The Dismantling You Podcast

Episode 114: Dr. Jennifer Kulp-Makarov Revolutionizing IVF for Women Over 40

In this episode of Dismantling You, I sit down with Dr. Jennifer Kulp-Makarov, a Board-Certified Reproductive Endocrinologist and founder of Fleura Fertility, trained at Johns Hopkins and Yale. We dig into how traditional fertility clinics often rely on a one size fits all approach to IVF, and why that can actually backfire for women with low AMH or those trying to conceive over 40. Dr. Jennifer shares the patient experience that changed everything for her: a woman who gave up on growing her family because she thought aggressive, high dose IVF was her only option. That moment became the catalyst for her to build a practice centered on personalized protocols and her signature Goldilocks approach to stimulation, finding the just right dose of medication rather than defaulting to the highest one. We also explore cutting edge fertility innovations including ovarian PRP, which is showing promise in improving markers like AMH and antifollicle count, and rapamycin, an emerging treatment that may help protect egg reserves and delay menopause. Dr. Jennifer breaks down how FSH dosing plays a critical role in egg competence and why monitoring it throughout the cycle, not just at baseline, makes a real difference. We talk about how fertility care is evolving to better support LGBTQ individuals through inclusive language and treatment design, and how AI could soon help standardize ultrasound data and embryo analysis. We wrap up with Dr. Jennifer's rapid fire answers on the most underrated factor in fertility, the biggest mistake patients make when choosing a clinic, and the one belief she had to dismantle in her own career. __________________________________________________ Key Highlights 💊 Dr. Jennifer developed a middle ground between high dose IVF and mini IVF called the Goldilocks approach. By adjusting medications through the cycle based on real time hormone levels, she optimizes egg growth without overwhelming the body. 🔬 For women over 40 or with low AMH, pushing more medication can actually cause eggs to stop growing altogether. Many patients labeled as poor responders simply needed a more nuanced, individualized approach rather than aggressive stimulation. 🩸 Ovarian PRP is showing improvements in AMH and antifollicle count, though large studies on pregnancy outcomes are still needed. Dr. Jennifer has seen clinical promise in her own patients, particularly those with low egg reserve. 💡 Early research suggests rapamycin may help protect egg reserves and delay menopause. A promising study also showed improved IVF outcomes for patients with endometriosis, though the data is still limited. 🧬 After 35, egg quality declines sharply, becoming more dramatic past 40. Dr. Jennifer monitors FSH levels throughout the cycle, not just at baseline, treating it like fertilizer that needs careful dosing. 🏳️‍🌈 Fertility care is moving beyond a heteronormative infertility model, and Dr. Jennifer emphasizes the importance of inclusive intake forms, vocabulary, and recognizing that LGBTQ patients may be perfectly fertile and seeking family building support rather than treatment for infertility. 🤖 AI shows promise in standardizing ultrasound measurements and analyzing embryo time lapse videos, reducing operator dependency, though the final clinical decisions should still rest with the reproductive endocrinologist. Bio Dr. Makarov is a fellowship-trained reproductive endocrinologist with training from Johns Hopkins Hospital and Yale University School of Medicine. With extensive experience treating complex cases including decreased ovarian reserve, recurrent pregnancy loss, and multiple failed IVF cycles, Dr. Makarov is committed to providing personalized, patient-centered care. She works closely with individuals, couples, and LGBTQ+ families, helping them achieve their dream of parenthood. Resources & Next Steps 🌐 Visit Fleura Fertility 📸 Follow Dr. Jenn Fertility on Instagram @drjennfertilityfriend, TikTok, and YouTube

Episode 113: Kelsey Bates On Helping Women Heal Chronic Illness and Medical Trauma

In this episode of Dismantling You, I sit down with Kelsey Bates, Licensed Mental Health Counselor and Founder of New York Women's CBT, to talk about the emotional weight of living with chronic illness. Kelsey shares how her own chronic illness shaped her decision to leave a 9 to 5 model and build a telehealth practice that meets women where they are. We dig into the difference between chronic pain and chronic illness, why so many women fall through the cracks of the medical system, and how stigma, racism, and cost combine to leave patients without a coordinated quarterback for their care.We also get into medical trauma and medical gaslighting, two terms Kelsey unpacks in a way that finally puts language to experiences so many women have lived through. Kelsey explains how repeated dismissals show up in the body (fight or flight, hypervigilance, freeze), and why third wave CBT approaches like ACT and DBT can succeed where traditional CBT often feels invalidating. We close with Kelsey's take on radical acceptance, the distress tolerance menu she gives every client, and the realistic version of self care that has nothing to do with facials and everything to do with PT and anti inflammatory food. __________________________________________________ Key Highlights 🩺 Chronic pain versus chronic illness: Kelsey draws a clear line between single injury chronic pain and the ongoing, no cure reality of chronic illness, and explains why each needs a different therapeutic approach. 🏥 Why women fall through the system: We discuss the missing quarterback in care, the cost barrier of private pay specialists, and medical racism including the myth that Black women have a higher pain tolerance. 💔 Defining medical trauma and medical gaslighting: Medical trauma is repeated, invasive pain you cannot escape. Gaslighting can be overt (you look fine) or covert (is it really that bad), and both erode patient trust in their own bodies. 🧠 How trauma shows up in the body: Kelsey explains the amygdala on overdrive, hypervigilance versus hyperarousal, and why patients can present as frozen and shut down or panicked and pacing in appointments. 🌱 Why third wave CBT works for chronic illness: Traditional CBT frames trauma responses as irrational thoughts. Kelsey uses the stuck point language from Cognitive Processing Therapy plus ACT and DBT tools to honor what patients have actually lived through. 🕊️ Radical acceptance is not giving up: Acceptance is acknowledging today's reality while still tracking the committed actions (PT, meds, stretches) that build long term stability. It is a journey, not an on off switch. 📋 The distress tolerance menu on the fridge: Kelsey has clients map out low, medium, and high pain day tools when they feel most stable, then post the list at home so partners and family know exactly how to help. 🤝 Loved ones want to help and need a script: Spouses and parents often freeze because they do not know what to do. Clear, concrete asks turn that helplessness into real partnership during flares. 👶 Chronic illness, IVF, and medical burnout: Living with conditions like endometriosis adds layers of fear about fertility, parenting, and overwhelm from stacked appointments. Self compassion and pacing are essential. __________________________________________________ Resources & Next Steps 🌐 New York Women's CBT website 📸 Follow Kelsey Bates and New York Women's CBT on Instagram & YouTube  @womenscbt  [https://studio.youtube.com/channel/UCrLbf-0mgtRCAmOgXxUULRA] 🎧 Subscribe to Dismantling You on Apple Podcasts

Episode 112: Dr. Randi Goldman The Truth About IVF, Egg Freezing, and Fertility

In this episode of Dismantling You, I sit down with Dr. Randi Goldman, a fertility specialist, to have an honest conversation about what the fertility world actually looks like today. We dig into the realities of IVF success rates, why one cycle does not equal one baby, and how age remains the single most important factor in fertility outcomes. Dr. Goldman shares what she wishes more patients knew before walking through her doors, from the importance of early education to the limitations of egg freezing as a backup plan. We also explore endometriosis and its often silent impact on fertility, the difference between ovarian reserve and egg quality, and why so many people are caught off guard by their own biology. Dr. Goldman breaks down the role of lifestyle factors like nutrition, sleep, stress, and environmental toxins, and explains what patients can actually control in a process that often feels completely out of their hands. This is one of those conversations that cuts through the noise and gives you clarity you can act on. __________________________________________________ Key Highlights 🔬 The Biggest IVF Misconception: Dr. Goldman explains why one IVF cycle does not equal one baby and how success rates are often misunderstood by patients starting their fertility journey. 🥚 Egg Freezing Reality Check: Egg freezing was likely "over-promised" for years. Dr. Goldman discusses who it actually benefits and why it is not a guaranteed insurance policy for future fertility. 🩺 Endometriosis and Infertility: Many patients do not realize endometriosis can silently affect fertility. Early diagnosis and treatment can make a significant difference in outcomes. 📊 Ovarian Reserve vs. Egg Quality: The number of eggs you have is not the same as the quality of those eggs. Dr. Goldman breaks down what testing can and cannot tell you about your fertility potential. 🥗 Lifestyle Factors That Actually Matter: From nutrition and sleep to stress management and environmental toxins, Dr. Goldman shares what patients can control in a process that often feels uncontrollable. ⏰ The Power of Early Education: Dr. Goldman emphasizes that knowing your options sooner can change everything. Many patients say they wish they had started the conversation years earlier. 💡 Embryo vs. Egg Freezing: There is a meaningful difference between freezing embryos and freezing eggs, and the right choice depends on your life circumstances and timeline. __________________________________________________ Resources & Next Steps: 👩‍⚕️ Follow Dr. Randi Goldman on Instagram @randihgoldman_fertilityddoc and LinkedIn for fertility education and updates Bio: Dr. Randi Goldman is a reproductive health and infertility specialist at Northwell Fertility and the Program Director for their Reproductive Endocrinology and Infertility fellowship program. She is an Associate Professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, and is the Chairperson for the Patient Experience Committee for Northwell Health Physician Partners.   Dr. Goldman’s clinical and research interests span a broad range of reproductive health topics, including endometriosis, Oncofertility, fertility preservation and treatment outcomes, and patient experience. She has authored more than 40 peer-reviewed publications, and her research on oocyte cryopreservation has been featured in The New York Times, The Washington Post, Boston Magazine, and TODAY, among others, and has been translated into a web application by MDCalc.Dr. Goldman completed her residency training in Obstetrics and Gynecology at Brigham and Women's Hospital/Massachusetts General Hospital and Harvard Medical School in 2015, and her fellowship in REI at Brigham and Women's Hospital and Harvard Medical School in 2018.

Episode 111: Johannes Soulages Breaking the Silence on Male Infertility

In this episode of Dismantling You, I sit down with Johannes Soulages, a scientist, corporate executive, and fertility coach for men, to have a raw and honest conversation about male factor infertility, one of the most overlooked and stigmatized topics in reproductive health. Johannes shares his personal journey from a diagnosis of oligospermia (critically low sperm count) through IVF, surgery, and the emotional toll of keeping it all a secret. We explore how his background in science, including a post doc at MIT, ETH Zurich and projects at NASA, intersected with the deeply emotional reality of infertility, and why his initial reaction was denial, anger, and shame. We also dig into the broader conversation about why men rarely speak up about infertility, the misconceptions around masculinity and reproductive health, and how Johannes channeled his own pain into purpose by launching a free monthly men's support group called Resolve for Men. He opens up about the guilt of watching his wife go through IVF injections, finding the right therapist through what he calls "an act of sabotage," and the transformative power of vulnerability in a group setting. Whether you're navigating an infertility diagnosis, supporting a partner, or simply want to understand the male side of this journey, this episode is a must-listen. Key Highlights 🔬 From Scientist to Fertility Coach: Johannes's career path from MIT and NASA to the beauty industry, and how a personal infertility diagnosis led him to launch a coaching practice for men. 💔 The Diagnosis That Changed Everything: How hearing "oligospermia" with a sperm count of 0.5 million (vs. the normal 20 million) triggered denial, anger, shame, and guilt, emotions most men with infertility silently carry. 🧠 Masculinity and the Stigma of Infertility: Why men associate fertility issues with performance, avoid testing, and feel "less of a man," and how these misconceptions keep them isolated. 💪 The Therapist Who Changed His Life: Johannes chose a tattooed biker-type therapist expecting to go once and quit, but that session became a four-year journey that transformed his mental health. 👥 The Power of Men's Groups: How structured vulnerability in a group setting creates breakthroughs, with 99% of men opening up within the first hour, even those who joined determined to stay silent. 🤝 Supporting Your Partner by Getting Supported: Why the best thing a man can do for his partner during IVF is to seek his own support first, because you can't pour from an empty cup. 📊 The Numbers That Matter: One in six couples struggles with fertility, and roughly half the time the issue is male factor, yet men are often tested last, sometimes after multiple failed IVF rounds. Resources & Next Steps Contact Johannes Soulages on Instagram: @Four.Consulting 🔍 Search for Resolve for Men fertility support group 🎧 Subscribe to Dismantling You on Apple Podcasts [https://podcasts.apple.com/us/podcast/the-dismantling-you-podcast/id1530428962]

Episode 110 Dr. Jaime Knopman On Taking Control of Your Reproductive Future

In this episode of the podcast, I sit down in person with Dr. Jaime Knopman, a leading reproductive endocrinologist and author of the book Own Your Fertility. Dr. Knopman shares what inspired her to write a book that cuts through the noise and delivers accurate, relatable information on women's fertility. From her early inspiration by Elizabeth Blackwell to her specialization in reproductive medicine, she walks us through her journey and why she believes every woman deserves to make educated choices about her fertility before time becomes a factor. We dive deep into the biological clock, the shame surrounding infertility, and why Dr. Knopman wants us to stop treating fertility as a given. She explains the global fertility crisis, the societal shifts driving it, and why she personally plans to have her own daughters freeze their eggs at 22. We also cover lifestyle factors, AI in fertility medicine, and a rapid fire round covering everything from supplements to saunas. This is a must-listen conversation for any woman thinking about her reproductive health. Key Highlights: 📖 Writing Own Your Fertility: Dr. Knopman explains that she wrote her book to fill a gap in the space for accurate, digestible fertility information. ⏳ Rethinking the Biological Clock: Rather than a cliff, Dr. Knopman describes fertility decline as a gradual slope. 🥚 The Case for Early Egg Freezing 🌍 A Global Fertility Crisis 🤖 AI and the Future of Fertility Medicine Resources & Next Steps 📚 Get Dr. Knopman's book Own Your Fertility on Amazon 📖 Get the book at Barnes & Noble 📲 Follow Dr. Knopman on Instagram @drjaimekopman 👉Learn more about the Chick Mission, the nonprofit organization providing grants for fertility preservation to women diagnosed with cancer