Dr. Angela Thyer and Judy Simon discuss their book 'Getting to Baby' and the importance of nutrition and lifestyle in fertility. They share their backgrounds and how they came together to help women improve their nutrition and health for better fertility outcomes. The book covers the connection between food and fertility, the importance of whole foods, debunking misconceptions about diet and fertility, and the benefits of intuitive eating and cooking. They emphasize the need for diversity in food choices and the impact of processed foods on fertility. The book also includes practical tips and recipes to support a healthy pregnancy journey. The conversation covers topics such as the importance of breakfast and meal timing, the impact of nutrition on fertility, the role of integrative medicine in fertility treatment, and the power of lifestyle choices in influencing fertility outcomes. The guests emphasize the importance of combining foods and the role of vegetables in supporting digestion and overall health. They also discuss the impact of stress, sleep, and epigenetics on fertility. The conversation highlights the need for a multidisciplinary approach to fertility treatment and the importance of finding a supportive healthcare team.   Takeaways

• Nutrition and lifestyle play a crucial role in fertility and improving fertility outcomes.
• Eating whole foods, including a variety of fruits, vegetables, plant-based proteins, and whole grains, is important for fertility.
• There are many misconceptions about diet and fertility, such as the need to cut out carbs or follow specific diets. It's important to focus on nourishing the body with whole foods.
• Intuitive eating and cooking skills are valuable in creating a healthy and sustainable approach to nutrition.
• Diversity in food choices is essential for optimal fertility and overall health.
• Processed foods can negatively impact fertility, and it's important to prioritize whole foods.
• The book provides practical tips, recipes, and a six-week blueprint to support a healthy pregnancy journey. Breakfast is an important meal for fertility and overall health. It is best to have a substantial breakfast with protein, fiber, and vegetables.
• Meal timing is crucial, and it is recommended to have more calories earlier in the day and fewer at night.
• Combining foods, especially vegetables, can support digestion and nutrient absorption.
• Stress, sleep, and lifestyle choices have a significant impact on fertility outcomes.
• Epigenetics plays a role in fertility, and lifestyle choices can influence gene expression.
• A multidisciplinary approach to fertility treatment, including integrative medicine, can provide comprehensive support.
• Finding a supportive healthcare team is essential for navigating the fertility journey.

  Guest Bio: Judy Simon Judy Simon, MS, RDN, CD, CHES is an award winning registered dietitian nutritionist who specializes in reproductive health. She is the founder of Mind Body Nutrition, PLLC and a clinical instructor at the University of Washington. Judy's expertise includes fertility, PCOS, eating disorders, weight inclusive medicine and reproductive health.  Judy has held leadership roles in the American Society of Reproductive Medicine Nutrition Special Interest Group and is a Fellow of the Academy of Nutrition and Dietetics.  Judy integrates mindfulness, intuitive eating, eating competence, while taking a non-judgmental, inclusive down approach to help people have healthier, more fertile lives.  Judy is the co-founder of Food For Fertility program and co-author of the upcoming (April, 2024) book Getting to Baby A Food-first Fertility Plan to Improve Your Odds and Shorten Your Time to Pregnancy, Ben Bella Publisher   Guest Bio: Angela Thyer Angela Thyer, MD is board certified in Reproductive Endocrinology and Infertility, Ob/Gyn and Lifestyle Medicine. She is a founding partner of Seattle Reproductive Medicine. Dr. Thyer completed her undergraduate education at Duke University, medical school at the University of Cincinnati College of Medicine, residency at Oregon Health and Science University, and fellowship at the University of Texas Health Science Center at San Antonio. She completed The Culinary Coaching program through the Institute of Lifestyle Medicine in 2020 and became a certified plant-based chef through Rouxbe in 2022. She and Judy Simon, MS, RDN created the Food for Fertility program and have co-authored a book coming out in 2024, Getting to Baby: A Food-First Fertility Plan to Improve Your Odds and Shorten Your Time to Pregnancy which highlights the best foods to optimize fertility.   Website & Social media links (Facebook, instagram, twitter)   Instagram: @angelathyermd Website: angelathyermd.com     For more information about Michelle, visit www.michelleoravitz.com   Click here to find out how to get the first chapter of "The Way of Fertility" for free.   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: So Angela and Judy, welcome. Angela: Thank you so much. We're excited to be here, Michelle. Michelle: So I'd love for you guys to give a background first. , I'm very excited to be talking about your new book, Getting to Baby. I would love for you first to share your background so people can know more about you and what got you to doing this type of work. Angela: Okay. Sure. I'm a reproductive endocrinologist and infertility specialist. So first I trained in OBGYN and then specialized in reproductive endocrine and infertility. And then I got board certified in lifestyle medicine. So, which is a more holistic kind of way to look at all healthcare, more of a preventive lens of like, how can we look at lifestyle measures to, you know, really help people in all phases of their life. Angela: And I've always been interested in food, nutrition, exercise. And so over the years, it just became a bigger and[00:01:00] bigger part of my practice. And I've always been interested in obviously hormones, but metabolism and Judy and I started working together at the university of Washington. And we found we had this common interest in really helping women, you know, work together to improve their nutrition and health, which subsequently leads to improvement in their fertility. Michelle: Oh, totally. Judy: And I'm a registered dietitian, as Angela mentioned, and my master's is in community health education. And I sort of went through traditional training, and when I came back and re entered, you know, medicine, gosh, about 20 ish years ago, all of a sudden, PCOS and all these things that I had never really learned about just came front and forward. Judy: And so I was fortunate to connect up with Angela and really do the deep dive into, Hey, what do we know about insulin resistance? How is this affecting fertility? And these were things that traditionally I hadn't been taught. [00:02:00]So really, I think we kind of joined each other's worlds. You know, I joined American Society of Reproductive Medicine and, you know, joined all the fertility docs. Judy: And You know, Angela would come to the nutrition conferences. So we did a lot of cross pollination and from that we went off and both started into private practices and she'd refer these amazing patients and we decided, wow, we're seeing them one at a time. Wouldn't it just be the coolest thing if we could start classes? Judy: So about 12 ish years ago, we started the food for fertility classes where we brought women in who were trying to conceive. Many of them had PCOS, endometriosis. unexplained, lots of different diagnosis. And that's who we brought the food and the people and the lifestyle into the classroom, which is really why we wrote the book. Judy: It's kind of, we took all our years of experience, science and knowledge and said, let's make it accessible to more people. Michelle: That's awesome. And so [00:03:00] talk about the book. What's in the book? And obviously it's for people trying to conceive, getting to baby. What were the top things?  Angela: Yeah. Well, we, we started off by, you know, kind of, we always want people to understand the whys, you know, why this, why that what's the connection, what's the underlying biology and physiology? And then what evidence do we know? A lot of nutritional studies about fertility or observational studies, like they'll a population will be observed and they'll say, okay, people who ate these kinds of diets or these kinds of foods had higher fertility and more successful outcomes than people who ate this kind of diet. Angela: So, you know, we, we want to, wanted to present all that information. So people kind of have background and good knowledge and can kind of say, oh, okay, well. Maybe that would be a good idea for me. You know, it's not, it's, it's a broad spectrum of what, you know, a good diet could look like. It's not just one thing. Angela: Obviously [00:04:00] mainly plant forward. Cause I think we all need to eat more fruits and vegetables and plant based foods. But there is room, you know, for some animal foods too, especially things like fish and whole fat dairy, which have shown to increase some fertility benefits. So, you know, we kind of go through all the food groups and talk about what's, what we, where we have evidence, what's good, what's not so good and what vitamins and minerals and nutrients they're adding. Angela: And then, you know, some of the biggest things that we're like, if you want to incorporate this, it's a really, it's a how to. Right. So we wanted to make it like accessible in this sense that anybody at home could be like, Oh, okay. I, gosh, I just want to add one little thing this week. What would I add? What can, what's my takeaway? Angela: What's my smart goal? So people can kind of set their own goals and try to move forward with that, making a little progress at a time. And then the greatest thing I think is sharing stories from our patients who are just fabulous[00:05:00] women who've been on their own journey. And we had so many stories, we couldn't even share them all in the book. Angela: But kind of telling these journeys that sometimes took months, sometimes took years and how they were able to incorporate changes and see changes in themselves. and feel increased energy and then kind of have improved fertility. Maybe if they had a partner, you know, their partner's health was also improving at the same time. Angela: And so many of them were successful either With natural conception, or if they were infertility treatments, having better success in those treatments and making better quality embryos that we were like, wow, you know, that's really what's in the book. So as much as we could share and keep it accessible and reasonable in length. Angela: That's, that's what the book's about. Michelle: I found it very user friendly and I really enjoyed the image of the plate and how half of it was greens, which is great because I do believe that it's so important to get the greens. And there's so many nutrients that you can get[00:06:00] from that. And you talked about some misconceptions too, like on treating PCOS and like common misconceptions on what to eat for fertility. Michelle: So I'd love to touch upon that. Judy: Yeah, well, one of the things that we tried to bring out in the book is when we first started doing our classes, a lot of the reasons women would be referred to us as we'll just go lose weight. So nothing, you know, focusing on their health and we're like, Oh no, no, no, this is not a weight loss class. Judy: This is totally about how to nourish yourself. And actually. Take away the shame and guilt in, you know, whatever size body you have being able to get the benefits of the nutrition and the lifestyle. Right? So, for example there's a lot of people that would come in with a whole list of foods that they thought they shouldn't eat because somebody told them that. Judy: And we're like, well, are you allergic to them? No. Well, okay, you know, here's a safe And that's what we tried to do in the [00:07:00] book. Like showing in all these different, you know, sure, maybe you can't tolerate dairy. Here's a sub, here's something else you can, you can place out so that everybody would feel included, that anybody could be in the classes, read the book and really get the benefit out of it. Judy: So when, when you talk about myths, probably the biggest one is, you know so many women are told cut out carbs. Cut out carbs and we're like, Oh no. Well, what's in whole grains and ancient grains. We know those inositols we hear about in PCOS. Guess where they come from? White beans, buckwheat. So we're saying where can you get these ancient grains are just so filled with minerals and also really showing that looking at the quality of carbs that you're choosing most of the time is actually going to be beneficial. Judy: And this is kind of relief for women to hear like, I don't have to starve myself. I get to eat and try new things. Michelle: Yeah. That's such a good point. And also, cause a [00:08:00] lot of times when people have carbs, it's simple carbs or juices where you're taking basically, even if it's fresh juices, like we're really meant to have the whole fruit, right? The fiber like, and digest it slowly so that it's not a sugar spike. I'd love for you to talk about that too, the importance of, of actually having the whole food. Angela: Yeah, we definitely talk about kind of it being a whole food diet because that is so important and The issue with I mean, yes, you can get some of the nutrients if you juice But you're also gonna get mainly sugar without the fiber if you've removed the fiber. So the fiber is so important both to slow down your digestion and really pay attention to gut health. Angela: And I know you focus a lot on gut health. You know, that's where so much of our health overall starts. And there's so many connections between the gut and the mind and the body and the hormones and everything else, every, every system. And so, having that [00:09:00] fiber in your diet, really from whole foods. I mean, especially plant based foods, right? Angela: Because animal foods don't have fiber, but the plant based foods really then is is great food for the microbiomes, the microbiome, our microbiome and the bacteria, the 3 trillion bacteria that live in our gut. And it helps create, you know, it's more anti inflammatory because so many people kind of can get. Angela: almost a chronic inflammation from not eating enough fiber, not feeding their microbiome. And then that can lead to more issues in more body systems that they may not even be aware of. But nobody is, you know, advertising whole foods, like whole foods. So much of what people see and kind of the noise that feeds in is just, you know, everything else that's marketed in a box or a bag or somebody. Angela: And so that's what, and so sometimes those help people put health claims on other products that [00:10:00] aren't whole foods and then whole foods kind of get neglected. And so, yeah, we definitely want to say, you know, it's important. And we talk about eating the rainbow and the colors because each colors, providing different phytonutrients. Angela: And so, you know, you want that broad range because the more diversity you have in your fruits and vegetables, the more diverse a microbiome you're going to develop, the better protection for your immune system and just make everything else work better in your whole body. Michelle: I love that you talk about diversity because actually a lot of people end up developing sensitivities even if it's healthy food that they eat all the time and it's important to have diversity because it really allows the body to get so many different benefits and also not get too intolerant of one specific thing. Michelle: The body likes diversity. Judy: Absolutely. And we really wanted people to feel inclusive with the book. So that's why there's so much [00:11:00]culinary medicine, like just basic skills. Here's how you can throw something together without even a recipe, you know, just really, you know, five steps to a great salad. What should it have, you know, different things like that. Judy: And we also wanted it to really highlight the, All the global cuisines. And so for example I see a large population of South Asian women, right? And so there's, there, there always were like their diets too high in carbs. And we talked about what are all the wonderful things that herbs that you're using, the dolls, you know, the pulses, but we tried to make sure we had things from all regions because unfortunately a lot of people here in the medical world, like, Oh, just eat the Mediterranean diet. Judy: We're like, Oh no, no, no way. That that's so exclusive. It's not inclusive. We want to talk about, you know, foods from, you know, West Africa or Central America, a lot of the indigenous healthy foods, and then also what's seasonally available. And so one of the things that we really tried to [00:12:00]share is a lot of different types of foods. Judy: Simple preparation, but let people start where they're comfortable. So if you're a chef that only has three or four recipes and you're still sort of using some are processed foods, maybe they'll start with adding a soup or adding some vegetable dishes or adding a salad and letting them know you're going to get benefits from those first steps. Judy: Because some people feel like, like I just talked to someone, she goes, I'm trying to be all in, you know, trying to be perfect. Do you know what I mean? Michelle: Yeah, Judy: And that's stressful. It's stressful to feel like you're getting a grade on your diet. And we want people to feel like it's fun. They're having a date night with their partner and maybe they're trying a new recipe in the book. Judy: Or they got inspired because there is a lot of pressure when people are trying to conceive. And the book is also for those people who are like, Hey, we want to get pregnant in the next year. What's the path to a healthy pregnancy? We have no idea how long it's going to take, but [00:13:00] what's going to prepare us? Judy: And you know, Michelle, that like 50 percent of pregnancies are unplanned. So a lot of people, you know, maybe they're exposed to a lot of those fertility disruptors, and if they would have known even a few months in advance, they could have decreased some of the risks, you know that could impact their fertility and pregnancy. Michelle: definitely. I remember seeing something, it was about a burger or like a chicken sandwich or something. It was a sandwich with a bun that the woman just kept in her closet and just saw what happened and it was not, it was not good. Breaking down and I'm like, whoa That is crazy. Like things are supposed to break down if they don't break down and they don't yeah Just break down like what happens in your body So talk about the importance of eating whole foods. Michelle: Listen, we're going to have processed food once in a while. It's not like, you know, end all be all like, it's not one thing or another, obviously, [00:14:00] but talk about the importance of really being intentional about choosing more whole foods in your diet.  Angela: Well, you know, I do think, I think that everybody's so different in what they eat, but I think that, yeah, the ultra processed foods and processed grains, so like breads, cereals, pastas, Anything it's just so it it's everywhere, right? It's it's you can't get away from it and it's become normalized And it and so it has become acceptable and ordinary And the problem with those foods is yeah, you don't need to say i'm not never going to eat that again But it replaces it, you know, it takes the place of whole foods. Angela: And so I think you know Where do you get whole foods? Well, it's hard to get whole foods You You know if you're eating If you're buying foods at convenience stores or fast food restaurants or even regular restaurants Sometimes i'm surprised that menus don't have Kind of like more vegetables available when we talk about the fertility plate[00:15:00] and the whole plate being half Vegetables, right? Angela: You're not going to get that in a restaurant, like the restaurant usually. So, you know, we, we have talked to women, we didn't really talk about this that much in the book, but like, I think some of the women gave us examples of, you know, planning when you go to a restaurant, gosh, what can I eat from this menu that would be more of a whole food, what are the, sometimes the side vegetables are something they'll order from some of those things to say like, yeah, I don't need to necessarily go for the most. Indulgent luxurious meal. I want to go for the whole foods cause I know that's what my body needs. So we talk about being intuitive eater or competent eater. It, you know, I don't think this is taught well in schools. So, you know, to, to be honest, nobody, it's nobody's fault. Like where you are, it's a growth opportunity for everybody to be like, Hey, I didn't really get this education growing up. Angela: My parents worked. I didn't, you know, I didn't cook that much growing up, but now I'm an adult. And I need to really learn about [00:16:00] nutrition and what my body needs and how to heal myself through food. And what that might mean is I need to cook more. And if I don't know how to cook more with whole foods, You know, there's opportunities to learn. Angela: There's so much now available on YouTube, or that's both good and not so good, but you know, you can find the good, the good things and learn to cook with whole foods and buy things like our book, which are trying to teach people almost some intuitive cooking skills. Cause you don't always want to be cooking from a recipe. Angela: You want to get some basic staples and some comfort in the kitchen and some things you really are good at, and then always build new and add new. Okay. But yeah, so that was like one of the tenants of our philosophy of how we taught was, let's talk about, you know, building a meal. Let's talk about what vegetables are going to be in the meal, what protein is going to be in the meal. Angela: And for us, that was mainly going to be a [00:17:00] plant based protein. So either beans, lentils. tofu or tempeh or edamame, so a soy based protein, or fish, since all of those have been shown to increase fertility. And then whole grains, those ancient grains, so not processed and kind of putting that all together and nuts and seeds and other things that provide those denser nutrients. Angela: And really starting with like cutting things up, like, okay, let's prep everything. Let's do the mise en place. Let's get everything ready. Let's plan meals. So you're going to have leftovers. because it takes work and effort. You don't want to put all that effort in and then only eat once. So you want to have some leftover meals that you can repurpose throughout the week or free some of these meals that you're going to be able to then thaw out next week or next month when you're more time pressed, and you know, you've got your own freezer meal that you've prepared that you're going to be able to thaw out and cook and have a nutritious, delicious, quick meal, right? Angela: So it's just a, I think it's a mindset, right? [00:18:00] It's a different way to think. And, and everybody can get there and just build that knowledge and build those skills. And that's exciting. Michelle: It is exciting. I find that whenever you're learning something new, like you, you make it more complicated in your mind. You're like, oh, I have to do this whole thing. But you don't realize, like as you learn it, you could really strategize and make it so much easier and cheaper. You could save money that way. Judy: Absolutely. Michelle, you bring up a really good point. And what's really fun is a lot of the women who've taken classes or patients of ours, like even after like two years after they have their baby, I'll get an email. You know, I saved all those recipes from class and I still love the, you know, the quinoa mango black bean salad. Judy: It's so delicious in the summer. I take it to parties or one patient just wrote me about the soca bread made out of chickpeas that they start to add them to their repertoire or you want to increase their self efficacy, their confidence and their competency. And then when they do eat out, you know, maybe [00:19:00] they do broaden and they, you know, they go for an Indian meal or an Asian meal and they know like, Hey, I'm going to order one whole vegetarian. Judy: So I get more broccoli and veggies like they know how to order and feel good. When they go out or they travel, you know, how can I take that and keep it better? And, you know, just really, you know, giving them that support. And so in the book, for some people, this is really new. We kind of do like a six week blueprint, but we also say like, If you feel pretty good on some of the skills and you've checked the box, awesome. Judy: Work on some of those things that you, you want to build up stronger in your repertoire. And if you feel like you need more time, I remember when our class switched to virtual and we started to go to every other week, the women were like, this is kind of good because I have more time to work on my goals. Judy: I kind of like that other, remember the every other week model? You could do that with a six week plan. Maybe I'm going to try to do this over twelve weeks, you know, three months, give myself some time to To try new things.[00:20:00] And the thing is you're getting the benefit with every step you take. There's a benefit, you know? Judy: And so the cool thing for us is sometimes at the end of the class, women who didn't eat in the morning, they like. You know, we started eating in the morning because of class and the food was really good. They started regulating their cycles, Michelle. It was amazing. And one of our last live classes before COVID, I remember one table of four, they were all kind of waiting to get their cycles and things and getting ready for IVF. Judy: And they all went on to conceive. They all got their cycles and went on to conceive. And that was just, the cost of food and, you know, putting a little bit of time in so that lifestyle does make a difference whether someone's going for art treatment or they're, you know, they're, you know, they're just maximizing their fertility options. Michelle: Yeah, there was actually a study on girls in college that skipped breakfast and how it impacted their cycles I thought that was interesting[00:21:00] Judy: I would guess negatively. I'm thinking if Michelle: Negatively, yes negatively. Yeah. Yeah, Judy: You know, I just want to check. Michelle: They most of them started regular and it they became irregular. Judy: You know, and people are getting into a lot of fads where they're really time boxing their food. I just talked to someone in a smaller body and she says, I'm trying to eat clean. So I only eat between this time and this time. I go, Michelle: Mm hmm Judy: you should eat when you're hungry. Your body needs nourishment all day, not just eight hours. Judy: So sometimes we see people that are going to overboard. And they're restricting, and then their reproductive axis is not getting the nutrients it needs. And I'm like, that's not what you want to do for ag health. That's not what you want to do for reproductive health. If you feel cold at night and you're, and, and you know, and as we know with, you know, acupuncture and Chinese medicine, energy is such an important concept. Judy: So if you're freezing all of a sudden, and you're starving [00:22:00] yourself, you're not nourishing your body. Michelle: Absolutely. And actually in Ayurvedic medicine, they say that when the sun is out, that is when, because we, you know, we, we respond to the elements. And when the sun is out, especially like around 12 PM, you should have your largest meal because it increases your own digestive fire because we get influenced by nature. Michelle: And actually the morning you should have breakfast, you should have food during the day when the digestive fire is. Increase the most and when you shouldn't is as it gets darker like a couple hours before you go to sleep That's when you can give your body a break. So it kind of According to Ayurveda, it's a little bit more flipped than what's typically done where people skip breakfast. Angela: Right. And, and, you know, that, that exactly parallels some of the metabolic studies, right? So what Ayurvedic medicine is known for so long, right? And then Western medicine has to come and prove it that like our digestion is[00:23:00] better in the morning and the way glucose and, and. nutrients are processed in the morning is better when we have more energy and we're more active throughout the day. Angela: And then at night, things are winding down and slowing down and you want your body to relax for sleep and not be digesting a big meal. And, and we do talk about that, but it is really hard for people to flip to try and get more calories and earlier in the day when fewer at night when the typical pattern is, is the opposite. Michelle: and it's going to give them a lot more productivity and energy to have a good breakfast because you know, protein, you got those good fiber and vegetables and berries and, really start your day right. Judy: We encourage people if they're really set in a way, we're like, we'll do it as an experiment. Be curious. Try it on the weekend. Maybe try it on the weekend because you don't want to change your flow. See how your energy feels, especially when people are telling us they're fatigued. Judy: They're like, I'm so tired. And it's [00:24:00] like, and most of their energy intake is at night. They wake up not hungry. You know, we do try, you know, try to flip that around and that's part of that intuitive eating and eating competence and see where your body, because really people know a lot about their body and so we want them to be in tune to that too and trust that. Angela: And I was just going to add that, you know, sometimes people have these ideas of what a typical breakfast, lunch, and dinner is and what food should be part of those meals. And we say, Hey, that does not have to be the case either. I love a breakfast salad. I love eating my leftover dinner from the night before for breakfast. Angela: If I've made something delicious, I made this great stir fry and I've had a little bit because it's late, but I'm like, I want to have that for breakfast. I'm going to have a big bowl, you know, so I love having those other things early in the day because I do feel like it gives me great energy. And then the other thing that we talk about is, you know, the[00:25:00] walking after meals and especially getting outside early in the morning and getting that sunlight to really Start your day and, and get your clock going and how important those rhythms can be to recognize that you have, your body has a rhythm, sleep consistency is important, exercise and movement throughout the day is important, all these other things that we want to build in, you know, to our base for overall wellness to support fertility. Michelle: Yeah. I love it. I love it that you're a doctor and you're interested in this because unfortunately it's not as common. Like people don't know about all of these things about really connecting with nature and the nutrition aspect of it. So it's amazing. It's so well rounded because you have like so many different backgrounds and perspectives on Judy: We, we, we, yeah, we try to bring it all together and that's why this book would have been much longer if our publisher didn't say stop, you know, it was like twice as long. You'll see when you're writing your book, you want to share everything. And so we did include [00:26:00] two chapters on like boosters and disruptors, you know, talking about stress and sleep. Judy: And then also some of the disruptors like, you know, alcohol, cannabis, endocrine disruptors, because we didn't want to scare people, but we felt they needed to know. And you know, science based, evidence based, but we did put it at the end. You know, we really focus on the food and feeding yourself because really that's what our program is all about. Judy: But we find that when they put it all together and they get to those boosters and they add the movement and the stress and so many of our patients, patients who do acupuncture will say, well, that's one of the ways I always say, what do you get out of it? Cause I always want to know. And they go, Oh man, I'm such a good place to do. Judy: I leave in my stress level is so much better. I go, then that's something you want to include in, in, in what you're doing for your health. If you have the privilege and you have the accessibility to it. So we, we try to make everything accessible. Because there's so [00:27:00] many women and men who don't have access to medical care when it comes to fertility. Judy: It's really the underprivileged do not have access or such limited access that we thought if we could at least cover the main things and it could be, you know, available in libraries or, you know, things like that and audio books that that would be a way that more people could really have that information. Michelle: Well, it's great information. And also, I love that it talks about. combining foods, in Chinese medicine, we have a lot of formulas of herbs. So each herbal formula has different herbs and they work together as a symphony. And a lot of times they'll include ginger or digestive herbs to help assimilate. Michelle: So working together, And a certain symphony is what makes it that much more beneficial for the body. And I like how you talk about the importance of combining foods. You were talking about putting [00:28:00] vegetables because if you just eat meat without vegetables, it's not going to be able to simulate as well and digest as well without those vegetables helping in that fiber. Angela: Right. The vegetables are actually pretty protective, right? So I mean, there, you know, there have been studies that look at people who eat just more of an all meat diet and then people who eat more of a vegetable based diet, but with meat and the gut is healthier, right? If you incorporate those vegetables the, the, because the fiber from the vegetables is so protective. Angela: That then you are able to digest the, the meat and make use of the nutrients in the meat as well. So I think that's, that's great advice. And I think that, you know, out here we're in Seattle. And so we have a lot of, you know, we have a number of people who are trained in acupuncture. They are, you know, trained in traditional Chinese medicine. Angela: And we have always basically said, you know, gosh, I don't know that area, [00:29:00] but I trust. The practitioners in my area who knows so much this has been around for so long that let's, you know, combine and talk about the best of all worlds and support everybody's health. And then the same with fertility clinics, like some people really are going to need that extra step of a traditional IVF clinic. Angela: They might need insemination. They might need IVF. And then all these other things are going to be supportive and enhance their success because it's so expensive. And the last thing you want to have to do is multiple cycles. And so the more efficient you can make each cycle by bringing your best self forward into the process and taking the time, like a lot of people, you know, want to kind of take a lot of time to get to a fertility clinic. Angela: And then once they get there, they want IVF yesterday. Like they want to be pregnant yesterday. So And it's still really about the time and the investment in, [00:30:00] you know, producing optimum health for you and your partner. And so that, you know, it might take a good three months, right? Of preparation to say, let's make sure when you do IVF, if you need IVF and you're going to do it, that everything's perfect. Angela: As great as you can make it going into the cycle instead of just like, Oh, there's an opening next week. Let's get started. You know Michelle: I wish all reproductive endocrinologists spoke like you Angela: Oh, yeah. Thank Judy: she, and she, and she walks the walk, you know, for all the patients we've had together. A lot of times after that initial consult, she'd be like, okay, I want you to do, you know, food for fertility and work on nutrition and lifestyle for three months. You know, let's see, you know, what we can do with some of these biomarkers that are, that are elevated in a very positive way. Judy: And then quite often during that three months, a woman starts cycling. I always, I remember saying to Angela once years ago, I go, What if you put the [00:31:00] fertility clinics out of business? I mean, we were kidding, you know, when I said that they have the role. So please don't think I'm saying that, but you know, we did. Judy: And she's like, great. She was like, wonderful. Let's help people on the easiest journey. Let's not, you know, when someone gets sent to me and they've already had three failed IVFs. for whatever reason. And they're like, okay, I want to work on my nutrition. I'm so happy to work with them, but I feel really bad because they're pretty wounded because they've been pretty disappointed and let down. Judy: And sometimes it was something obvious that nobody ever brought up, you know, their eating disorder, their PCOS, that things could have been optimized first. So I think that's where we all work together. So I feel like that's why when you work in integrative planning, You know, practices. We, we work with, you know, fertility yoga instructors that we really trust and, and, and, and D's and dietitians and, and, you know, we know which clinics are going to be weight shaming, you know, we want to know [00:32:00] where can our patients put the best team together, where can they get support groups from resolve or other organizations so that they feel as fully supported as they go on this journey, because a lot of people, Never expected this. Judy: They just, I went through unexplained infertility for years. Never thought that was in the bags for me, but it was like. You know, you feel helpless. So having a community, and I think when we all work together interdisciplinary, you know, and we know the best people to send our patients to, or best organizations, or how to check, we really help them. Judy: We really, we really can help. So we're excited about you, you know, your future book. Yes. I mean, you know, I was just coming first, but yeah, looking for resources is so important, Michelle. Angela: And I, right. And I think, you know, those resources are great. And then also if somebody is seeing somebody and it's not clicking. You know, it could be it could be their doctor. It could be their [00:33:00] dietitian. It could be whatever They you don't have to stay with the same person. You can actually go get another opinion you might You know, click better and work better with someone else who Has different information even it's not all the same. Angela: So each of us don't necessarily provide the same information or You know, it's an art and a science and I think we all feel that that we connect with people It's so important, but we all connect differently And and as an individual each person should really You Make the most of that and, and really make that work for them. Angela: They're the ones they're invested in it. Michelle: That is so true. Absolutely true. I've seen people who have been going for years to one reproductive endocrinologist and then when they changed different approach, different energy, just like, and it was a different outcome, Angela: Yep. Michelle: you know, it happens.  Judy: And if you make a change, [00:34:00] no one's mad at you. We all want the same end result. I always tell them all the clinics in this town, they're all friends. They all know each other, you know, professionally, they all know each other. They're going to send your charts. Judy: They're not going to hold them back. You know, everybody does want a positive outcome, you know, to take place. Michelle: Yeah. Yeah. That's great. I mean you know, not always the case, , but when it is, it's amazing, and it's true you really do have to find that alignment and I always say, you know, it takes a village and creating a team of different people that can support you in different ways. Michelle: When going through this, but of course nutrition is so important in Chinese Judy: We all eat. Michelle: Yeah, we all eat and we eat for a reason a good reason, right? Angela: Mm hmm. Michelle: And the spleen and stomach are actually the center and they're like the mother in a sense, you know the nurturer Aspect of our bodies and that is really where everything else gets built they [00:35:00] talk about pre heaven chi pre heaven energy in the kidneys And of course the kidneys are really important But sustenance, the energy with which we can sustain and increase after our genetics is food, Angela: Right. And I think, you know, that's just kind of being understood. I mean, I think in science, Yeah. We now are recognizing, you know, there's genetics, and then there's epigenetics, which is how the genes are expressed and the epigenetics is how we influence which genes are expressed. And that has to do with our nutrition, our stress. Angela: Our sleep, our movement, our community, our mental disposition, our mental health, our optimism. All these things have a huge impact in our health by the epigenetics. And I think people sometimes think it's just genetics and things are. A predetermined and it's going to be one way and it's totally [00:36:00] not. You have so much influence as a, as an individual about what path your life can take and how your health is affected by these decisions you make every day. Michelle: which is so empowering, I think, to know that you actually can have a hand in your Angela: Mm hmm.  Judy: , I was just thinking we almost wanted to add a whole another chapter on epigenetics, but we had to pull it back. So we just kind of sprinkled it in, you know, the lifestyle things. But even when we work with people who are using donor eggs, their health will have an impact on these epigenetics. So that really empowering that mom, you are the full mom, you know, even with a donor egg, what you eat, your life, your health. Judy: Is going to have an impact on your baby. And I think that really helps people to know that Michelle: That is such a good point. It's really true because it's, it's all important. It's all parts of the [00:37:00] whole.  That's where you do have control right over your lifestyle. And these some of these decisions because you don't always have control over your fertility. I mean, certain aspects are just out of your control, and you do feel that helplessness. Angela: And so I think where you can feel good and feel empowered is, you know, these are the actions I can take. These are the steps I can take. I am making progress. I am growing as a person. I'm helping myself. I'm helping my community. Whatever the case may be, I try to recommend not kind of losing yourself in just trying to get pregnant. Angela: Really recognize your, yourself as a whole person and all the things you are providing to, to your community through purpose and service and love and, and everything you're doing is just, it's key to who you are and it brings you strength and peace. And that's just really [00:38:00] Great to know and you, those are decisions you can make. Angela: That's not something out of your control. Michelle: That's so important. And thank you for bringing that up and you guys, I could talk to you guys for hours cause you know what, you know what I love? Well, first of all, your knowledge, you guys are very knowledgeable about what you're talking about, but the passion , and the compassion. With which you are operating  Michelle: I think we both have one major thing in common is that we love this community and it's a beautiful community to serve. And so for people who want to find you or read your book, how can they find you? Judy: Well, the book is available at all major books, booksellers and many of the independent ones request it getting to baby book.com. It will be released April 9th. So I'm not sure when this is released, but April 9th will be released. It can be pre-ordered. You can follow me at Fertile Nutrition or on my website, mindbody nutrition.com [00:39:00] and Angela. Angela: And you can also request the book from your library. So libraries don't automatically stock books, but if individuals make a request to a library, the library can order the book. So that's something to know as well. And then I'm at AngelaThiremd. com or at AngelaThiremd on Instagram. Michelle: Awesome. It was such a pleasure meeting the two of you. You guys are so nice and so knowledgeable and just really lovely to talk to. So thank you so much for coming on the podcast today. Angela: Thank you, Michelle. Judy: Michelle. Thanks, Michelle. Angela: to you as well.