Fertility Foundations: How to choose the best IVF clinic with Dr. Rahi Victory
Welcome to the latest series of Fertility Foundations, where we speak in depth with expert guests about how to prepare the foundations for healthy pregnancy. This week Sandra Greenbank is talking to Dr Rahi Victory from Victory Reproductive Care.
Dr. Victory is a board-certified Obstetrician, Gynecologist and infertility specialist dedicated to helping improve the reproductive health of men and women. He is a Fellow of the Royal College of Surgeons of Canada and Fellow of the American Congress of Obstetricians and Gynecologists. His passion for promoting reproductive health is reflected by his deep commitment to educating and helping patients, his active involvement in fertility research, and also for creating a multidisciplinary clinic environment that embraces patient-centred and holistic health care.
Find Dr. Victory on Instagram here: www.instagram.com/rahivictory.md
Follow him on YouTube here: www.youtube.com/@DrVictory
You can also contact him via the Victory Reproductive Care website: https://www.drvictory.com
This podcast is sponsored by Invivo Healthcare, a human microbiome company. They specialise in accurate testing of different microbes such as the gut, vagina, oral and urinary, as well as a range of specially curated supplements focused on the microbiomes. They support healthcare providers and their clients navigate the complex world of the human microbiome and it’s one of the most use labs and supplements by our own fertility specialists at the Fertility Nutrition Centre. Visit the Invivo website for more information at www.invivohealthcare.com.
Podcast transcript
Sandra 00:06
Hello and welcome to the Fertility Foundation’s podcast, where we go into detail about how to prepare the foundations for healthy pregnancy. We dive deep into the underlying root causes for fertility issues and natural solutions. I want you to know that you’re not alone and you’re not broken. I hope that by sharing these episodes, it will help you move from feeling overwhelmed and lost to feeling hopeful and empowered to take charge of your own path to parenthood, because there are actually lots of things that you can do to help rewrite your own story. I’m Sandra Greenbank, Nutritional Therapist, functional medicine practitioner, coach and educator, specialising in fertility, pregnancy and postpartum health. I’m also the founder of the Fertility Nutrition Centre, where you can find fully trained experts in nutrition, lifestyle and functional approaches to healthy fertility and pregnancy. You can find out more information over at www.fertilitynutritioncentre.org and also begin a free strategy call with one of our experts.
Today I’m speaking to Dr. Rahi Victory from Victory Reproductive Care. Dr. Victory is a fellow of the Royal College of Surgeons of Canada and fellow of the American Congress of Obstetricians and Gynaecologists. He is a Board Certified Obstetrician, gynaecologist and infertility specialist dedicated to helping improve the reproductive health of men and women. He is fully licenced in both Canada and the US and welcomes patients from all backgrounds to his State of the art clinic, also called Dr. Victory. His passion for promoting reproductive health is reflected by his deep commitment to educating and helping patients, active involvement in fertility research, and also for creating a multidisciplinary clinic environment that embraces patient-centred and holistic health care.
This podcast is sponsored by Invivo Healthcare, a human microbiome company. They specialise in accurate testing of different microbes such as the gut, vagina, oral and urinary, as well as a range of specially curated supplements focused on the microbiomes. They support healthcare providers and their clients navigate the complex world of the human microbiome and it’s one of the most use labs and supplements by our own fertility specialists at the Fertility Nutrition Centre. Visit the Invivo website for more information at www.invivohealthcare.com.
Now let’s get into today’s interview with Dr. Victory. Thank you so much for joining me on my podcast.
Dr Victory 02:30
My pleasure. Thank you for having me. It’s, it’s a pleasure and an honour to be here.
Sandra 02:34
So just before we launch into all my questions, would you mind introducing yourself to those who don’t know you?
Dr Victory 02:40
Sure, my name is Dr. Rahi Victory. I’m a reproductive endocrinology and infertility specialist in Canada, but I am double board certified both in Canada and in the United States. And I tend to have a bit of a different approach to fertility, it’s very sort of patient-centred and patient focus. And our goal is always to help patients achieve their fertility their way. So we don’t push an agenda or push IVF or push one treatment over another, we really just focus on what your goals are, and what is best for you and your family. And then try and formulate a plan that really fits your needs. And of course, it’s different for everybody. So sometimes there’s options and other times there’s, you know, fewer options, but generally speaking, we want to present people with the information they need to make an informed choice that’s right for them.
Sandra 03:36
I mean, that all sounds so simple, but actually, it’s really revolutionary. And then the fertility space, isn’t it? Because all I see is the cookie cutter approach. And this is why I wanted to speak to you because you know, it’s sort of those who are forward thinking and open minded, who are going to be the ones who are going to promote both sides, not just IVF or just natural fertility, which is just not possible. But like you said, it’s very individual.
Dr Victory 04:05
For sure. You know, we have and I love the fact that you use the term cookie cutter because we have a very well known expression on a social media programme that we do every week where we say we’re not baking cookies, we’re making babies. So I am very opposed to cookie cutter approaches to fertility care. Cookie Cutter approaches are good for making money, but they’re not very good for helping patients. And we know that everybody has a unique background. They’ll have a unique biology, whether it’s on the male side or the female side, they will have unique needs. And so all of that has to be addressed in order to approach this in a meaningful and frankly efficient fashion. And if you just apply the same medicine to everybody. It may end up working it may not but it’ll definitely be more cost Believe less efficient. So for example, if I treated someone with completely normal fertility history, good Hmh strong ovaries, reasonable sperm, maybe they just have blocked tubes, the same way that I was going to treat someone, for example, who has endometriosis, my endometriosis patient is not going to get optimised care, they need a whole other approach. You just can’t equate those two patients together. Same thing for someone with PCOS, same thing for someone who’s got much weaker ovaries or a male with very poor quality sperm. So it’s critical to really think about the individuals involved, and then think about what their goals are, do they want one baby? Do they want to a football team, whatever the case is, and then custom tailor your fertility care for that family, it really doesn’t make sense to do it otherwise. And unfortunately, it’s true that the majority of fertility centres right now are so financially focused, that they really are looking at how do we maximise doing more IVF? Because there’s no question we all myself included, make money when we do IVF. And so if you’re pushing people into that, it’s great for your bottom line as a as a clinic, but it’s definitely not great for the patients. And it’s even worse, when you’re just doing a cookie cutter approach because then not only are you pushing them into potentially unnecessary treatment, you’re pushing them into potentially unnecessary treatment, that’s not even optimised for those patients.
Sandra 06:39
And unnecessary debt and trauma and everything that comes into, you know, the rounds of treatment. I mean, I, I had this realisation because I used to think that a fertility clinic was a fertility clinic. But but but then I realised that a fertility clinic is actually an IVF clinic, generally speaking, you go to a fertility clinic, thinking your fertility is going to be optimised but actually, you’ll be sold IVF in lots and lots of instances.
Dr Victory 07:10
Yes, yeah, I agree wholeheartedly with you. I wish that wasn’t the case. But I can tell you that definitely in the UK, certainly in North America, Canada and the US, it’s a little bit better. In Canada, it’s terrible in the US, when you walk through the door, they have something called a conversion rate that they actually use as a metric. And that conversion rate is how many people that walked in the door ended up doing IVF. And that’s what’s important to them, because it’s critical for generating income. Whereas for me, a I’m very religious and bi, I’m very, very keen to be, you know, sort of very good at what I do. My goal is never to optimise or to maximise, I should say, the IVF numbers that we’re doing, if anything, I’ve been telling people like the true mark of a good fertility specialist, is how many people we can get pregnant without doing IVF. Anyone can succeed with IVF. It’s succeeding without IVF that really shows that you are paying attention to the details. So you know, if if you’re looking at focusing on the patients and what’s good for them, you’ll figure out what’s wrong, you will inform the patient, you will advise them of their options, and then you let the patient make a informed choice. That’s right for them. There’s no question sometimes it’s going to be IVF. But lots of times it’s stop smoking, stop drinking, stop using drugs, lose some weight, have sex more frequently, or in very rare cases, less frequently. Take some vitamins and so on. So you know, we have some very simple, elegant solutions that are essentially cost neutral or cost free. And then we have some cheaper options like insemination where it’s necessary. And in many cases, surgery is what’s indicated. And that often gets ignored because they’re trying to push people into IVF. And surgery is always a delay and be your patients actually may succeed. If you find something surgical like endo endometriosis to correct in which case now you’ve lost, so to speak of potential IVF patient and fertility clinics don’t like that. I do love what you said, you know, I’ve never thought of it that way before. But now that you say it that way, it’s true fertility clinics have become IVF clinics, and they’ve lost sight of the fact that we’re supposed to be helping people with their fertility, which can mean a variety of different things.
Sandra 09:41
Yeah, I think I mean this I’ve been doing nutritional therapy for fertility now since 2009. So a really long time. And I was working with clinics at the beginning. And then I noticed that the more of their patients that were getting paid Without IVF, the less referrals I got, and then the end, they were like, we’re not going to send any more to this, you know, to have because this is not what we wanted. We wanted to they, I imagine that they wanted to improve their outcomes, but they didn’t actually want to not do the treatments.
Dr Victory 10:18
Yes, whereas for me, you know, I look at any patient that avoids IVF as a win, it’s not a financial win, but none of us are going hungry, right? So fertility, places that are pushing people into IVF, are purely looking at their bottom line. They’re not looking at what’s best for the patient. So for me, if I can help you succeed and get you pregnant without doing IVF, I feel like I’ve really achieved something. I mean, again, IVF is a wonderful tool. But you know, it’s not needed for every single case. In many instances, we don’t need IVF. And when you can avoid it, you’ve really achieved something for the patient, you’ve avoided a lot of the trauma, you’ve made it a safer, more natural process, you’ve saved them 1000s upon 1000s of dollars, you’ve potentially saved them a lot of heartache from an IVF failure. And so these are really important things. You mentioned trauma. I mean, trauma is a big part of what we deal with, with our patients. So you know, avoiding all of that and optimising patient’s care. That’s really the true mark of a great fertility specialist. Everybody else is practising business. They’re not practising medicine.
Sandra 11:33
I agree. And I think that you, you mentioned that sometimes, you know, you might recommend some vitamins, and I know that you, a, you know, you, you run some tests and look for deficiencies and, you know, correcting those ultimately is going to have an impact on that month that mums pregnancy and the baby’s health, but also future health, because this is about the genetic imprinting into the child in utero and before conception as well. So ultimately, you know, you’re creating healthier families, if you’re correcting those things upfront. All
Dr Victory 12:06
for sure. Yeah. And I, I actually find it kind of appalling that fertility centres are not paying attention to the holistic approach. I mean, we very much favour the approach of looking at the nutrition looking at their overall well being, making sure that they’re not exposed to smoke and drinking marijuana, any drugs. We try and optimise patients weights. We talked a lot about diet. We have nutritionists that we work with here as well. And then we have an onsite naturopath at each of our clinics. So we very much favour that holistic approach. Because yes, of course, the science part, which is my part is important and and oftentimes critical to success, but it’s not everything. And if if I can get 5% or a 10%, or God willing a greater percent success rate by also accommodating all of these other elements. Why wouldn’t I do that? And I find it really horrifying that other places don’t pay attention to that because A, again, many people only need that and they don’t need the big gun of IVF. And also, you know, why would you not want to optimise care, like if the only reason to not optimise care is to bring patients back for more cycles of IVF. And I can’t do that I’m, I’m I’m too religious to do that. So for me, I feel strongly that patients deserve the best care on their first try. Not on their second, third trial.
Sandra 13:38
I agree and do you but do you think that like because they always think oh, you know, it can’t it can’t possibly be that people are so led by finances? And maybe, maybe it’s because they don’t know? Have from your point of view? Is there information out there? There’s sort of as in your face as it is for me because I think you’re living and breathing this information. For me it’s sort of a non you know, it’s a non negotiable, but I wonder if clinicians just don’t come into contact with this information unless they really go looking for it. Okay,
Dr Victory 14:09
so I’m gonna give you my very biassed personal opinion here. And so forgive me if I’m stepping out of bounds. But as a general rule, I find that fertility specialists are a very obstinate, stubborn, entrenched group of individuals who have learned how to do one thing, maybe too, and they are completely unwilling or in some cases in unable to consider alternatives. And so in many ways, the the learning curve ends the minute they hand you a licence and a an IVF. egg retrieval needle unsay fire ahead. I mean, they stop poking into the books and they start poking the patients instead. And so I find Many times that fertility specialists are either unwilling to learn something new, or are just so entrenched, they won’t even try. And then there are in some cases, there’s a famous clinic in Toronto, not far from where I am where the owner literally said, don’t make the success rates too high, it’s going to cut down our return business. And so they’re looking to only get a reasonable success rate. So that people do have to do those repeat cycles. So, you know, I, I do feel very strongly that fertility specialists who own their own clinics, such as myself, in large part are very stubborn, very obstinate, they don’t want to change anything, because they’re comfortable with where they are. And if you go in and you say, Well, why aren’t you looking at the immune system? Or why aren’t you looking at diet? Or? Or why are you doing useless tests like the era, they just aren’t willing to listen? I’ve had chats with some very famous colleagues, social media, you know, wunderkind who have ended up refusing to acknowledge scientific articles, which were randomised controlled trials demonstrating that something didn’t work. They just they won’t accept it. And I’m, I’m sitting there baffled, because, I mean, that’s the basis of our learning. Right? So we are a very stubborn group, I have to say, I’m proud of our team. Because we’re not stubborn, we’re willing to accept, we’re willing to try we were more than willing to experiment to learn if something is beneficial or not. But getting others to do that, wow. It’s not easy. For sure. It’s not easy. And it’s it’s particularly bad in Europe, I’ve dealt a lot. Oh, yeah. I’ve dealt with UK physicians, German physicians, I mean, you’re, you’re hitting a brick wall, like it’s impossible to get through to them it is. And even in the US and in Canada. You know, we offer our services to other clinics, where I tell my patients who contact me from other centres, like don’t move your embryos I, you know, you don’t have to come to us. Let me see if I can work with your team, we’ll tell them how to do things better give you our protocols, you can’t get anyone to accept that because they’re they don’t want to change what they’re doing. I
Sandra 17:31
don’t find it hard to believe, because I have seen things with my own eyes. But I find it difficult to understand and to get my head around. And also, I think that the idea that you’re getting repeat business by providing a poor service is flawed. Because surely word of mouth, you know, we’ll have people coming and talking about your clinic, and you’re getting more business in that sense, because they’ve had a good experience.
Dr Victory 17:58
Well, word of mouth is detrimental when people know enough to complain. And the problem is that essentially patients come in, they’re told they should do IVF. They try the IVF. It doesn’t work, they go back and they say Why didn’t it work? And the doctor says immediately, well, it always doesn’t, or it doesn’t always work on first try. So let’s try another cycle of IVF. And they may try a second cycle of IVF. And then they’ll tell you, Oh, well, you have bad egg quality, or we didn’t get enough, we need to do it again. And by the time you’re at the point where you’re realising maybe this isn’t a great clinic fit for me, or I’m not getting all of the information that I need, or they didn’t do all of the tests or whatnot, you’re 30 $40,000 into it, you’ve developed a relationship with your nursing team and your blood draw people in your ultrasonographer is and your physician. And it’s actually kind of hard to pull out of that and abandon that and then go and start fresh somewhere else. Because now you’re taking the trauma that you’ve just gained. And you have to carry that burden with you somewhere else where you’re not terrified, you’re going to be traumatised again. And so it’s it’s only easy to see the word of mouth have a significant impact. If the patients go in knowing they need options, they need to know why they’re getting the treatment that they’re getting. They need to know is the protocol that I’m getting the appropriate protocol for me. And realistically, it’s very hard for patients to know if they’re getting all that that’s our job. And if and if we don’t do our job well or our job is biassed and we’re pushing you into something, well then the patients won’t know whether or not it’s going well or not right or what to expect. So we can’t kind of expect patients to go out there and complain or to create a fuss in an negative fashion, because they don’t know enough to know when to fuss? I do. And that’s why I create the fuss for the patients. So that’s why we have the social media programme that we do where we tell patients every week like, don’t do these tests don’t do this unnecessary treatment. You know, I frequently tell patients stop doing IVF figure out what’s wrong first, once you’ve figured out what’s wrong, then look at your options. But it doesn’t make sense to just plough people through the IVF grinder. Like, I hate saying that it’s terrible. It’s it’s very inhumane. And as doctors, our job is to be exemplary and being good human beings and, and to treat humanity. And we’re not doing that in the fertility realm.
Sandra 20:49
I think that’s really interesting. I mean, you’ll make that point. But actually, I think sometimes it’s not. The clinicians have the doctors fault necessarily. They’ve got their hands hands tied a little bit. And this article that we mentioned is called fertility startup with the profit mindset pushes doctors for more egg retrievals and was a Bloomberg article and it does talk about how the owner of the clinic pushed certain parameters on to the conditions and they were not happy?
Dr Victory 21:20
Well, there’s no question that the infertility world is being a highly sought after, as a very prized and valuable asset in any private equity or venture capital, effort. fertility clinics, generally speaking, are profitable, they do well, there is return business, even when you know, I do my very best not everybody will succeed on first try. And after people have had one child, they’ll often come back for a second. So this is very much a big business. And if you look at the statistics on fertility, right now, the estimate is that about 10 to 15% of the population is infertile, but that by 2030, that’ll be as high as 20%. So this is a massive growth market. Not to mention, we’re only actually accessing 2% of the fertility population with IVF. So 98%, who could be going into some kind of fertility treatment or not accessing necessarily all the treatments that are available to them. So business minded people are looking at this saying, I just hit the jackpot, like this is a great opportunity. But they then come in, and because their bottom line is the bottom line, they want to make money, patient care goes out the window, and they are forcing clinicians, practices, nurses, staff, everyone to be very financially minded. And to nudge or push or cajole or coerce or whatever term you want to use patients into doing expensive treatments, which are primarily IVF. So you know, you’re never going to find a business owned IVF or Fertility Centre that is telling patients, you know, to encouraging them to do insemination, because they don’t make nearly as much money from doing insemination. So I personally, am strongly opposed to having businesses owned by venture capital, private equity, for IVF, I think IVF should only be owned by doctors, and that those doctors have to have a good conscience and their conscience has to dictate healthy, appropriate moral patient care. Sadly, that is less and less the case these days. And just, you know, we don’t see it as much. I mean, I’ve been approached multiple times to sell my business. And I keep saying, because I know what would happen. I mean, I could walk away with a fortune, and I probably never have to work again. But I’d never sleep again, either. Because I know that the patients that I abandoned, were getting terrible care. And that’s actually been research. They’ve got data showing that the fertility centres or or even other medical businesses, like plastics, and so on surgery, the ones that are owned by these big venture capital, private equity funds, are actually substandard, or not providing the best quality care compared to the privately owned clinics. And so this is something that we have data on now. And they keep saying, Oh no, we do a good job. And, you know, we’re using the money to promote wider access to care. No, you’re not. You’re using the money to promote more IVF cycles under this guise of wider access to care. It’s not wider access to care at all. Like, do all of those patients need that treatment? Absolutely not. Oh, that’s
Sandra 25:00
really interesting that you mentioned that the prediction is that infertility rates are going to go up to 20%. In the next, I don’t remember what you said. But this is this is an accepted statistic. I think this is how it’s going, how it has been going and how the predictions are. And I know what I believe to be the root cause of death. But I would be interested to hear if you’ve got any theories as to why that’s the case
Dr Victory 25:23
as to why it’s the case that the businesses are going in there, you mean, well,
Sandra 25:28
the fertility fertility rates are actually declining or
Dr Victory 25:32
sorry. So yeah, I mean, we know some of it. So some of it is environmental. You know, we got a world did with BPA is and toxins and all sorts of pesticides and horrible diets. And Lord knows in North America, you know, if it isn’t greasy enough, we’re probably not enjoying it. So, you know, there’s a lot of environmental dietary determinants. We know that globally, men sperm is plummeting. I read a terrifying study, which said that by 2050, they anticipated that over 50% of men would have sperm that fell below the global standard for what is considered normal. So I mean, we know that male fertility is very compromised, stress, smoking, obesity, drug use, you know, infrequent ejaculation, infections, so on and so forth. There’s a lot of stuff that goes in there. And then from the female standpoint, right now, the biggest determinant is age. So because we now have everybody piling into the workforce, unfortunately, a lot of women are delaying their fertility. And because they’re delaying their fertility, the egg quality undoubtedly takes the burden of of that, you know, event. And when you’re dealing with egg quality, you’re dealing with lower numbers of eggs, lower qualities of eggs, higher aneuploid, or genetically abnormal embryos, and so very rapidly becomes exponentially more difficult as the age goes up. So we know when you look at a graph of fertility for women, up until 35, it’s fairly level, but you hit 35, and you hit the ski slope, with 37, being the middle of the ski slope, and, you know, kind of 3940 being where it starts to level off and your chances get difficult. We have untold numbers of women who are unfortunately, whether it’s for career or because financially, they have to are being forced into pursuing, you know, avenues of their life that are delaying their fertility. And then as a result of that we’re ending up with compromising the fertility potential that they have. So from all sides, we’re really taking a hit. And it’s no question that women are equally if not more susceptible, to those environmental factors and the weight changes and the dietary habits because you’re born with all the eggs you’re ever going to have. And so everything you do impacts all of your eggs all the time. Whereas for us as men, we can constantly produce new sperm. So if I was smoking, God forbid, because I hate smoking, and I, you know, had bad quality sperm. If I stopped smoking three months later, I’m making new sperm that was never exposed to the nicotine. So we have a whole other biological milieu, at our at our disposal, men don’t have that. And so we have to do a good job of educating our women when they’re young, so that they know what to do.
Sandra 28:48
What would you advise somebody who say they were in their early 30s, and haven’t found a partner yet do you speak? Would you advise somebody to consider freezing their eggs as an insurance policy? And at what age? Should you do that in that case?
Dr Victory 29:02
Yeah, egg freezing is another interesting domain. So egg freezing is useful if you do it when you’re young. And if you do it and you’re able to collect a high number of eggs, for women that are 30, if they have a partner, or they’re anticipating they’ll have a partner in the next few years, you will actually do better doing fresh IVF even at the age of 35, then you would with frozen eggs at age. So you kind of have to have a little bit of a crystal ball approach where you can sit down and say, I’m pretty confident I’m going to be in a stable relationship by you know, X age, and that once I’m at that stage, I can go ahead and and get pregnant without difficulty or with assistance but unwilling to go down the IVF path. If you’re in a career track or a relationship track or whatever. are the cases where it’s going to be very delayed? You’re going to be 38 3940. Yeah, there’s no question you should either be freezing eggs or embryos first. So there’s this big movement to push women into freezing their eggs. But a lot of women don’t realise that egg freezing is not as useful as they think it is.
Sandra 30:19
Yeah. Okay, I see. So actually, embryo freezing is much more of a sort of safe bet. But obviously, if you don’t have your partner, then you’re not, you’re then gonna have to find that genetic material. So that’s
Dr Victory 30:34
right, you know, you’re either looking at donor sperm, which then locks you into that individual. And then if you find a partner, now, what do you do, because your new partner may want to, you know, use your eggs. And if you’ve already used them with somebody else’s sperm, you’re really in a compromised position. So it can be very useful. But it’s not always the best approach. Yeah, just
Sandra 30:58
it’s a very, very stressful time. I think, being a female. It’s sort of 30s and looking for a partner, and then you’re sort of thinking, is my choice of partner impacted by my stress? My worries, my stress is about not finding that you do the right one, you know, perhaps you might sort of go, I’ll just make do because my age, the clock is ticking. Yeah, there’s so much that goes into this. The whole you know, and it’s a separate conversation, I suppose. But it’s interesting what you said about the eggs versus the embryos. And I know it’s very, very expensive.
Dr Victory 31:42
Well, egg freezing is not terrible. For example, we charge 6000, Canadian to freeze every number of eggs we get from you in one round. So egg freezing is reasonably manageable. I wouldn’t say it’s inexpensive, but it’s, it’s manageable. For most, you know, most individuals out there. IVF is definitely more expensive, but also yields a much higher chance. And you still have to do the IVF portion of things where you do the injection of the sperm into the eggs and so on. When you freeze your eggs, it’s not like they’re magically going to become babies later, you still have all the attendant costs, that would have been part of an IVF cycle. They’re just delayed till a later point in time. Yeah, but it is doable. I always have a very detailed informed discussion with my patients who are thinking about egg freezing because they need to know what they’re they’re getting out of it. Less than 35, you need somewhere between 12 to 15 eggs to have one life birth, over 35 it very rapidly increases so that by the time you’re let’s say 40, you need 60. And there are very, very few women who can produce six eggs for freezing at 40. Even with multiple tries of IVF. Yeah,
Sandra 33:07
I mean, yeah, the numbers definitely drop in my experience. I’ve seen that too. I mean, and also, if you’re getting lots and lots and one round, that’s not necessarily brilliant for the quality either, is it?
Dr Victory 33:17
No. I mean, if you’re overdoing it, you can definitely compromise the quality for sure. Yeah, yeah.
Sandra 33:23
I share your your opinion that you know, IVF is incredible, or artificial reproductive technologies, as I suppose I should say that it’s amazing for those who need it, but far from everybody who has it actually needs to have it. And sometimes, you know, putting a sticking plaster on top of somebody and forcing their body into something that then it’s not ready for and it’s not, you know, then that’s kind of not great for the person who’s then going to be carrying that baby and needs all their energy reserves and all the nutrient reserves as well to get through it. So I’m really interesting, interested in how this works in your clinic. And I understand why you’ve decided to take this slightly unorthodox avenues. How does it work? If somebody say, sort of the average customer journey so they come to you and they say we’ve got unexplained infertility?
Dr Victory 34:21
Yeah. Well, unexplained infertility is is kind of my pride and joy. So for lack of a better term, I’ll call that one my baby. So the reality is that with unexplained infertility, often the situation is not a circumstance in which there isn’t a problem. It’s that we have failed to identify the problem. So for example, I just posted recently, up to 44% of women with unexplained infertility actually have endometriosis. And then the treatments that are out often applied to this are not necessarily, again, the ideal treatment. So you need to look at their vitamins, you need to look at their annual health behaviours, you need to look at their diet, you need to look at their nutrition, you need to look at how much inflammation is in their lives, whether it’s from habits or their diet, or just their, their own well being. And then we know for unexplained infertility, that there are only four things that actually work, one of which is almost universally overlooked, and the other two of which are sort of downplayed, because they’re not as valuable. So we know that pills with insemination will work. We know that injection medication with insemination will work. We know that IVF will work and we know that surgery will work. So insemination whether it’s with pills or shots is by and large ignored. So people are pushed into IVF. So
Sandra 35:59
just for anyone who’s listening in the UK, we call that IUI.
Dr Victory 36:03
So enter urine insemination is often ignored, because it has a lower success rate for sure. And on top of that it also it does not make the clinic as much money. So it’s often downplayed, what then we end up following through with is either the IVF for surgery, and the vast majority of fertility specialists are no longer reproductive surgeons. So they’re not doing their own surgery, I still do and I love surgery, but most of them don’t. And again, because it reflects that delay in getting patients to IVF, or a loss of a patient getting to IVF because if you treat Endo, they’ll do better and often conceive on their own, they often tell patients to ignore the surgical approach and go straight to in vitro. So you know, going through unexplained infertility is actually really easy. You need a physician who will a investigate everything, take the holistic approach, look at all of the different avenues for evaluation. And then if you truly can’t find anything, you cannot determine what the cause is. Yes, you do need to go through those four options. Does everybody need IVF? Absolutely not. I tell patients, here are your four choices. Here are the chances with this here are the chances with that? Here’s how much it’s going to cost you. What would you like to do and, and in Canada, where we are, the cost of surgery is free. So a lot of my patients are opting to do the surgery. And I think that’s great, because if I can save them $12,000 or $10,000, or even $400 Why wouldn’t I mean, that’s a huge savings for them. And and if it benefits them and they get pregnant without needing all the invasive, potentially traumatic investigations, that’s a great thing to do.
Sandra 37:53
The waiting times here are very, very long at the moment if you’re going with the NHS, for sure. So that’s another factor to consider as well. of care. Yeah. So what about the male partner?
Dr Victory 38:06
Yeah, so I mean, beyond the basic semen analysis, and the history and dietary nutritional all that stuff. The only other tests we really have for men these days, which can be useful are sperm DNA fragmentation, testing. And now there’s two other tests, which are kind of up and coming. One is the amount of oxidative damage in the sperm, which is similar to DNA fragmentation, but a little bit different. And the other is the amount of sperm aneuploidy, meaning the percentage of sperm that are genetically abnormal, these are kind of up and coming tests that we use, but the sperm analysis and the DNA fragmentation are really instrumental and figuring things out.
Sandra 38:49
Yeah, I agree. And again, it’s this one. It’s something that’s generally overlooked here. And, you know, it’s quite upsetting, I think, to see how much treatment some people may have gone through until we run the DNA fragmentation tests. And then they say, Well, why why did nobody do this before? And I think that the general message to patients is that we could do it, but there’s nothing we can do about it anyway, which
Dr Victory 39:20
is patently untrue. So so we know that there are devices we can use to sort the sperm, which are micro porous filters, which can sort of retard the accessibility of the abnormal or DNA fragmented sperm. On that one device in particular, it’s called zymox. It has a 90% reduction in DNA fragmentation. Even easier than that is just a second ejaculation three hours after the first your second sample will have 80% Less DNA fragmentation than the first one does. So anytime we have Any gentleman with high DNA fragmentation, we just tell them to ejaculate a second time. I just had a couple. I was speaking with yesterday who had done IVF multiple times and other clinics, they finally chose to come to us. And we they had never succeeded with good quality embryos before. And we got them three spectacular embryos. And they said, Why do you think what you did is different? And I said, Well, number one, your partner had high DNA fragmentation. And we use the second sample three hours after the first we’re dealing with infinitely better sperm. So there are some very simple ways to account for things. The UK is a little bit more difficult because of the hfpa, which does create some barriers to optimising care. I understand what they’re doing, and I applaud them for the fact that they’re defending patients. But they’re defending patients on the basis of a research standard, which is not reasonable or rational. They want a randomised controlled trial for everything. And randomised controlled trials can’t exist for everything. They have recently softened it a little bit. But they’re still not allowing practitioners to necessarily facilitate all available options for patients. So it’s problematic. And I’m very keen to actually open a clinic in the UK so that we can offer some of these things without getting in trouble with the hfpa. But it’s it’s a challenge I’ve been working for over a year to get a UK licence and coming from Canada to get a UK licence has proven enormously difficult and challenging. Yeah, even though I’m licenced in two separate countries, and getting it to the UK is is is a difficult battle.
Sandra 41:52
Oh, that’s great. I have kept me posted when you’re opening.
Dr Victory 41:57
And well, for sure. We’ll have you there.
Sandra 42:00
Yeah. So finally, then what? How how can people? How can patients sort of tried to establish where whether their clinic that they’re choosing, you know, if they’re not in Canada, that they’re the right type? Because it’s, it’s not that easy to find out? Who owns the clinic, necessarily. And I think, on your website, you actually have the, you know, you’ve got your team on there, you’ve got your naturopathic doctor, you’ve got, you know, so that’s a really good sign for me that this is an open minded clinic that’s going to help support you in a holistic way. What are some of the other things you might want to look out for?
Dr Victory 42:41
Yeah, so I would spend a considerable amount of time kind of feeling the or sussing out the relationship with your physician, if you walk through the door, and the first thing they tell you is you need IVF, I would generally encourage people to turn around and run. I think that you need to have your investigations, and then have them carefully explained to you. And then when they present you with options, ask them for all of the options. Ask them for the success rates with all of the options, ask them, you know, to explain why they think one is better than the other. And not just to explain why but to provide evidence for that, right. So when I’m talking to patients, and I’m showing them for example, our our endometriosis protocol, I can reference a study for each step in the protocol. If your fertility specialist cannot point to a study, then that’s someone that’s entrenched and dogmatic and is just doing what they do, because that’s what they know how to do. That’s not someone that’s considering your physiology or biology or your needs. So they really need to be people who can point to studies point to research and not just out of hand, dismiss things that you think or that you asked about. So that’s how you foster the best possible care for yourself. And I say this all the time. In fact, I think I posted it yesterday. Patients shouldn’t have to advocate for themselves in the fertility world, or quite frankly, in any field of medicine, because that’s really our job as physicians to take care of people. But sadly, more so than anywhere in the fertility world. You have to advocate for yourself, because you are dealing with big business, you are frequently dealing with financial concerns from the clinics. And so you really need to make sure that you are getting the answers that you need, and the answers that you deserve. And to do that, you got to ask the right questions.
Sandra 44:41
Thank you so much. This has been so fascinating. How can people find you? I know you’re active on Instagram, but there’s lots of impersonators?
Dr Victory 44:48
Yeah, I guess so. So yeah, you can find us on our website www.drvictory.com. You can ask for a consult right from the website. You can email info@drvictory.com and then we are all over social media, we do a weekly show at eight o’clock eastern standard time which is quite late for the UK although we do have quite a few people to watch it and it’s on pretty much every social media venue, YouTube, tick tock, Facebook, Instagram, and so they can follow us on the show. YouTube is the easiest, it’s just Dr Victory on YouTube. And we can watch the videos there they can ask questions live. It’s a great opportunity.
Sandra 45:34
Great thank you. I will link tool is in the show notes as well.
Dr Victory 45:38
It was lovely speaking with you thank you so much for having me on you too.
Sandra 45:46
I really enjoyed this chat with Dr. Victory and I hope you enjoyed listening to this episode. Please like share, save and rate this podcast if you found that useful as it helps us reach more people. And if you’re looking for a fertility specialist to support you, our practitioners can be contacted over at www.fertilitynutritioncentre.org. They all offer a free strategy call to help you decide on your best next steps on your journey. Thank you for listening.
