IVF Isn’t Working: Now What?

IVF Isn’t Working: Now What?

When IVF hasn't worked — and especially when it "should have" by now — it can feel like the ground is shifting beneath you. Dr. Erica breaks down exactly how she thinks through unsuccessful IVF, what questions haven't been asked yet, and why the answer is almost never "just keep doing more of the same." This episode is for anyone who has had high-quality embryos not take, who has been told everything looks fine on paper, or who is wondering if there's something being missed. In this episode: * Why "unsuccessful IVF" means something different depending on how many transfers, what embryo quality, and what protocol — and why context is everything * The question Dr. Erica always asks first: what were the odds IVF should have worked by now? * Chronic endometritis: how common it actually is in this population, why so many people haven't been screened, and what happens to outcomes when it's treated * Occult endometriosis and adenomyosis as drivers of implantation failure — even without classic symptoms * Hydrosalpinx: the diagnosis that cuts success rates in half and is frequently missed on standard imaging * Inflammation, PMOS, and why GLP-1 medications are showing up in the fertility conversation * Uterine factor: IUD history, hypothalamic amenorrhea, Asherman's syndrome, and the compounding effect of multiple insults over time * When stepping back from IVF — and trying Letrozole, Clomiphere or gonadotropin IUI cycles — is actually the smarter clinical move * Two powerful client stories: one who conceived spontaneously after surrendering the outcome; one who got pregnant on her first letrozole cycle after multiple failed IVF retrievals * Third-party reproduction and gestational carriers: how Dr. Erica helps people move toward those decisions thoughtfully, not reactively * Why "just keep trying" is not a strategy — and what thoughtful, empowered decision-making actually looks like Support the show [https://www.buzzsprout.com/2285234/support] As always, please keep in mind that this is my perspective and nothing in this podcast is medical advice. If you found this conversation valuable, book a consult call with me using this link: https://www.loveandsciencefertility.com/private-fertility-consult [https://www.loveandsciencefertility.com/private-fertility-consult] Follow us on social media: IG: www.instagram.com/loveandsciencefertility [https://www.instagram.com/loveandsciencefertility/] FB: www.facebook.com/profile.php?id=61553692167183 [https://www.facebook.com/profile.php?id=61553692167183] Please don’t let infertility have the final word. We are here to take the burden from you so that you can achieve your goal of building your family with confidence and compassion. I’m rooting for you always. In Gratitude, Dr. Erica Bove

From Vice Chair to Whole Human Health: Identity, Burnout, and Lifestyle Medicine with Dr. Annahieta "AK" Kalantari

This week Dr. Erica is joined by Dr. Annahieta Kalantari ("Dr. AK"), a double board-certified emergency medicine and lifestyle medicine physician and founder of Whole Human Health and Well-Being. After years of climbing the academic ladder — vice chair of education, a near-offer as DIO — Dr. AK had a wake-up call that led her to walk away from the path she'd spent her career building and reinvent her practice entirely. This conversation is about identity beyond the white coat, the courage it takes to let go of a role you've outgrown, and why small, sustainable changes (not overhauls) move the needle on health and fertility alike. In this episode: * Dr. AK's path from ER residency to vice chair of education to founding her own practice * The family Google Calendar moment that became her wake-up call * Mourning the loss of a professional identity you spent years building * Finding the common thread (educator) that carried her from academic medicine to lifestyle medicine * Why "I am resourceful" is a mindset that applies far beyond career pivots — including the fertility journey * The six pillars of lifestyle medicine and how they intersect with fertility and stress * The Kaizen effect: why small, cumulative tweaks beat all-or-nothing overhauls * Reframing infertility as a question of aligning many small vectors, not one giant fix * Why physicians especially struggle to prioritize themselves — and what it takes to change that Where to find Dr. AK: * Website: thewholehumanhealthandwellbeing.com [http://thewholehumanhealthandwellbeing.com] * Blog: From Dr. AK's Desk [https://thewholehumanhealthandwellbeing.com/blog/] * Podcast: No Filter Doctor [https://nofilterdoctor.podbean.com/] (available on Apple, Spotify, Amazon) Support the show [https://www.buzzsprout.com/2285234/support] As always, please keep in mind that this is my perspective and nothing in this podcast is medical advice. If you found this conversation valuable, book a consult call with me using this link: https://www.loveandsciencefertility.com/private-fertility-consult [https://www.loveandsciencefertility.com/private-fertility-consult] Follow us on social media: IG: www.instagram.com/loveandsciencefertility [https://www.instagram.com/loveandsciencefertility/] FB: www.facebook.com/profile.php?id=61553692167183 [https://www.facebook.com/profile.php?id=61553692167183] Please don’t let infertility have the final word. We are here to take the burden from you so that you can achieve your goal of building your family with confidence and compassion. I’m rooting for you always. In Gratitude, Dr. Erica Bove

Making Fertility Treatment Decisions: A Framework for Choosing Your Next Step

Choosing the next step in your fertility journey can feel overwhelming — IUI or IVF? Wait or escalate? Dr. Erica breaks down the exact framework she uses with her patients and clients to cut through analysis paralysis and make evidence-based, values-aligned decisions about treatment. In this episode: * Why every treatment plan has to start with your desired family size — and why this question gets skipped so often * The history that actually matters: how long you've truly had sperm-and-egg exposure (not just "trying") * Red flags that move IVF up the timeline: tubal disease risk factors, genetic conditions, and more * Why the difference in success rates between trying 6 months vs. 12 months under 35 is smaller than you'd think * The “two to three follicles” rule for IUI cycles for unexplained infertility or endometriosis — and why hitting that goal can take you from under 5% to 10–15% success per month * Letrozole vs. Clomid: side effects, success rates, and why letrozole is often the better first choice * "Hybrid therapy": using a baby dose of FSH with letrozole in women in their late 30s — the physiology behind why it works * When IVF makes sense from the start: large desired family size, genetic risk, tubal factor, or PGT-M/PGT-SR indications * Why "less is more" isn't always wrong, even when IVF feels like the safer bet * Reframing scarcity mindset around embryo numbers and aneuploidy risk Support the show [https://www.buzzsprout.com/2285234/support] As always, please keep in mind that this is my perspective and nothing in this podcast is medical advice. If you found this conversation valuable, book a consult call with me using this link: https://www.loveandsciencefertility.com/private-fertility-consult [https://www.loveandsciencefertility.com/private-fertility-consult] Follow us on social media: IG: www.instagram.com/loveandsciencefertility [https://www.instagram.com/loveandsciencefertility/] FB: www.facebook.com/profile.php?id=61553692167183 [https://www.facebook.com/profile.php?id=61553692167183] Please don’t let infertility have the final word. We are here to take the burden from you so that you can achieve your goal of building your family with confidence and compassion. I’m rooting for you always. In Gratitude, Dr. Erica Bove

Father's Day on the Fertility Journey: Tools for Getting Through the Weekend

Father's Day can hit differently when you're in the middle of a fertility journey. Whether you're navigating it as a couple, as a male partner who is secretly dreading the weekend, or as someone supporting a loved one through it — this episode is for you. Dr. Erica covers why these "softer holidays" can feel like salt in the wound, why men in particular are often left without language or permission to process grief on the fertility journey, and how couples can use this moment as an unexpected doorway back to each other. In this episode: * Why Father's Day (and Mother's Day) hit so hard on the fertility journey — and why that makes complete sense * The emotional burden men carry as "protectors" and why giving them permission to feel is good for everyone * The serenity prayer reframe: what you can control, what you can't, and why knowing the difference matters * A communication framework for sharing feelings and needs — especially when you and your partner are on different pages * How to use curiosity ("what is it like to be you right now?") to reconnect with your partner * Tips for supporting a loved one through this weekend — including one thing to absolutely not do * Five tools (plus a bonus) for getting through Father's Day with more grace and agency:  * Trigger prevention and real-time management * Honoring all of your feelings — including the ones that coexist * Knowing your village before you need them * Boundaries and permission to leave situations which are causing pain * Intention setting before you walk in the door * Trusting the process and finding your reasons for authentic hope Support the show [https://www.buzzsprout.com/2285234/support] As always, please keep in mind that this is my perspective and nothing in this podcast is medical advice. If you found this conversation valuable, book a consult call with me using this link: https://www.loveandsciencefertility.com/private-fertility-consult [https://www.loveandsciencefertility.com/private-fertility-consult] Follow us on social media: IG: www.instagram.com/loveandsciencefertility [https://www.instagram.com/loveandsciencefertility/] FB: www.facebook.com/profile.php?id=61553692167183 [https://www.facebook.com/profile.php?id=61553692167183] Please don’t let infertility have the final word. We are here to take the burden from you so that you can achieve your goal of building your family with confidence and compassion. I’m rooting for you always. In Gratitude, Dr. Erica Bove

Unlocking Creativity to Improve Fertility: Practical Strategies for Women Physicians, with Dr. Lara Salyer

In this insightful interview, Dr. Laura Salyer and Dr. Erica Bove explore the intersection of creativity, nervous system regulation, and healing in healthcare professionals, especially women physicians on the fertility journey. They discuss practical strategies to reduce stress, foster joy, and enhance fertility through flow science and trauma-informed approaches. Key Topics: * The role of creativity and flow in healing and stress reduction * Impact of medical trauma and gender bias on women physicians * Practical tools for nervous system regulation and actual self-care * The connection between stress, cortisol, and fertility * Trauma-informed approaches in healthcare organizations Dr. Lara Salyer is an integrative and family physician, leadership mentor, and Creativity Catalyst. After experiencing burnout fifteen years into her own medical career, she began exploring a different way of living and leading. One rooted not only in science and strategy, but also in nervous system awareness, embodiment, creativity, self-trust, and sustainable success. What started as painting, running, and tiny moments of creative expression became something much larger– a return to herself. That experience transformed the way she understands leadership, healing, performance, and human potential. Today, she helps women in medicine reconnect with the parts of themselves that became buried beneath overfunctioning, perfectionism, caregiving, and chronic responsibility. Through trauma-informed leadership, transformational coaching, strategic redesign, creativity, flow neuroscience, and embodied practices, she supports women who are ready to stop abandoning themselves in the name of achievement. Here is a link to her free resource Catalyst Energetics™, a somatically informed framework designed to help clinicians reconnect with parts of themselves that were often set aside during medical training. This map offers a way back — gently, safely, and without force: https://rightbrainrescue.com/l/digital_download/971232/catalyst-energetics [https://rightbrainrescue.com/l/digital_download/971232/catalyst-energetics] https://drlarasalyer.com/ [https://drlarasalyer.com/] IG: @drlarasalyer [https://www.instagram.com/drlarasalyer/] Support the show [https://www.buzzsprout.com/2285234/support] As always, please keep in mind that this is my perspective and nothing in this podcast is medical advice. If you found this conversation valuable, book a consult call with me using this link: https://www.loveandsciencefertility.com/private-fertility-consult [https://www.loveandsciencefertility.com/private-fertility-consult] Follow us on social media: IG: www.instagram.com/loveandsciencefertility [https://www.instagram.com/loveandsciencefertility/] FB: www.facebook.com/profile.php?id=61553692167183 [https://www.facebook.com/profile.php?id=61553692167183] Please don’t let infertility have the final word. We are here to take the burden from you so that you can achieve your goal of building your family with confidence and compassion. I’m rooting for you always. In Gratitude, Dr. Erica Bove