In this episode of The Wholesome Fertility Podcast, I sit down with Dr. Marc Sklar to delve into evolving perspectives on fertility, especially for women over 40. We discuss the need to shift our focus from quantity to quality in fertility treatments, and the empowering impact this has on women navigating their fertility journeys. We cover the realities of IVF, the importance of patience, self-advocacy, and creating space for personal growth and healing. Marc and I also explore complex factors such as genetics, autoimmune issues, and male-related factors in recurrent pregnancy loss. This conversation is full of valuable insights for anyone on their fertility journey, promoting a holistic approach to healing and growth.   Takeaways  

• A shift in mindset is crucial for couples seeking fertility care after 40.
• Quality of eggs and embryos becomes more important than quantity as women age.
• Understanding hormones is important, but shouldn't be the sole focus.
• Regular ovulation is a key indicator of fertility, regardless of age.
• Real-life success stories provide hope and perspective for those trying to conceive.
• Patients should feel empowered to advocate for themselves in medical settings.
• IVF is not a guaranteed solution and should not be the first option considered.
• Donor eggs can be a valuable option, but should not be the first recommendation based solely on age.
• The energetics of fertility are crucial for healing.
• Recurrent pregnancy loss can stem from various factors, including genetics and autoimmune issues.
• Male factors contribute to 50% of miscarriages, often overlooked.
• The importance of the uterine environment in fertility cannot be ignored.
• Quick fixes are a societal conditioning that impacts health decisions.
• Understanding the microbiome can enhance fertility treatments.
• Emotional states can significantly affect physical health and fertility.

  Be sure to check out our Fertility Empowerment Holiday Bundle here https://www.michelleoravitz.com/fertilityempowermentbundle before it's gone!   Guest Bio:   Dr. Marc Sklar — a.k.a The Fertility Expert — is a natural fertility specialist helping couples get pregnant for 21 years. He's mission is to help you feel HOPEFUL and CONFIDENT about your fertility journey again.    In addition to his Doctor of Acupuncture and Oriental Medicine, Dr. Sklar trained at the Harvard Medical School, Mind/Body Medical Institute. He is the creator of Fertility TV, MarcSklar.com and ReproductiveWellness.com, and a Fellow of the American Board of Oriental Reproductive Medicine and Medical Advisor for Symphony Natural Health.   As well as his online program, he also supports his community via his highly popular YouTube channel: FertilityTV where he shares information packed videos to educate his followers on all things fertility.    The Fertility Expert lives in San Diego, with his wife and two sons, where he has his clinic Reproductive Wellness. He also works with couples all over the world through his fertility online coaching - the Hope Fertility Program.   FERTILITY TV WEEKLY EPISODE - http://bit.ly/thefertilityexpert FACEBOOK - https://www.facebook.com/thefertilityexpert INSTAGRAM - https://www.instagram.com/the_fertility_expert/     For more information about Michelle, visit: www.michelleoravitz.com   Be sure to check out our Fertility Empowerment Holiday Bundle here https://www.michelleoravitz.com/fertilityempowermentbundle before it's gone!   Click here to get free access to the first chapter in The Way of Fertility Book! 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/     Transcript:   Michelle (00:00) Welcome back to the podcast, Dr. Scalari.   Marc Sklar (00:03) Welcome, well, thank you for having me. It's automatic. But no, it's awesome to reconnect. It's been a while and I'm excited to have a conversation that we both are passionate about, which is everything fertility.   Michelle (00:07) I know it's automatic. Yes.   For sure. We're like, you could say we're a little obsessed, right? With fertility. It's like, live it, we breathe it, So awesome. actually today we're going to talk about a couple of different topics, but I wanted to talk to you about pregnancy after 40. Cause I know that a lot of what we hear out there, even about,   Marc Sklar (00:25) 100%. Yeah, absolutely. Yeah.   Michelle (00:46) how even after 35, it's considered a geriatric pregnancy, which I don't know about you. just don't love that term at all. It's icky. yeah, because I'm sure you see most people like closer to the age of 40 and doing really well. So I'd love for you to talk about it, your experience with that, and also some really cool examples of how it can work despite all of the naysayers.   Marc Sklar (00:55) Yeah, not a fan of it.   Mm-hmm   Yeah, so I think, I so many things I want to talk about when you say this that I need to prioritize it in a good way. here's a couple of things that I think are really important. One is, I think our perspective about fertility, and when I say our, not ours as practitioners and doctors and providers, but more like ours as in like,   the couple who is seeking care during this time and wanting to get pregnant in their 40s, I think a mind shift has to happen. And I think that they need to think about their fertility in a slightly different way. If we are thinking about our fertility and reading everything that is really focused on   couples that are 30 or 35 or whatever age in their 30s, then we're going to be skewed differently about our own fertility and our approach needs to be different. And so I say that in the sense that, you know, we have to have a different reality of what is okay and what we're trying to achieve. A woman who's in her 30s is trying to get as many eggs as possible.   Michelle (02:43) Mm-hmm.   Marc Sklar (02:43) So they have as many options when they have their embryos created and they are, you know, it's usually more about in general and this is a making a generalization, but it's more about quantity versus quality. We're like, let's have as many as we have so that we can choose the best quality of those and then we can move forward, you know, with our pregnancy. And...   the approach may or may not be in those situations about egg quality, because there might be other variables that are impacting their ability to conceive. Whereas I think when we are 40 and older, my approach really shifts. I don't care about quantity. I'm really, really focused on quality. And I think that mindset has to be different as a couple.   because then we were not as disappointed like, I didn't get that many follicles and they didn't retrieve as many eggs as I would have hoped. But because that's all we hear about. We hear about, look, we need all these eggs, we need all these embryos. But the reality is, is when we get older, I don't need 20 eggs or 20 embryos, I need a couple good ones. That's really what I'm looking for is a couple good embryos.   to work with and to transfer. So I think really a mind shift needs to happen and our perspective on fertility needs to change. And so for reading and understanding things as if we were 30 versus 40 or older, then we're gonna have, I believe, skewed perspective on our fertility journey. So that to me is number one. Number two is we do all get caught up in our hormones and some of that is appropriate and some of that is not appropriate.   Is it appropriate to understand where our hormones are at when we're at any age? 100%. Is it important to understand what our estrogen is doing and what our progesterone and FSH are doing? Absolutely. Is it important to know what our AMH is? Yes. Should we get caught up in AMH and make our whole focus about AMH? No.   The research doesn't promote, doesn't support these variables. Even FSH, AMH are not good indicators for a couple's ability to conceive and have a healthy pregnancy. Are they important for us to just have a baseline and understand? Yes. Will they potentially or can they potentially influence your IVF protocol? Yes.   But that doesn't mean we as couples need to get wrapped up in those numbers and make our fertility all about that because it shouldn't be. My rule of thumb is are you having a regular cycle? Check. Are you ovulating regularly? Check. Is your bleed healthy? Check. You can conceive.   Michelle (05:40) Mm-hmm.   Marc Sklar (06:00) Do we have to look at these other variables? Do we need to check your thyroid? Do we need to work on your adrenal glands and stress? Do we need to make sure your gut is healthy? Do we need to make sure all the systems are functioning properly? Seem analysis is good. Fallopian tubes are open. All of those things are still important. But the main thing that as long as you're ovulating, you can get.   And I think that's a really important piece. Now, we're not talking about IVF or not IVF right now. It's just like conception at 40, right? And or older. And so I think if we just focus on the right things and don't get bogged down by these little details of someone who might approach things a little differently if they were 30, then our approach will be better. It will be healthier.   Michelle (06:37) Mm-hmm.   Marc Sklar (06:57) you'll be more grounded in your approach. And we could focus on the areas that really need attention and support. And so I think that piece is really important as we are in our 40s, approaching fertility, still wanting to conceive. If we're always comparing ourselves to other women and other circumstances, we're gonna lose sight of what we need to do and always be trying to like catch up or do what they're doing. And I think that is...   That can really push us down the wrong road. I say this because truly I work with so many women who are over 40. And I see this time and time again. So it's coming from a lot of experience working with women over 40. And I have a wonderful story to share of a woman who is, and everyone will gasp when they hear, okay, when she conceived she was 48.   Michelle (07:55) That's awesome. I love that.   Marc Sklar (07:55) She is, I just spoke to her two days ago. When she delivers, she will be 49. Okay? And I'm not saying she didn't have a long journey.   Michelle (08:08) Was this natural or was it IVF?   Marc Sklar (08:11) This time was natural, but I'm not saying she didn't have a long journey. She did. I'm not saying it was easy. It was not. It was a long journey. It was difficult. Miscarriages, conceiving naturally, conceiving through IVF, long IVF protocols, multiple clinics, like all these things. So it wasn't easy. It was long, but she's 32 weeks pregnant right now.   Michelle (08:40) Wow, amazing.   Marc Sklar (08:41) And I say that because it's possible. It can happen. And these are the sorts of things we see on a regular basis. I'm not saying it's easy at 48, not at all. But I say that for some perspective on the process. Okay. And I think that, you know, do I think everyone could last for seven plus years trying? No, I don't think that's for everybody. She was never going to give up.   Michelle (08:51) Mm-hmm.   Marc Sklar (09:11) Like regardless, like she was never going to stop and never give up until she was pregnant. And that's what she told me. She's like, I'm not going to stop and I'm determined. I was like, okay, I'll support you. Right. That, that, that process is not for everybody. Some people will be on it for a year or just have one or two IVF transfers. And they're like, this is too much. I'm done. I'm going to move on. And I respect everybody's path in that process, but   Michelle (09:21) Wow, amazing. Yeah.   Right.   Marc Sklar (09:39) I want everyone to know it's possible and that's why I share that story. I think it's possible regardless of age with the right support and the right process and the right focus of our attention.   Michelle (09:51) I love that. I really do. And I love the stories because I think that there's so many people that can benefit and you have that sign hope in the background. And it's true. Like those are, but stories, real life stories, there's nothing like real life stories to provide real hope. Cause you can hear, you know, there's a chance of this or a chance of that. But when you actually see an example of somebody going through those challenges that you are and having a successful pregnancy,   Marc Sklar (10:00) Yeah.   Michelle (10:21) I think that there's nothing that compares to that.   Marc Sklar (10:24) Yeah, absolutely. And I love to bring in stories wherever possible. And she was just at top of mind because I just booked her two days ago. So yeah.   Michelle (10:33) That's awesome. You know what I find really cool is the Guinness Book of World Records, the oldest pregnancy is 58 and it was natural. And it was a woman in England who, you know, in England, they don't have a lot of sunlight and, know, and vitamin D access naturally. So I thought that was really cool. But it's, it could be done. It's possible. Just like you said, and I love that you said   Marc Sklar (10:45) Wow. No.   Michelle (10:58) as long as you're ovulating, there is a possibility that you can get pregnant.   Marc Sklar (11:02) Yeah, yeah, we see this, we do see this all the time. Look, as soon as you hit 35 and 38 and certainly 40 and older, you're going to read things and hear things that say, you can't, it's not possible, you won't, you need donor, you need IVF, whatever it is that you're gonna hear, you're gonna hear it all.   I think the hardest time is when you hear it from the person on the other side of the desk in a white coat that says to you, your only option is donor, just give up. And we all hear variations of those words, whether it's not possible, just use donor, whatever variation of that, of what I just said, when you go into an office, whether that's your OB,   Michelle (11:46) True.   Marc Sklar (12:01) or your REI or whoever it might be, and you're sitting down talking to them and they see your age, they assume certain things and they make certain judgments. And they express those verbally to you. And you hear that and that registers in your brain that embeds into your brain. And you start to believe it. Well, yeah, right.   Michelle (12:22) It's nocebo.   True.   Marc Sklar (12:28) I've never heard it, say it. really like that phrase. Yeah.   Michelle (12:31) You're never going to be able to get it out of your head now. Every time a woman comes in and tells you the story.   Marc Sklar (12:36) Yeah. And so look, they said this to you, it and our our brains are really strong and we imprint with these negative things very easily. It's much harder to imprint with all the positive, it takes more effort. And so it imprints into our brain. And now we start to believe it. Well, Dr. So and so said, it's not possible, I'm not going to do it, I can't. And then we repeat that to ourselves so often that   Michelle (12:49) Right. It's true.   Marc Sklar (13:05) Now our body and our brains believe that to be true. so if someone says something negative to you, you have to work double or triple as hard on yourself to get that out. And you need to express to them, I didn't come here to hear negativity. I didn't come here for you to tell me that I can't. I'm determined to get pregnant.   Michelle (13:09) 100%.   Marc Sklar (13:33) And it's fine if you're not able or willing to help me, I'll go someplace else, but I don't need you to tell me that I can't do it, because I know that I can. And you have to do it in that moment. You have to say that in that moment to them, because what you're saying to them is repeating it back to yourself to retrain yourself and get rid very quickly, get rid of that negative comment so it doesn't embed into your brain, into your conscious.   Michelle (13:52) Yeah.   Marc Sklar (14:00) But it also allows them, they need to be woken up. One, they need to be told this is not okay. And two, you have to have the power and the strength to verbalize that truth to them. Okay. You might not be getting pregnant in the conventional way that you thought or they thought. You might not get pregnant in the way that they would like you to. It doesn't mean that you cannot get pregnant. It means that it might take longer. It might be a different path. It might be...   whatever. And so I think it's really important in those moments to stand up for yourself and verbalize that and let them know they might not like it. It's okay. Yeah, you didn't like what they said to you. So it's fine.   Michelle (14:41) Yeah, exactly.   Totally, totally. And that's like really taking your power back regardless, ultimately it's your journey. You're not there to make the doctor feel better.   Marc Sklar (14:53) Right, listen, I think that's such an important piece. Unlike most other medical visits and specialties, you are a consumer buying their service. Just because they're wearing a white coat and they have MD after their name does not mean   that they get the say in everything. It's your journey, it's your process. You're paying them a lot of money for their service. And even if you have insurance coverage, by the way, it's still insurance coverage that can go someplace else to pay for somebody else. So it doesn't have to go to them. And so...   You have the power, like they make it feel like they have the power and they control the situation. I want you to know you have the power. You control the situation and your outcome. It's your dollars that you're spending. You are and should be an equal participant in this process with them. And they don't have to dictate everything. Now, I'm not saying, you you're telling them the protocols to use all the time, but   It needs to be a joint effort in this process. It's totally different than going into a different medical environment and a different provider for different services. They're not charging you $20,000, those other people, for a service that's elective. So stand up for yourself. Have that empowerment to do so.   Michelle (16:34) Yeah.   Right.   Yeah. And another point that I want to make is, you know, when you're working with a doctor, it doesn't matter how qualified, like, I feel like they should believe in your outcome. If they're doubting your outcome, find another person.   Marc Sklar (16:57) Yeah, right now, 100%, 100%. Look, I am not opposed to donor egg. I think that donor egg is something that is super valuable and has its place. What I don't like is that just because of your age, someone is telling you, need to use donor egg. What they're really saying,   And there is certainly a place for donor egg. have lots of women that I work with that use donor egg very successfully and I'm a big proponent of it. But what, why they are telling you just based on your age to use donor egg is because their success rates are impacted by your age and the challenge, the potential challenge of getting pregnant at your age.   Michelle (17:51) Right.   Marc Sklar (17:55) And so for them and their success rates, they have higher chances with using donor egg and they would just prefer, it's an easier process, they would prefer that you use donor egg for that purpose. Okay, now again, does it mean that it's not the right decision for some? It just means that I think if they're just making that decision based on age, I think there's a lot of other pieces that need to be looked at before that decision is made.   Michelle (18:24) What you just said is so important because it's the reality. Really if the system, it's the reality because their ability to really stay on top of their game is for their statistics to make them look really good. And it's human nature. They're going to be thinking about that when they're talking to you, regardless if they're, you know, they can be great doctors, the two can coexist, but   They're also in a business. So it's important to keep that in mind in the realistic aspect of it is that it's going to make them look better. They don't want to take a risk. They see it as a risk, but that doesn't mean that just because they see it that way, that that's really the case for you.   Marc Sklar (18:54) 100%.   Right, yeah. Look, absolutely. I say this also from, so everyone knows who's listening, 50 % of the couples that I work with, 50 % of them are doing IVF. I could group IUI into that as well, so IUI or IVF, some form of assistive technique. Of that number, about 15%, use donor egg.   Michelle (19:33) Mm-hmm.   Marc Sklar (19:34) So I'm fine with it. I'm happy to support you with it. I just often think that choice is made prematurely or that push in that direction is done prematurely without really giving you a fair chance, really looking at your case as a whole versus just looking at you as an age, as a number.   Michelle (19:56) Same thing with IVF. I also find that with IVF that people will start out maybe three months and they're young and they're like, you know, I just want a baby now. So I'm going to go to IVF. And a lot of people have a preconceived notion just because you're paying a huge amount of money and that there's technology involved that doesn't give a guarantee. in fact, I've seen people get more successful naturally, even at an older age than going through IVF.   Marc Sklar (20:05) Easy.   Well, the success rates for IVF for those who are listening and aren't aware are relatively low. You know, in your, from 30 to 35, those success rates are around 35 to 40 % ish. You know, depending on the clinic, some clinics might have a little higher, some a little bit lower, but roughly, you know, in the United States, that's an accurate statistic. It only goes down as you get older. And if you look, because most clinics,   Michelle (20:50) you   Marc Sklar (20:56) Don't have to report, but most clinics do report their statistics. If you look at statistics for IVF in their 40s without donor egg, those statistics are very, very low. So then you have to ask yourself, is this worth the money or can I get the same or better statistics and results trying naturally by addressing the root issues, by focusing on the things that I need to focus on, by getting healthy.   are those better for me? Are those odds better? One of the beautiful things you mentioned it with, you work with younger women and after three months they move forward with IVF. One of the beautiful things that's happened over the last 20 years is that fertility treatments and the fertility journey has become something that is more accepted and people are more willing to talk about it. And as a result of that,   marketing towards those communities has increased dramatically. And as a result, IBF has been spoken about more frequently because of that marketing. And so it's become so much more commonplace that couples who want to get pregnant, young, try for three months or six months, hey, it's not working.   you know, so and so did IVF and got pregnant or so, you know, we should just go do IVF. And they don't know the real statistics. They believe that it's a hundred percent successful. And as a result, it becomes the first line of treatment versus, you know, what used to be the third or fourth or fifth line of treatment, right? Well, I used to go to my OB and they used to do that. And then I would try other things. Now it's like, I'm not pregnant. Let's just go do IVF. Right. And so so many couples end up doing IVF.   thinking it's faster or more convenient without really working on themselves. And in turn, then they realized later on, I really shouldn't have started this way because it's not a guarantee. I haven't been successful. So they go there very prematurely. My preference would be is to see couples have patience. Take a step back. What's not working for me?   Michelle (23:03) Mm-hmm.   Yeah.   Marc Sklar (23:17) What do I need to improve and correct? And let's work on the root issues so that way you can be successful moving forward. And I had a conversation two weeks ago with a woman. I talked about it briefly this week on my Instagram stories because I think we were both frustrated with each other during this conversation. She has a history of repeated chemical pregnancies.   And she is frustrated with the lack of results and I've just started working with her. And so I asked her, know, she, and as we just started working together, she had another chemical and I asked her to stop trying for a little bit. I'm like, you're just having these ongoing chemicals and we're really not able to make progress. I just wrote out this plan for you. I want to give it some opportunity. You know, it's the end of the, it's close to the end of the year.   How about we just take off right now through the end of the year? Let's just take a break. Let's enjoy life and let's work on ourselves. And she felt like she was wasting time and she was feeling, I could feel her as soon as I said it, like getting anxious about like just the time of giving, creating this time to, and she's in her early forties. And she said, you know, I don't think I'm gonna do that. I can't do that. I'm gonna.   Michelle (24:19) Mm-hmm.   Marc Sklar (24:44) I'm going to keep trying because I feel like I'm wasting time. We had this back and forth, this long conversation back and forth. I'm going to totally support her and respect her decision about how she wants to move forward. I just don't agree. Sometimes taking a step back and working on ourselves and creating space is progress towards our ultimate goal. I know that we think that if we're not actively having intercourse and trying to conceive at ovulation every month, that we're wasting time.   Michelle (24:57) Yeah.   yeah.   Marc Sklar (25:15) Well, in a situation like this, we're just spinning our wheels. If all we do is continue to do the same thing every month, expecting a different result, I don't know how that's gonna change. So we need to give ourselves a little bit of opportunity. And she's so worked up about it and anxious about it, she's trying to control every aspect and she's scared. She's making this decision out of fear.   Michelle (25:19) Totally.   Mm-hmm.   Marc Sklar (25:43) So one, the decision's being made out of fear, and two, she's trying to strangle, like, I'm gonna control all of this. It's not, we are typically not successful if we make decisions out of fear, number one, okay? And number two, the more we try to strangle something, the more you strangle it and you don't allow it to be successful.   We need to create some space, some room for things to occur. Okay? And I'm a big proponent of this, like, let's just take a step back. Let's take a deep breath. Let's understand, let's give ourselves some space and not have to be so stressed about this. Most things, if you think about it, are created in space, in a little bit of a vacuum. Sorry, not a vacuum, in a little bit of a space. If we have this vacuum, we're constantly trying to control it. There's no space for creation.   Michelle (26:19) Yep. Yeah.   Marc Sklar (26:39) There's no place for an opportunity for something to be created in. So I think it's, know, painting a beautiful painting is created from a blank canvas. It's created from space. And the same thing with our life. We need to create an opportunity for life to be created. And so that means not straining, not holding on so tight, not trying to control every little thing.   Michelle (26:52) Mm-hmm. Yep.   Marc Sklar (27:08) Let's take a step back. I'm not saying you don't like do the right things. I'm saying we don't try to control all of those things so closely. And I think this is really such an important lesson for all of us because our tendency when we're told is I'm gonna do it differently. I'm gonna add this in like, right? And you're just like more and more and more more and more. So that's like this stranglehold that happens.   Michelle (27:29) Mm-hmm.   Marc Sklar (27:35) And I want us all to just let go a little bit more. It doesn't mean you're giving up. It doesn't mean you're taking a break. It doesn't have to be. It means you're just not holding on so tight to the outcome and the process. And I think this is so, so valuable for us. Difficult to do. I'm not saying it's easy, but it's so valuable. you know, I know her and I, were both...   kind of frustrated by the conversation because it didn't feel like she was listening to me and she didn't feel like she wanted to move on with my recommendations. She felt frustrated by me asking her to take a break. But I say it out of all love, like that is what I feel like is going to be the most beneficial for her in that situation. And I've had these conversations with others in the past and I'm just saying this from experience. So for all of you listening, sometimes we just gotta let go a little bit.   We've got to just ease up just a little bit.   Michelle (28:31) love this.   Yeah, no, I love this so much. you have no idea. Cause it, think that like you just said, you've had so much experience, you've seen this. And when you do something over and over again for many years, what happens is you start to get a feeling for it. You know, my husband works in the ER. He's starting to have a feel. He gets a sense when somebody's really sick or somebody saying they're sick, you start to get a sixth sense. You know, maybe we can't measure that, but it's a real thing. And I love that you talk about that. Cause to me that's   Marc Sklar (28:37) Yeah.   Michelle (29:04) being in a state of flow, being in a state of flow is the same exact thing that happens in our body when our chi flows and our vitality is able to feed all of our organs. cannot happen when it's constricted. And then going inward. Yeah, that's just going into the yin. You can't be constantly yang. You have to go back into the yin as well. And yin is incredibly productive.   Marc Sklar (29:25) Yeah.   Michelle (29:28) Like what happens when we're sleeping? We're in a state of yin. It's the most productive thing your body can do. You can't possibly have so much going on without that kind of like inert state. know, so it's, yeah, it's totally important, but also I don't know if you ever follow Dr. Joe Dispenza. I'm obsessed with his teachings. And have you ever done his meditations? So his meditations, he actually takes you through a form of induction, which   Marc Sklar (29:48) Mm-hmm. Yeah.   No.   Michelle (29:58) It's not hypnosis, but he gets you into a state of space, of becoming aware of space. Because when you become aware of space and everything that he does is based on science. actually has a whole research team on this. And this idea of kind of allowing this state of space, as they learn in quantum physics, you know, getting to this place where we're not locked in to the material world. We're not locked in.   We're kind of like moving back so we can allow this divine intelligence to take over. And then, and then it fixes things. It takes care of your body. does what it needs to do. Cause that's not our job. Our job is yet to direct and to intend, but our job is not to fix every single thing. When we try to do that, all we're doing is getting in the way of this divine intelligence. So I love that you're saying this because it totally like, it totally speaks the language that I'm feeling when it comes to.   fertility health and overall health like every way really.   Marc Sklar (31:00) Yeah, I agree. it's something I talk about. I have to do it, I feel like, repeatedly to the same person to get them to hear the message. And it's not intuitive. Like, personality-wise and for many of us, our goal is like, just want to fix it. I want to solve it. I want to do it. That creates this stranglehold. And so it's not intuitive for them to kind   Michelle (31:08) Yeah, because it's not common knowledge. It's not common.   Mm-hmm.   Marc Sklar (31:30) pull back a little bit and feel like that's moving forward. But it is.   Michelle (31:34) Yeah. Yeah, totally. Cause I mean, we have, we're conditioned to, you know, to first of all, get quick fixes. I mean, this is, we've been conditioned for years and this is all marketing for quick fixes, like quicker, faster, better, you know, and we also are conditioned to no pain, no gain. You know, you have to work for it. You have to get it. You have to be on top and   Marc Sklar (31:46) Mm-hmm.   Michelle (31:59) So over time, this is just a habit. That's going to be our knee jerk reaction or response to pretty much anything, but it's not necessarily the response your body needs.   Marc Sklar (32:10) Yeah, no, absolutely. And it's actually with the younger generation, that's only getting worse. Maybe not the no pain, no gain part, but the quick fix. That's our generation. Yeah. The younger generation is like, I don't want any pain, but I want all the gain. Yeah. And the quick fix, you know, part of it is because of the phone.   Michelle (32:20) Yeah, that might be more our generation. This is true. It's true. Yeah. I just want to be on my phone.   Dopamine.   Marc Sklar (32:39) the dopamine, but also like this, as much as Amazon has been a great service to so many people, it's a huge disservice. We, and especially the younger generation, expect everything now in a day. Right? That's the quick fix. That's like immediate gratification. Free delivery, two days. Now everyone expects free delivery and they want it there in two days. And it doesn't work like,   Michelle (32:55) Mm-hmm. Yeah.   Marc Sklar (33:09) The world doesn't typically work that way, but they've preconditioned us to this. And that's to our detriment, right? Because that gets translated across the board to all aspects of our life. Now we want things faster. We more immediate gratification. it should have been fixed. Why didn't they get back to me, right? Like all of these things, I think that's a problem. Yeah.   Michelle (33:32) I'm like, we're on the same page. 100%. Yeah. And I think that, yeah, it just, these are mental patterns that we're constantly repeating. And I'll be honest. I mean, ever since I had my phone, I just don't feel as sharp. I don't remember as much. My attention can't stay on one thing. And even me, I'm aware of this and it's impacting me.   Marc Sklar (33:41) Mm-hmm.   Right, yeah, yeah, yeah. One of my favorite things to do both to bother my children and because it's beneficial to them is if we need to order something from Amazon, I put it on the longest shipping option as possible. Like if it says one week or two weeks, that's what I pick. Every time. I mean, unless I like immediately need something, whatever. But like.   Michelle (34:08) that's smart.   That's actually really smart.   You need it. You'll use it when you need it.   Marc Sklar (34:18) Yeah, but like in general, I use the longer shipping option because I'm trying to retrain their minds to be like, it's not here yet. Okay, we'll come. It's not, it's not the end of the world, right? It will arrive. and usually Amazon gives you a little benefit for that delay, by the way. Yeah.   Michelle (34:36) Yeah, yeah, yeah, right. It's a little cheaper. That's really smart. That is actually really, really smart. And then you can put things in one box. So it also is good for the environment. So when it comes to recurrent pregnancy loss, because you'd mentioned you're talking about chemical pregnancies and what are some of the common factors that you've seen clinically?   Marc Sklar (34:46) Yeah, and good for the environment.   Yeah.   Yeah, so chemical pregnancy could be a little bit different, but if we're talking about, you know, reoccurring pregnancy laws or, you know, multiple miscarriages, then the, there are four buckets that I put things into. The first bucket is one we have to look at and analyze, but one we potentially can't do much about, which is genetics, right? Is there some sort of genetic abnormality that's occurring potentially?   Michelle (35:24) Mm-hmm.   Marc Sklar (35:30) due to my genetics or the combination of mine with my partners and what's that going on. I might end up with five causes actually now that I think about it. The next one is autoimmune issues. I find this is a huge reason for reoccurring pregnancy loss. will say also I find this is a big reason for secondary fertility issues.   Michelle (35:41) Hey, good.   Marc Sklar (35:59) with recurrent pregnancy loss. So secondary meaning you've been successful with the pregnancy one time or multiple times, and then at some point you're trying again and you're not successful, but in this case you've had, let's just say a loss. And so I would say I find that autoimmune issues are much more common in that situation because something happened in one of the previous pregnancies or postpartum that caused some sort of autoimmune issue that has triggered this outcome or contributed to this outcome.   Michelle (36:26) Mm-hmm.   Marc Sklar (36:28) Another one is blood clotting factors, that there is some sort of, you know, some issue, whether that's genetic or not, because it doesn't have to be genetic, that is contributing to more clotting factors that doesn't allow for that embryo to implant properly, and you could have a miscarriage. So that's three. Four, uterine issues.   That could be wide, that could be like a bigger bubble that doesn't get talked about as frequently. So what's going on in implantation that might be contributing to that? Is there an infection, a virus, a bacteria? Is there inflammation? Is there endometriosis? What is going on inside the uterine cavity and with the endometrium that could be causing this pregnancy or multiple pregnancies to not be able to be held?   And then the last one, which is male factor. So 50 % of all miscarriages are male factor related. Most typically in those, it's going to be some sort of DNA fragmentation issue. So the DNA of the sperm has been compromised in some way and that's contributing to that loss. That's the one that unfortunately we don't talk about as much because, like why would a male...   Michelle (37:43) Mm-hmm.   Marc Sklar (37:57) contribute to the miscarriage, you know, and they're not carrying. So that one gets ignored, but something that needs to be ruled out. So those are the, I said four, but really five, those are the five reasons that, you we should look at.   Michelle (38:10) Yeah, for sure. And also the microbiome, know vaginal microbiome can impact a lot.   Marc Sklar (38:14) Yeah, so that I look at that in that fourth one with the uterine environment. So to me, that microbiome is a piece that I look at when I'm evaluating that. Yeah.   Michelle (38:23) Yeah. And I feel like, I feel like they should always look at that, like before transfers. mean, cause people are paying so much money. And I know in Spain, it's more commonplace for them to give vaginal, suppositories for, probiotics. And I feel like it would really be very helpful for a lot of people.   Marc Sklar (38:33) Yep.   Great.   Yeah, I've started running that test much more frequently in the last year. And I can't say I run it for everybody because at some point I'm just balancing cost of things, right? Like we could run every test under the sun. It's just like, it's a matter of cost. But certainly if I see implantation failure, if I see chemical pregnancies, you know, these are the sorts of things that for sure I'll start to look at.   Michelle (38:48) Yeah.   Mm-hmm.   Yeah.   Chris. Yeah.   Yeah, for sure. I mean, we could talk for hours, I love that we talked about, first of all, it's really interesting just to get your take on things and to hear from another person who's doing the same thing, But also, you know, I love the fact that you were talking about the energetics of it, because I think that when you do this long enough, you start to see patterns and you could start to see how emotions can really constrict the chi, you know, from our perspective.   Marc Sklar (39:38) Yeah, sure.   Michelle (39:39) So I think that that is really important because yes, we could look at all the little details and the numbers and the stats, but the energetics aspect, we can get so kind of like focused on the small parts. And then sometimes it's good to kind of go zoom back and see the bigger picture. So I thought what you said about that to me was very, very powerful.   Marc Sklar (40:01) Yeah, all of these things, like everything we talked about today is so valuable for those individuals who need that specific message, right? Like we're all in a different place and we all have our own journey, but hopefully, you know, the messages we shared today and the information we shared today really resonated with those who are listening.   Michelle (40:10) Yeah.   I'm sure they did for sure. mean, was a really valuable information. So it's been great having you back, Dr. Sklar. It's been too long and we should do this every so often because I feel like we're never going to really run out of things to talk about. Thank you so much for coming on.   Marc Sklar (40:34) I agree. I'm happy to be on any time. Yeah,   Yeah, I appreciate it and wishing everyone success on their journeys.