mean, sorry, what different from a physician's think patients want.
[00:11:49] Michelle: Right. sometimes they think that just cause here's the thing, there's this argument and I hear this a lot, like, well, I don't really need necessarily need a doctor that has bedside [00:12:00] manners. I just want someone who knows what they're doing and I don't care how they're treating me or talking or whatever.
[00:12:05] And I'm not so much with fertility. I'm not, I'm saying this like a conversation with my cousin about like, you know, a gastroenterologist,
[00:12:13] things like that. Right.
[00:12:14] Yeah. But, talk to us about the research, first of all, like, cause I feel like it does make an impact actually, how they're treated.
[00:12:23] Alice: So it's, it was a study funded by MD Serrano on patient centered care because all of the research out there was done in Europe and all over the world and had not a single study had ever been done in the U S. And. The study that I pay the most attention to, or had paid the most attention to, on patient centered care, where they compared patients and physicians, and this is, I think it was out of France, that it showed that patients prioritized patient centered care over pregnancy rates.
[00:12:54] And they were willing to sacrifice a 10 percent drop in pregnancy rate for more patient centered [00:13:00] care. While physicians said, oh God, no. All patients care about is getting pregnant. And so I've literally bopped around the world for the last 10 years saying to physicians and practice managers and nurses, patients really want patient centered care.
[00:13:15] Like this is really important that you care for patients. And yet our study of over a thousand patients. And I think we had 39 of our physicians, showed that patients want to get pregnant and physicians think. They want this compassionate care with nice environment, blah, blah. Now, apparently in the, in the US, at least, you know, amongst inception prelude clinics, which are all over the country, highest priority for our patients is, is pregnancy. So that's very different from Europe.
[00:13:44] Michelle: yeah, here's my question though. I have heard, correct me if I'm wrong, or let me know if you've heard of this study. There was something that I heard about, but I haven't actually seen myself. It's kind of one of those hearsay, about [00:14:00] how people who have doctors who believe in their journey or have like a little bit more, you know, belief in them doing well, that can impact how they actually do.
[00:14:10] So there's like kind of this positive or sort of belief in a person's ability to do well. Mm
[00:14:16] Alice: Well, that would add to me, I haven't heard of that study, but it would add to my hypothesis that stress Decreases treatment outcomes and having a physician who believes in you and is encouraging and, and positive is going to make the patient less stressed and they're probably more optimistic as they go through a treatment cycle.
[00:14:35] And I think that will help them get pregnant.
[00:14:39] Michelle: No doubt. And I know that, there's also a study that was done on laughter and after transfers.
[00:14:46] Alice: Oh, it was done out of Israel. It was a great study. It was,
[00:14:50] I think It was,
[00:14:51] it was, it was, they had, I think it was actually a randomized controlled trial and I thought it was awesome. But on alternate days, they had a clown in the recovery [00:15:00] room. So for women after transfer, you know, while they're waking up and recovering, they got to see a clown and their pregnancy rates were higher, significantly higher.
[00:15:09] So
[00:15:09] Michelle: Wow. That's incredible. It's just amazing.
[00:15:12] Alice: so many studies now. I mean, it's very difficult to do research to prove that stress impacts, for example, IVF outcome, because up until the study that I'm doing that we just finished, we're handing patients like paper and pencil questionnaires. Like how anxious are you? How depressed are you?
[00:15:30] And there are a lot of factors that, that are going to influence that. You know, one is, you know, at what point did you measure their stress or anxiety? Was it three months before their cycle? Was it the day before egg retrieval? And that makes a difference. Also, patients tend to be very optimistic right before they start an IVF cycle because you have to be optimistic to put yourself through it.
[00:15:52] In addition, Most patients, at least in the U. S., they know their prognosis. They know how old they are. Right now, they know what their [00:16:00] AMH level. Their physician has probably shown them on a computer what their chances are. And so, if you've got a 25 year old with blocked tubes, her physician's going to say, Wow, you are so likely to get pregnant.
[00:16:12] And so she's going to start her cycle being Very optimistic, probably not depressed, not anxious. And if she gets pregnant, is it because she's 25 or because she wasn't anxious compared to a 44 year old whose AMH is barely detectable, whose physician is like, yeah, your chances are almost null. She's going to be very anxious and depressed.
[00:16:31] So you, you can't use paper and pencil questionnaires because they're just too subjective. And patients also fake good because they want their physician to think they can cope with a cycle. And are they really going to report how incredibly depressed and anxious they are? So we're working with this company in Canada called Otto that makes this little device that for the study, actually, it was like a little circle thing.
[00:16:56] They were on a, on a band around their waist for about three minutes every [00:17:00] morning. I think now they're converting it. I think it to a bracelet or a ring. So it'd be much easier for us to do research, but anyway, so we recruited 240 women who are about to start their first IBS cycle. And this device.
[00:17:13] actually measures central nervous system and cardiovascular parameters. So for the first time, we're really getting true physiological feedback on patients stress levels. And we had them wear the band for a week before the first IVF cycle, for the two weeks of STEM, and for the four weeks of their frozen embryo transfer cycle.
[00:17:35] So we have, and the, the, the device actually collects, I think, 54. different physiological measures of, of stress. And so we presented at, ASRM in October, just the first amount of results we had, which simply compared how the patients were at baseline. So the seven days before their IVF cycle compared to how [00:18:00] they were during the stimulation phase of the cycle.
[00:18:02] And The results, I, I've been doing research for almost 40 years. I have never seen statistically significant levels like that. Like to be statistically significant, it has to be less than 0. 05 and our levels were like 0. 00001. So what that showed was going through the STEM phase. Like when patients are self injecting with gadadotropins is insanely stressful on the body.
[00:18:30] And in fact, we had a number, we just act, we actually just had to notify a number of patients who developed cardiac arrhythmias during the STEM phase. Because they were so stressed. Yeah, that's how stressful and no one has really paid attention to how hard it is You know the physical and psychological burden of doing an IVF cycle.
[00:18:52] So now we actually have Physiological proof. I
[00:18:56] Michelle: That's incredible. You know, I've said this before. I've said this to my [00:19:00] patients. Cause like your body, you know, when you hear like really loud noises. Okay. Your mind knows, Oh, that's just the truck that's moving, you know, like the fire truck, but your body could still respond completely different, almost like a animalistic.
[00:19:16] So if your body's constantly getting prodded and poked and, you know, Your body's gonna go under stress. It's gonna feel like what's going on. I don't feel safe. Something's off Yeah
[00:19:28] Alice: it means total stimulation of the sympathetic nervous system
[00:19:32] And so now we have all this data. We're actually we have a meeting tomorrow, to look at because there are 3 sets of data. 1 is the difference between baseline and stem. The 2nd, 1, the difference between. Baseline and STEM and IVF success rates.
[00:19:50] And the third is, can their stress level at baseline predict outcome as well as things like age and [00:20:00] AMH and BMI? So we, we're going to, I have to write all these manuscripts in the next few months and I can't talk about the results yet, but it's going to be incredibly valuable data. And then we're starting our second study where we're going to do a randomized controlled trial where patients.
[00:20:15] All the patients, sorry, half the patients get the device and the device, we can turn it in such a way that they get feedback as to how physiologically stressed they are. And it literally is like, you know, red, light, yellow, green. And then it gives them, if they're in the red or yellow zone, here are things you can do.
[00:20:35] And it's like biofeedback. And so we'll see if we can reduce a patient's stress during her IVF cycle to pregnancy rates go up. And I'm guessing. The answer is yes, because all the psychological, I can't say all, the most recent meta analyses where you just sort of take data from a bunch of studies have consistently shown that [00:21:00] women who are randomized to some kind of psychological intervention have higher pregnancy rates. So how can you say stress doesn't play a role?
[00:21:11] Michelle: no, it absolutely does have you heard of heart math
[00:21:14] Alice: No.
[00:21:16] Michelle: Oh, you would love this.
[00:21:19] Oh my gosh, you would really, really love it. Okay. So HeartMath Institute is basically it's a, they, it's an organization that does research on the role and the relationship of the heart and the brain. And the heart actually has a much larger electromagnet.
[00:21:38] Uh, frequency than the brain does.
[00:21:40] And there is such a thing as heart brain coherence and also the heart rate variability shows, I'm sure you've heard of that. It like shows just the heart health. Chinese medicine has been saying this for thousands of years that the heart houses the mind. And so, But you never really understood what that meant until now.
[00:21:58] And they actually [00:22:00] have data and they have a biofeedback devices, which I highly recommend. I think that you would really, uh, find good use for this because what happens is that basically they put it on their ear and they connect it to an app and it will, record and measure their heart rate variability, and it will also record and measure their heart brain coherence.
[00:22:23] So what they found was that the more coherent the heart and brain are, the more we feel like levels of peace, safety, calm, ease, we can think more clearly, and the more erratic and incoherent our the relationship between the heart and the brain, the more, almost like disconnected, we feel, I guess that that's the best way to say it.
[00:22:43] It's almost like they're, they're disconnected when we're disconnected from the heart. You know, all these things that we've been hearing for like years and years and years, but it's actually shown now is showing to be true. It's being revealed almost to be able to measure it. And so there are certain things that people can do [00:23:00] and one of them being breathing really deep and slow and connecting with that heart space so that you're breathing really deep into the heart and and then thinking about things that you love.
[00:23:10] So similar to like the meta meditation, the loving kindness meditation, really having that connection, that oxytocin that provides a sense of feeling safe and so having that. has been shown, and that's one of the exercises that they have on the program, has been shown to help increase the coherence between the heart and the brain.
[00:23:32] So I find that really fascinating. And, Chinese medicine, the heart actually has a very important role on the uterus. So, and oxytocin increases around labor time, so it's, it's considered to be something that opens the uterus. This is something that I would love to talk to you about one day because I love this kind of stuff.
[00:23:52] And so I'm wondering, it hasn't really been studied a lot for conception, but it increases around ovulation. A woman's, [00:24:00] oxytocin increases and it increases after orgasm. Why? If it didn't have any role in conception. So that's kind of like my hypothesis.
[00:24:09] Alice: I a thousand percent agree with you, and it's ironic that this research we're doing is reassessing the heart and the brain.
[00:24:16] Michelle: Interesting. Oh, wow. Incredible. Oh, I love this stuff. So when the research comes out, is it on your website? Is that the best place to find it?
[00:24:25] Alice: I suspect when it's published, our PR team is going to go crazy and
[00:24:29] Michelle: Good. Well, let me know because if, if it is, I'll have you back. Like I love this stuff. This stuff is really so important. I think for people to hear, I think people need to hear this because I think it empowers them.
[00:24:42] Alice: Well, I think, you know, for people, for any woman, man, anybody going through infertility or infertility treatment, and I know we talk about women all the time, but you know, stress affects sperm production. Acupuncture helps sperm production.
[00:24:55] Michelle: Yep.
[00:24:55] Alice: the naysayers who are saying to me, Oh, there's no relationship between [00:25:00] stress and reproductive outcome.
[00:25:01] I'll say to them, okay, but you can believe that if you want, but what's the downside of offering our patients ways to relieve their stress? Because going through an IVF cycle is really hard. Going through infertility is really hard. Trying on your own is really hard. I mean, as I said, it's equivalent. To cancer patients.
[00:25:20] It was equivalent to the beginning of the pandemic or is worse than the pandemic. So our patients women and men who are going through infertility are suffering and there was a study at a UCSF by Laurie
[00:25:33] Pash,
[00:25:34] who's,
[00:25:34] Michelle: They're suffering.
[00:25:35] Alice: and you know, the majority of men and women in, in their, who came to their clinic, the majority of men and women had psychiatric levels of anxiety, The majority of women had psychiatric levels of depression and about a third of the men had depression.
[00:25:51] So, we're talking about the majority of the people who are going for treatment are miserable. And why, I mean, you know, got [00:26:00] to Inception Prelude two and a half years ago. I'm the Chief Compassion Officer. And so I've been spending the last two and a half years trying to implement ways to improve the patient experience?
[00:26:14] I mean, how can we relieve stress? In our patients in a much better way than it's been going on for the last 50 years.
[00:26:22] Michelle: I love that. I think it's so important. I mean, it's, I feel like you're answering a huge call. Like really, really, really, you know, it's interesting. I really think that you would love Dr. Lisa Miller's work. slightly different. I don't know if you've heard of her. She's written, she actually went through her own fertility journey and she has a TEDx talk, fascinating story.
[00:26:41] She talks about like just her own journey and. How she, she ended up adopting and she felt like this calling to adopt. And, uh, the moment she adopted, she conceived, but she knew that she had to adopt in order to conceive because she was meant to be with her adoptive child. It was, it's a really fascinating story, her, her [00:27:00] own personal story, but she wrote a book called the awakened brain.
[00:27:03] And so she studies, in, in, uh, Columbia University, she actually does research on the brain on spirituality and how spirituality impacts the brain and believing in something that's higher than ourselves, how that actually protects the brain from depression.
[00:27:19] Alice: Well, let me tell you about a study I participated in many years ago. So, you know, I used to run these, my body groups like for 25 years and, you know, 10 week programs for women going through infertility. And because I was at a teaching hospital at Harvard Medical School, you know, we had interns and residents.
[00:27:39] So for two years we had a psych intern who was getting her PhD. And she happened to be a woman, I think at that point, probably in her 70s, who in her 40s became an ordained Episcopalian minister. And then I think in her late 60s decided to get a PhD in psychology. And so she was my intern for two years and she sat through my body groups [00:28:00] and the issue of God and God punishing and you know, what have I done comes up a lot in infertility and because I'm not.
[00:28:08] trained in pastoral counseling, there wasn't a whole lot I could do, but having her in my groups, the patients love talking to her about that. Anyway, so for her dissertation, her dissertation was really to solve an argument that the two of us were having, in that I felt that deeply religious women suffered more with their infertility because they believed God was punishing them. And she believed that deeply religious women suffered less because they believed in a higher power. So her dissertation, you know, we were, I don't remember how many patients she recruited and she assessed their religiosity, their spirituality, and their distress. And I was wrong.
[00:28:54] Michelle: That's interesting.
[00:28:55] Alice: Yeah. So the more religious and spiritual the [00:29:00] woman was, the less distressed she was by her infertility.
[00:29:04] So, So, and, and again, very statistically significant when you published it. and so I, I, I encourage my patients who may have left. The religion of their childhood to say, you know what? Maybe explore other options. Explore your spirituality. You know, if you grew up Catholic and you just don't want to be part of the Catholic church, you know, go to an Episcopalian church or Unitarian church or, you know, because having faith, having spirituality, believing in a higher power.
[00:29:33] may provide some comfort to you.
[00:29:36] Michelle: Right. And actually, Dr. Lisa Miller says it's not necessarily religion,
[00:29:40] Alice: Right.
[00:29:41] Michelle: it's spirituality. It's really just connecting and it's, it really comes down to this. It's connecting to something that, you know, you can lean on almost like a, there's something higher that's able to, Protect you in some way or like give you guidance.
[00:29:55] But it's one of, it's become like one of the top questions I ask [00:30:00] when I first start working with people, I ask, do you have some kind of practice where you're able to connect or some it's you do too, yeah.
[00:30:09] Alice: And I, you know, and again, you know, I'm in Boston where we have a huge Catholic population and a lot of young women. don't practice Catholicism anymore. And so I encourage them to pursue other ways to encourage spirit and not necessarily religiosity, but, you know, I've had a lot of patients, you know, go to, for example, Unitarian Church and feel a deep sense of belonging and comfort and inclusion.
[00:30:36] And, you know, I was watching the today show this morning and they had a psychiatrist on who was talking about how hard it is these days to make friends because of social media and how the older you are, the harder it is to make friends. And we all need connections and infertility patients tend to really isolate themselves from family and friends who are pregnant or have kids.
[00:30:57] And so it worries me how [00:31:00] isolated our patients become. And so if they can get some kind of connection from some form of spirituality, think that's great.
[00:31:09] Michelle: Yeah. And actually, as a matter of fact, I've been, um, inspired lately to form more, groups. like a zoom calls for free for my patients just to, so they can connect with each other because I'm like, I'm thinking like, there's so many times I'm like, you should talk to this one. This one should talk to this one because I feel like they really, and they thirst for it.
[00:31:29] As soon as I want to connect them. Oh my God. Yes, please give them my number. You know, they're really excited about that. So I think that community is so healing and really that connection. I think that was one of the biggest, Issues during the pandemic. I think that that was the biggest, you know, impact.
[00:31:45] Obviously it was you know, people getting sick, but it was also that social isolation, how much we need each other. We just need people.
[00:31:53] Alice: Remember people made little bubbles? it was, it was so great was there had already been research showing that [00:32:00] Like zoom therapy was just as effective as one on one. And so we had to switch our mind body groups to being online and they were just as effective. And, Inception dash prelude is doing a new program for our patients in conjunction with pulling down the moon, which is a yoga, based company in Chicago.
[00:32:21] And. they, not we, they have created this online program for our patients that's like half yoga and half support group. And I think we hit almost 500 patients in a row in the first couple of weeks.
[00:32:32] Michelle: Wow.
[00:32:33] Alice: I have not seen a single negative comment at the patients. I mean, they love the yoga because it's, it gives them, you know, relaxation.
[00:32:41] It keeps them fit and toned, et cetera, but they really love the support group.
[00:32:46] Michelle: That's amazing.
[00:32:47] Alice: they love connecting with other people. So,
[00:32:51] Michelle: I love that. So for people listening, I mean, I can pick your brain for like literally hours. And I want to talk to you actually after, because it's just, [00:33:00] I, I find what you're doing so exciting and we're also at a time where things are really exciting. I think we're really discovering a lot about ourselves and the power that we hold as humans, like kind of, we're wired.
[00:33:12] Really amazingly. And I think that we just don't even know how to tap into it. So for people listening to this and saying, okay, I really do want to connect with like some kind of practice that will help me get through this really difficult journey, what are some tips on how people can get started? Mm
[00:33:31] Alice: well, you know, ASRM, which is the American Society of Reproductive Medicine has about 700 mental health professionals who are basically reproductive mental health professionals. So if you want one, one on one or couples counseling, Those are the people you should go to because they actually know what infertility is about.
[00:33:49] And so if you go in and say something like IUI or PGT or AMH, they're going to know what that means, which is really important for patients. I mean, I happen to think that this new [00:34:00] half yoga, half support group is just a really great thing because it tackles the mind and the body. And I think most people going through infertility are feeling incredibly isolated.
[00:34:11] Resolve, which is the National Infertility Organization, has support groups, I think, in just about every state, because I think tackling loneliness and isolation is really important because, you know, infertility impacts every aspect of their lives and if they're in a relationship, it's going to impact their relationship, their sex life, their family, their friends, their job, their financial security, their self esteem, their body image.
[00:34:35] And No one should be going through that alone.
[00:34:40] Michelle: Absolutely. No one should be going through that alone. And I think that also feeling like you're the only person going through that. I think when you have other people that can share or understand you on a level that like, maybe you won't see in your normal, like day to day is incredible. It's an incredible [00:35:00] gift.
[00:35:00] To have that relatability. So, I think that just what you bring up is so important. I am a huge fan of you and your work and what you do. I think, honestly, I there are certain people that I have on the podcast that I just feel like . I feel like you're God sent, like I really do. I I do. I I feel like that some people are just kind of, they're, they're answering a greater call that's gonna impact so many people.
[00:35:25] Alice: Okay.
[00:35:25] Michelle: Yeah,
[00:35:26] Alice: so, you know, I'm going to get off this podcast and go tell my husband that I'm a godsend and
[00:35:30] Michelle: yes, you do that and tell them I said, I said, so, so, so for people listening to this, and I'm sure people are going to be really like, just amazed at a lot of the things that you shared and intrigued to learn more. How can they find out more about you? How can they find out more about the studies when they do come and kind of like, where should they go to look out for those?
[00:35:56] Alice: I'd say everything, everything is on the Prelude website. So P R [00:36:00] E L U D, I think it's prelude. com.
[00:36:02] Um,
[00:36:03] okay. Yeah, so everything we offer our patients, and actually one thing that I'm hoping will be offered to, well I know is going to be offered to our patients and I'm hoping more is, I wrote a book about 25 years ago called Conquering Infertility.
[00:36:17] And so our chief marketing officer said, you know what, I really want to, you know, offer this book to all of our patients, but it was 25 years old. And so it was definitively medically outdated as well as the names of the patients that we quoted, like popular names 25 years ago are now popular names now anyway.
[00:36:37] So I actually spent the summer revising the book
[00:36:40] Michelle: Oh, awesome.
[00:36:41] Alice: and So hopefully in the next month or two, all of Prelude patients will get a copy of the book. And I'm hoping the publisher is also going to make it available to anybody who wants one because it's literally the mind body program in a book. And it's got a [00:37:00] zillion patient stories.
[00:37:01] We interviewed a lot of my patients just talking about how they felt, how they coped, what worked for them, what didn't work for them. Because I can either see one patient at a time, or you can offer programs that can offer or books or whatever to help a lot of other people.
[00:37:18] Michelle: Yeah, for sure. And that's such a gift. Honestly, it's such a gift. And I think the stories, hold so much power too. So I, I love that you have stories in there. For people to hear, because I think when people see examples and say, okay, like I'm not the only one going through this and it can actually shift and change.
[00:37:35] And I do have power. And, and then also, you know, sometimes stories that are not always like exactly how we want them to come out, but we can share in that. So I think that that is really powerful and I appreciate you coming on today. I really enjoyed our conversation.
[00:37:51] Alice: Thanks for inviting me.
[00:37:52] [00:38:00] [00:39:00] Description text goes here