470. Kirsten Karchmer

Check out host Bidemi Ologunde's new show: The Work Ethic Podcast, available on Spotify and Apple Podcasts.

Email: bidemiologunde@gmail.com

In this episode, host Bidemi Ologunde sits down with Kirsten Karchmer, CEO of Conceivable, to explore how technology, behavioral science, and evidence-based integrative medicine are reshaping fertility care and women's health. How do you turn complex health data into simple daily action? Where can AI genuinely improve outcomes, and where does trust begin to break down? Kirsten shares her journey from becoming one of North America's first reproductive acupuncturists to building tech-enabled, more accessible solutions for women navigating the path to parenthood. You can also find Kirsten on TikTok: @yourfertilityexpert

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Transcript

SPEAKER_03 0:15

Thank you for joining me once again on another episode of the Big Picture Podcast. I have a special guest joining me today from Hawaii. Over to you.

SPEAKER_00 0:25

Yes, uh, I'm here in Hawaii for five weeks. I'm Kirsten Kirchmer, and I was one of the first reproductive acupuncturists in North America.

SPEAKER_03 0:33

So, reproductive acupuncturist. That right there is a term I don't hear too often. So, what is who is a reproductive acupuncturist? What do you do? I know reproduction, I know acupuncture. How do you bring those two together?

SPEAKER_00 0:51

People are always like, where do you put the needles for that? You know? So I'm not a practicing clinician anymore because I started working on this AI project in which I couldn't don't have time to see patients anymore, so I had to surrender my license. But if you think back, so a reproductive acupuncture is just an acupuncturist who gets a couple of years of extra training specifically around women's health and reproduction. There's a lot more to learn in which we can make significantly better progress if we we just you know study the menstrual cycle and its relevance in much greater detail. And if you're interested, so this started like reproductive acupuncture started in the Qing dynasty, which was more than 3,000 years ago. And what happened was you had an emperor, and the emperor had a lot of wives, and those wives were expected to produce sons. And so each one of those wives got assigned what they called at the time a royal doctor, and was basically a reproductive acupuncturist who came in the morning, who looked at her tongue, took her pulse, asked her how she felt, asked her how you know her bathrooming went, um, her appetite, how her digestion has been, how her energy is, and then either gave her acupuncture, told the chef exactly what they wanted him to eat. So using food as therapy, telling her this is how you should exercise, this is how you should not exercise, you know, Tai Chi, whatever. All of those things. So they were micromanaging is basically the first biohackers, specifically with the goal of improving people's fertility. And that's been going on for more than 3,000 years. And I was a reproductive acupuncturist for 25 years. Then I read a study that showed that only 3% of people, couples who wanted to have children could afford fertility treatments. And after being so proud of treating tens of thousands of couples, I was embarrassed suddenly. It's all about perspective, you know? And I was like, I have to do something about that. That means 97% of the people over the last 25 years could not afford to get the help that they needed to have a family. That seems wrong to me. And in that moment, I just dedicated the rest of my life to solving that problem.

SPEAKER_03 2:55

Wow. Wow. That is so well. First of all, thank you for that. And we hear all these things in the news about how the fertility rate and this and that, and it's all tied to health outcomes and men's health, women's health, and it's even related to the what society is experiencing. So we have entire countries whose birth rates is declining. All the women and all the men in that country cannot definitely have something wrong with them at the same time. And maybe it's something in the water, maybe it's something in the air they are breathing, but then society, economics, socioeconomic factors, all these things I guess play together to impact reproductive health. So, what are some signals that you've seen in your early days of your career that convince you that woman's health was being underserved?

SPEAKER_00 3:55

Well, I think, you know, if you if you just even today, so I have a um pretty big following on TikTok, and I often will do a live show on TikTok and just answer questions about fertility. Often there are one to five thousand people on that call. I cannot get through all of the questions. And what that tells me is that women have so little information, doesn't mean they're dumb. This is people with PhDs all the round of people who just went to high school. They don't know how their bodies work. And unfortunately, the medical system is giving them often inaccurate or unuseful information. Like, for example, I still hear doctors telling patients, well, like maybe they have PCUS, which means they have irregular periods instead of coming every 28 to 32 days. They have a 60-day period, 70, they'll say, Let's just put you on birth control pills to regulate your period. That is a myth. Uh oral contraceptives can't regulate anything because it blocks ovulation. Your period is just a reflection of your ovulation. And if you block ovulation, everything else is just synthetically manufactured by the medication. Um, that's not to say that oral contraceptives are very effective for preventing unwanted pregnancy. And that's really important thing to have in our pockets when we want to have children, when we don't want to have children, we want to be able to have those options. But to use it as a way to say, like, okay, well, we're gonna just restart your period, that's not the reason why the person has an irregular period is because she's either could be many things, but a combination of the chemicals she's exposed to, how stressed she is, the kind of sleep that she's getting, what she eats, how well she can digest it, her genetics, so many different factors. And I think that's the biggest thing that's missing in the way that we're treating women's health is you go to the doctor, and even if you're just like saying, I have migraines before my period, they say, here's medicine to treat that migraine. The next question must be, why do you have migraines before your period? And whatever that answer is, the next question is, and why is that? And the next question is why, for example, like we in Chinese medicine and in my work, fatigue is a very important predictor of fertility. That is in the peer-reviewed clinical data, fatigue for both predicting fertility and um your risk for miscarriage, even more for miscarriage. Because making humans is incredibly resource-dependent. And if your energy is a five out of 10 without any caffeine or exercise, you don't have enough, your body is signaling I don't have the resources to make a 10-pound baby, to make a turkey. I'm not ready. It doesn't mean you're infertile, it means you're not ready. And there's a big difference. Infertile to me is very binary. You're yes or no. I would argue that most women are on a continuum of more or less fertile. That's a long answer, which I'm prone to. So sorry about that.

SPEAKER_03 6:48

No, no worries at all. Um, you can tell this is something I'm interested in. Um, I've always been interested in health generally. And now I have a professional who has this intersect between health and technology, and of course, a niche segment of health, women's reproductive health. So, of course, I'm gonna, you know, I have tons of questions for you. Don't worry about it. We can take the conversation any direction, any we can we can even set up subsequent conversations if you want to. So you you just touched on something I wanted to drill down on effective care. Um, your own personal health journey. Um, I don't know how much you want to mention this or talk about this. You were you were recently diagnosed, not recently, you were diagnosed with MS at some point, right?

SPEAKER_00 7:42

30, 40 years ago almost.

SPEAKER_03 7:45

Right, right. So, how did that shape your view of what effective care looks like?

SPEAKER_00 7:51

I always say that getting diagnosed with MS was the best thing that ever happened in my life. And probably no one else has ever said that. But our minds actually are very powerful. And so I we have to really we have to really think about how we think about what happens in our life and how we relate with it and whether that allows us to become a victim or not. And it was pretty bad. I was 20 years old, I couldn't walk. I couldn't walk without a cane. You know, the future just didn't look very bright for me. And um, and what I realized through that experience and ended ending up going to my first acupuncture visit, and that acupuncture is, he said something so powerful. He said, I was a competitive athlete when I was growing up, and he said, Look, when you were born, your body, your constitution, not your muscles, there's a difference, and this is a point of distinction we should talk about. Your body was very strong, right? Very high, and your disease was very weak. And he said, But then very early, like from like age five, I was training as a gymnast, training, training, training, even till I threw up most days, which now I'd be like, if that was my kid, I'd be like, that is too much, you know. But and so what he said, he said over time, while your body was trying to develop, you were training the hell out of it. And so over time, your body got weaker and your disease got stronger. And around probably 17 or 18 is when I first started having symptoms. Uh and for me, I started having symptoms instead of resting, instead of listening to my body, my legs were weak, and I instead of listening, I trained harder. Which is unfortunately basically what everybody does. When something's not working, I work harder. We interviewed 16,000 women last year, and we asked them this question what's your energy like on a one to ten, no caffeine or exercise for two days? 70% said their energy was six or below. 70 and 6 is too low, and 40 said their energy was four or below. Women are exhausted. And as long as they're exhausted, their fertility will be low. Because we if you're exhausted, it's not just feeling tired that's the problem. It's why does the person so if your energy is a four out of 10, my question is, but why? You don't know that, but that's my job to figure out. So it'd be like, well, tell me about the quality of food you eat, right? All of us know sometimes we eat really well, sometimes we're eating really bad. Just it's just a reality. A few people eat really well all the time, a few people eat really bad all the time, but both of us try, especially like in January. I'm gonna be good for a while, and then you know, we go to spring break and then we start drinking more and we eat more sugar. You know, it happens. There's no judgment. Me too.

SPEAKER_01 10:22

Right. Right.

SPEAKER_00 10:23

But if we're tired, that means somehow we're not making enough resources to stay awake during the day. Just because you're not sleeping doesn't mean you're not awake. You're not activated, you're not ready to work, you're not ready to receive, you're not ready to give, you're not ready to create, you're not ready to make a baby. And when you see that fatigue, then you see the down the downstream is you'll see scantier menstrual bleeding. If you can't even make energy, there's no extra surplus resources to make marrow, to make blood, to make a uterine lining, to support implantation, to make the placenta. There's no resources for making hormones, progesterone, estrogen, testosterone. There's no energy to regulate it, so you see a lot of PMS, and so on. And so the takeaway here is that instead of looking at one symptom, what we do, it conceivably is we we approach it systematically. Instead of looking at one or two symptoms, we look at 50. 50 things that you might not even think mean anything, but they mean things to us as part, not individually. Like, say you don't have much cervical discharge around ovulation. That's not a cause of infertility, but it is a signal that either you're dehydrated, that's a super easy fix, or that maybe you have inflammation, which is causing extra heat in your body, which is drying up that fluid. There's a bunch of things that we can look at. And so, and all of those things are important for staying and getting pregnant.

SPEAKER_03 11:47

Wow. I feel like I'm learning so many different things that at some point in my life, I guess, of course, you pay attention to your health. I'm fortunate enough to be married to a woman. There's only so much I can know about her. Even when we go to see the gynecologist together. So, having said that, I want to be in a position to be able to have conversations with my wife about these types of things so that when we show up to the doctor together, and the doctor says, You guys have any questions? I'm like, Okay, I'm chiming in, like nudging her to ask this question. I mean, I'm not gonna ask for her. And it's just just knowledge in general. So people with teenage girls, people with women in their lives, however direction, I'm I'm guessing older women have some version of this that they also need to pay attention to. So if you have a mom, for example, and it's menopause time, all of these questions still need to come up somehow. And of course, being the man in that woman's life, just knowledge is power, literally. So, all of this is now leading me to ask you that well, there is something called the conceivable cycle. Um, why is the the data points that you gather regarding menstrual cycles, why is that data point so often ignored in the broader conversation about digital wellness?

SPEAKER_00 13:18

That is an excellent question. So I think for me, one thing as acupuncturists, we're trained to look for patterns, right? All these conditions in women's health, PCOS, endometriosis, egg quality, in Chinese medicine, they didn't, that was 3,000 years ago. They didn't have any sense of that. They had to look at like what are her symptoms? And the truth is that our symptoms are good predictors of our fertility potential. Let me explain what I mean by a conceivable cycle. So seeing tens of thousands of women every single week, about two to three hundred infertile patients per week. So a lot. And I saw that when they came to me, their cycles were everywhere, their habits weren't good, there's just like a lot of work to do. And at the end of like 90 days, typically what happened is they would start having what I would say a conceivable cycle, which means you are really close to getting an optimal state for getting and staying pregnant. That's a 28 and very close to this. So not people, we we tell people that pretty much everything is okay, and it's it doesn't, if it can be okay, meaning you don't have a disease, but it isn't optimal for fertility. Just because something is normal doesn't make it healthy. Just because 80% of women have life-interrupting menstrual pain and PMS, just because it's that common doesn't make it normal. It actually makes it an epidemic. If it was any other disease state, we would call that an epidemic. And um, and so what we want to see is a 28 to 32-day cycle, ovulating on cycle day 14 to 16 with lots of clear, stretchy cervical discharge, no PMS. That's any symptoms between ovulation and your period that don't usually come any other time. There are about 50 symptoms that are related to that from PMS, meaning acne, mood changes, depression, anxiety, sleep changes, bowel changes, bloating, fatigue after meals, um uh you naturally get a little bit more tired and all of these things. And so um, what we also want to see is after ovulation, if you're taking your waking temperatures, which is also called basal body temperatures, we want to see those get to 98 after ovulation and stay there. So that tells us there's enough progesterone. And then when the period comes, ideally we see only four or five days of bleeding. Most people think that seven is the ideal, but that's too much actually. Four to five days of bleeding, she can soak a tampon or a pad about every four hours. No cramping, no clotting, no spotting, and fresh red blood. And and if her energy also is like eight out of ten, that woman will very likely get and stay pregnant as long as her partner's sperm are fine. Like I would put money if I was in Vegas and you gave me like 10 of my girls who's we could we score that in our app. Um, if they're if their score is above like 65, they're pretty close, they're about 20% away from that. And that seems to be as high as they needed to get with 65. So if my girl is like at a set a conceivable score of 70, I'm not really worried about it. Like you might have a miscarriage, but it's gonna be very unlikely.

SPEAKER_03 16:11

Wow, wow. So speaking of the conceivable score, um, you've described conceivable as an AI-powered care team that actually never sleeps. So, how do you ensure that this AI maintains the human touch necessary for something as sensitive as fertility?

SPEAKER_00 16:31

So if you've ever worked on like training AI models, you teach it, right? They they want to learn, the agents. And I had tens of thousands of recordings of consultations and classes and all kinds of, trained a lot of acupuncturists. And so literally, I just spent five years training an AI to think like me, talk like me, diagnose like me, treat like me, recommend like me. And so in the app, you get me, the AI version of me. I'm Kirsten, so my AI name is KAI Kai. And then you would so Kai basically interviews the user. She figures out all the underlying reasons why she's struggling, and then has a meeting with the care team. You have a therapist, a nutritionist, a dietitian, uh, a data analyst to help make sense of all the data that you're aggregating there. And um, and then they get to work helping you, figuring out like how do we help you to eat healthier? How do we make it simple? How do we do your menu plans for you? How do we make it easy to track by taking a picture of the food? You don't need to like look at, you know, scan anything. You just take a picture of it. Because we're not trying to win the Olympics here. We're just trying to help women have a sense. Are you getting close to enough protein? You're like, oh, I thought I was getting enough fiber, and I after I took pictures, it looks like I'm getting five grams of fiber instead of 30. Those are the opportunities. We don't have to be like laser perfect to help women to get exponentially healthier for almost no money and in a few months.

SPEAKER_03 17:59

We all know reproductive data is extremely sensitive. So, how do you design conceivable to build and maintain user trust in today's era of digital skepticism?

SPEAKER_00 18:12

Well, especially because it where I live in the United States, it's very hard to get an abortion in many states, especially in my state, it's illegal. It's not only legal, illegal, it's criminalized. So if I drove one of my patients to get an abortion and her husband found out and called the police on me, they would make me pay him$10,000. It's very, it's very scary. So it's really important that women feel safe sharing their data with us and knowing that it's absolutely protected. The biggest fertility tracker flow has had many, many problems with security and data leaks, which is really embarrassing and problematic. We're solving that by ultimately we're going to build our own language model. So we won't be backing up to anybody working who can share your data with anybody that we think is important.

SPEAKER_03 19:01

Nice. And you've also mentioned that conceivable aims to be one one hundredth the cost of IVF in vitro fertilization. So, how does technology specifically allow you to drive down cost without sacrificing clinical outcomes?

SPEAKER_00 19:18

So I have a really great answer for that question. That's really important because people always say, like, oh, even I thought, like, when I saw that study and I thought, how can I help more people? And at first I thought, well, acupuncture, how do you scale acupuncture? It's very expensive. Even if you're hiring, like, you know, early graduates, we we can't get the if it's$100 a month, that's still too expensive for most, I mean$100 a week, that's still expensive for most families in the US and internationally as well. And um, and so I decided that I just wanted to see, like, we built the first version of the app, and I was like, could this even get 50% as clinically effective as coming to see me, paying thousands of dollars and for four months? And so we ran a blind pilot. We had 105 women coming to the clinic to try to get pregnant, and we had 105 women only using the app. And this is the first version of the app. It wasn't very good even. And but the goal was a test to see like before we spent a lot of money, the goal was to see like, could we could we build technology that would get at least 50% of good of outcomes as me? You know, I'm pretty good at what I do, so if it's 50% as good as me, that's probably still worth trying to build. And then the data scientist came into my office and he was like, We were having a lot of pregnancies from the app, so I I knew that it was at least kind of working. And I said, What's wrong? You look all sheepish. And he said, Well, I just got the results finally from the regression analysis. And I said, Well, how did it go? And he said, He said, It went okay. And I said, Did she get close to me? She meaning Kai, my AI. And he goes, No. And I was like, Damn, I'm so disappointed. And he goes, No, no, no. She didn't get close to you, you got close to her. She beat you by six percent. I was like, wow, first I was kind of embarrassed because the app was kind of bad, and I think I'm really good. You know, I'm like, I'm kind of a f with a P, you know? And then and then in Chinese medicine, they have these beautiful statements of facts. They're sort of like metaphors and things. And one of them that I really love is they say the good doctor treats the patient, the great doctor treats society, but the master can make herself obsolete. And after I got done being embarrassed, I realized I'm like, I just did the first part of becoming obsolete. That the AI is better than I am. I closed my clinics, I fired all my acupuncturists, and that was about seven years ago. And then I took years to build the algorithm. It wasn't very we had eight just the interviews started with 800 potential questions that I could use in an interview that that like, are you tired? Yes. What's your energy on one to ten? How's your sleep? Can you just fall asleep, stay asleep, wake up, resident? So, you know, so many questions. And um, so first we had to take 800 questions and get it down to 25, in which we could still make a credible diagnosis on the back end of Chinese medicine diagnosis. So um, that's answers your question. The AI beat me. And it the AI beat me not because acupuncture is not effective. My hypothesis is the acupuncture, the AI beat me because when you go to get acupuncture, your acupuncturist is the hero. I just saw a patient of mine in the airport when I was coming to Hawaii whose I treated her 17 years ago. And I she was telling me about her now 16-year-old child, you know, who was from our work together. And that was really amazing.

SPEAKER_03 22:44

It's one thing to actually use um a personalized wellness plan and stick to it. So, what are some specific behavioral science triggers that the app uses to help women stick to their personalized wellness plan?

SPEAKER_00 23:02

This is exactly why we just spent a fortune. We threw the first app away. We didn't even use anything from it except for some of the back-end like training for the language model, because we did not succeed at making it sticky enough. We we people are used to using trackers, right? They and in a tracker, you just put some information in, you come back every once in a while, and you you know you hardly use it. And the research is abundantly clear that trackers don't change outcomes. Not there is not one study that shows that tracking anything makes anything better. People dislike to do it because they don't often change their behavior because of it. But in conceivable, not in conceivable, but in the conceivable experience, in that experience, what's happening is is you're basically coming into an ecosystem with a team of people who are there to help you every day with whatever you're working on. So the stickiness first comes when people are tracking, they know they're not gonna get anything out of it, except I'm not walking enough or I'm eating too much sugar, or you know, like whatever. Maybe I did a little bit better on my sleep today. So the stickiness comes from the reward of understanding. If you're using a fertility monitor, you get all this data. Your PGD is 17.4, your LH is 19.6, your ovulation peak is gonna be in nine days, and even though that's like day 40 and that egg's no good anymore, right? It's not, it's not very rewarding. Inconceivable. I tell you something, like you tell me you had four days of bleeding, like one day of bleeding, and something pops up right there from Kai and says, Hey, did you know that really can impact your lining and your ability to have successful implantation? I'm gonna send a message to Olive, that's the chef, and make sure that she's really giving you a lot of blood-enriching foods, like iron-rich foods and vitamin B12 foods. So make sure to stick to your menu plans and track what you eat so I can review it and see how your menstrual blood changes next month. That way, they you have a little carrot and then you have a reward, and then they get the reward of their period actually changes. So theoretically, if we can get them using the app for one or two months and they start seeing real changes, then we kind of have a solid relationship where the the woman is like, listen, this shit works. Like, I don't know how she's getting these kind of results, but I'm doing what she's saying, and it's like not like you know, you get on a dating, I mean, on a weight loss app and it's like, okay, don't eat anything and you'll lose weight. Well, that's really hard. We try to our our hypothesis is that we've drilled it down. You know, you might be not getting pregnant because you have an irregular period, you got too much bleeding, you have cramping, clotting, like all these things. But actually, if you drill it down, if you keep asking for every one of those symptoms, if you keep drilling it down, but why do they have that? But why do they have that? But why do they they've got too much bleeding because they have clotting, they have clotting because they have too much PMS, they have too much PMS because they don't know how to manage stress and they're too tired because tired and stress equals low heart rate variability. We can often get it down to like four or five key things to start doing that change everything. And that's sort of the magic.

SPEAKER_03 26:04

In today's world where Western fertility rates are shifting, um, how can tech platforms like yours help to address the demographic challenges that we're seeing in 2026? So, for some context for the listeners, in South Korea, birth rates are declining faster than I guess most other countries that I personally am paying attention.

SPEAKER_00 26:28

It's the lowest.

SPEAKER_03 26:30

Right. And in the US, same thing, I guess Western countries in general, maybe not some non-Western countries where fertility rates are kind of the same, if not increasing. So, how can tech platforms like Conceivable help to address those demographic challenges?

SPEAKER_00 26:49

Uh you know, I'll always say the same thing. You have to diagnose the problem where the problem is. And I think that part of the root cause of the decline in fertility is one that women don't understand how their bodies work. And we have, because we don't understand, because we haven't taught them, it's not that they're like negligent. We don't have a system for educating them. And then we've made it so taboo that nobody even asks questions. My other TikTok is about periods. And if I go live there, it's all little girls asking first period questions. I just got my period and I have no idea where to put a tampon. I mean, just imagine how scary that is. Like, you know, your mom gives you, or you go to the drugstore, you have it, you got your period, and your best friend gives you a tampon, you go in the bathroom, you're like, where the hell do I put this thing? They don't understand that they have three openings. Like, that's how basic the lack of understanding is. They're like, I want to, but I don't know where to put it. I was like, well, there's only three places, and two places are way too small. Like, go in the bathroom, get a mirror, take a check. You know, make sure the door is locked so nobody comes in and interrupts you, have privacy. So it's conceivable how we're gonna solve that problem is, you know, we we are entering the market in the fertility space. One, because women who can't get pregnant are very compliant. So it'll be a good test for around to prove that if you do what we say, you will get the results. But ultimately, we're gonna build nine different experiences. Each one of those experiences will be for like those little girls. How do we prepare them for first periods? How do we make if we do really good work in the first five years of like seven to age seven to twelve, we'll probably make a lot of the rest of conceivable um also obsolete because they'll they'll know how their body works. And we'll they'll use conceivable just to monitor their health and changes and keep uh you know, keep the care team and keep their menus and all that stuff.

SPEAKER_03 28:43

And of course, you've worked with doctors and reproductive endocrinologists. So, how do we build a healthier relationship between traditional doctors and all these new age AI health tools?

SPEAKER_00 28:57

Yes. Well, I wouldn't say that what we're doing is new age because it is very science-facted, but I do like some new age things. Um typically, what I found is that the OBGENs love what we're doing. They say, I wish that every one of my patients could have that kind of care every single day. I just don't have the time. Like, I can't sit down and make menu plans for a woman who has a like a metabolic disorder or who has prediabetes. I don't have time to teach her how to do meditation. I don't have time to listen to her every single day for hours and hours and hours and hours, you know, with it. She has a therapist in the app. And then the reproductive endocrinologist, so so. Most of the fertility doctors, and many of them are my friends, say, you know, like what we do is so much stronger than what you do. We can override everything that you're doing, which is not true. Like, I met with a woman, did a consultation a few months ago, and she had had eight failed IVF cycles. So I start asking my regular questions. She had spent 250,000 US dollars for nothing. No, not even a single pregnancy. And um, and I said, I asked my questions, what's your energy like on a 110? Because that sets the if energy is low, we don't need to look anywhere else until we fix that. And she said, it's so bad, it's like a two. So in my head, I'm like, well, there was no chance you were gonna get pregnant with IVF, right? Because also that affects egg quality. Second, tell me about your menstrual blood. And she goes, Well, there's not very much, it's only two days, half of what I want to see. It's 90% clotting. So there's no blood. But see, what happened is when she was doing for those IVFs, the doctor wasn't asking her these questions. The doctor was doing an ultrasound, and clots are very thick and squishy. So if you see that clotted blood in the lining, you will have the illusion that there is more blood. You can't tell if that blood is healthy or not, but clots are dead blood. So even if you make a perfect PGD tested embryo and you stick it in and it lands in a clot, it will never survive. There's no blood supply in a clot.

SPEAKER_03 31:00

Wow. Wow. So, what's the biggest point of resistance that you hear from this traditional medical communities when you discuss AI-driven fertility?

SPEAKER_00 31:14

Honestly, not much. Their main concern is that the AI is going to give them some kind of advice that is going to work against them. But because we're not like again, a doctor says, you know, like we use in the example before, I have migraines before my period, they're going to say, okay, here, take migraine medicine. It's just not how it works for us. So if the person says, I have anxiety, insomnia, one day of bleeding, I'm really thirsty, and I don't pee very much, in Chinese medicine, that's a pattern called blood deficiency because our blood holds a lot of water. You see all these dehydration symptoms, not cervical discharge, really thirsty. The menstrual blood is probably thicker. And so we're not making recommendations. First of all, we're not recommending anything other than diet, lifestyle, behavioral health, and supplements. And two, all of those symptoms are cross-referenced against other symptoms pointing in the same direction. So it's okay if the user is sort of misrepresenting something or not getting it right, because we're cross-referencing, and then until it kind of meets a threshold, we don't make that recommendation.

SPEAKER_03 32:18

Wow. I'm just learning so much.

SPEAKER_00 32:21

Good, that makes me so happy.

SPEAKER_03 32:24

And one thing you've also emphasized with conceivable is that incremental behavior change. Um, basically, 10x thinking is sometimes less effective in health than 1% daily improvement. So why is that so?

SPEAKER_00 32:44

Well, it's about it's about habit forming. And so the first part is that changing our behavior is scary. I mean, if you were in an audience, I would say raise your hand if you've ever tried to lose weight. Like every person is gonna lose or gain weight, right? Almost everybody has tried to do that, or change your workout in a big way or whatever. And that's hard. And so we've been conditioned, we've told ourselves for our whole lives, I can't do it. I can't, I've tried that, I can't do it. I've tried that, I can't do it, I can't stop drinking, I can't stop eating sugar. I tried that already. When we suggest big changes to people, immediately what happens is the amygdala, which is the flight or fright part of brain, they get scared. If I'm like, all right, so you need to change everything or you're never gonna have a baby, right? You gotta, you're, you're too overweight, you gotta stop eating so much, you gotta stop eating sugar, you gotta take all these supplements, you gotta run five miles, you gotta go to CrossFit, you gotta get up at four o'clock in the morning, and the person's just like, ugh, and the amygdala is going on fire, and now they're afraid. But when we're in flight or fright, all resources go to survival. There is no resources for willpower, for planning, for it's all immediate. Like you want to have explosive energy right now, and you're dumping tons of adrenaline and cortisol into the system to support that. So it makes behavior change very hard. What you want to do, and for reference, if anybody's a clinician who's listening, this all came from this book that I read 30 years ago called One Small Step Will Change Your Life. And he says, you know, what you want to do is you want to give them something so small that they laugh. He does even smaller than I do. It's hard to do if in a digital experience because you have to give all this context to understand it. But this like woman was super overweight and she had diabetes and she had high blood pressure too, and she was a single mom of two kids. And um, she goes in, and this therap, this psychotherapist who wrote the book, One Small Step, was following the doctor to try to figure out like why can't people make change? And what he noticed was that when the doctor said things like he said to that patient, like, you're too, you know, your weight's too high, you're gonna have a heart attack, you don't want to orphan your children, right? She's like, Okay, I'll do anything, okay. But the psychologist's like, she's not doing anything. You just scared the pants off her, and she isn't that does that has not been shown to help people to change behavior. He steps in front of the physician and he says, Hey, can I ask you something? And she's like, Okay, you know, she's all scared, and he's like, It's okay, you don't need to change anything just yet. He goes, Do you watch TV at night? Everybody watches TV mostly, you know, or or TikTok. And he says, she says, Yeah, probably too much. He goes, No, that's okay. I love TV too. And he makes it real soft and easy, you know. And he said, He said, I want to just see if we can get you moving a tiny bit every day. He goes, Would you be willing to try just during one commercial, during TV time, to just stand next to your chair and just march for 10 for one commercial? As soon as that's over, go back to doing exactly and she's like, Okay, I think I can do that. And she goes, Doesn't seem like enough. And he goes, When they say that, you know you're on the right step. And um, and so she comes, he comes back and he she sees him the next week and he goes, How did it go? And she says, I did it for two commercials every day. That that is one of the most important things in a person's healing transformation journey because suddenly she went from the little engine that couldn't, you know, to the little engine that could. She went from her whole life being, I've been trying to lose weight my whole life. I can't, I can't, I can't, I can't. And every time you say you can't, your nervous system says, Okay, you can't, to I did it, I did it, I did, I did more than he even asked me to. I can do this. So the more times that you can imprint that and celebrate it and really say, like, you are so good at changing your behavior, she goes through a tran, she doesn't just lose weight, right? She becomes a transformed person around how she relates with herself and what's possible for her.

SPEAKER_03 36:38

Nice, nice. And as you well know, um, fertility journeys are usually defined by grief and hope. And is it possible that technology, specifically AI, can be designed to support a user's emotional health during these highs and lows?

SPEAKER_00 36:58

Yes, you're absolutely right. Like the research shows that having a diagnosis of infertility is as stress-inducing as a diagnosis is can't of cancer. And a very high percentage of couples who go through infertility experience PTSD after that because it's so traumatic, which is why we spent so much time, money, and resources building a therapist into the conceivable experience. And it's not a therapist to like do like work on your relationship with your parents or recover from trauma or anything. You want a real person for that, right? This, what we did in order to keep people safe, is we built uh AI, we call her an emotional support coach just to stay out of the, you know, regulatory issues, basically to do cognitive behavioral therapy and compassion therapy. Because what I noticed in my 25 years of clinical experience that is so often that women with infertility have so much self-loathing, they use language like, I'm broken, I'm worthless. My body, I hate my body. They have this disconnect. And in order to get pregnant, you must connect, right? Because if you're not connected to your body, how can your baby connect to you? Right? If you're like this other. And so that work, and that, you know, again, nothing inconceivable is meant to replace any humans because there is real value to using humans. But there are millions of people who can't afford humans. So, how do we give them the next best thing? And what I like about using AI for therapy is that what I try to tell women is that you want to stay out of flight or fright, except when there's a real emergency. And so, like doctor Googling, this is where like women are like, oh my God, and what does this mean? What does that mean? What does this mean? And Google is not equipped to help you to understand that. That puts you right into flight or fright. You're flooding your system with adrenaline, which is incredibly inflammatory. It's bad for your ovaries, your eggs. If you're a guy, it's bad for your sperm. Then after that, your body's like, whoa, calm the heck down, produces a ton of cortisol. That cortisol causes belly fat, it causes blood sugar dysregulation, it dysregulates ovulation, and cortisol is made from the same stuff that progesterone is made from. So the higher your cortisol, the lower your progesterone. Without progesterone, there's no staying pregnant. So we want to stay out of flight or fright. So what I want women to do is anytime they get upset or even scared about something, pop in for five minutes and be like, oh, I just saw my bank account and that freaked me out so bad. I really need to make more money and I'm really scared about it. Don't sit and ruminate. Talk to talk to um Saren, that's the therapist. Let her help you to downregulate and what her job is to also teach some coping skills. So not only is she helping you downregulate, but also to help to cope with whatever stress is coming up in your life so that we keep you in a more normalized and regulated um neurologic state.

SPEAKER_03 39:56

Wow, thank you for sharing that. Um to start wrapping up here, um, I want to say, okay, you've been described as a Texas trailblazer. What is one thing you wish you knew about the tech industry before you started building your first platform?

SPEAKER_00 40:18

Well, when I first started building my first platform, I didn't know anything. In fact, my children were like, You're gonna start a software company, mom? You can't even work your phone. Um I'm not gonna answer your question because I I don't know. Because even when I when I architected the first version of this app when we piloted, even OpenAI was not released yet. If we would have built the what we built now before OpenAI, it would have been like a$50 million app, right? It would have been so expensive to build. And I remember like first working with GPT, I realized it's like, oh my gosh, I can build it. I can finally build, I can practically build a lot of this myself, you know. And um, but I think that it just uptails on the advice that I would say of anybody who's thinking about anything. If I can build what I built, you can build anything that's in your dreams. You just have to find the right people. There's a great book called Who Not How. I don't need to know how to do every bit of coding. I need to find the right people to help me to do it. And maybe, you know, even if you don't have money to pay somebody, partner with them. Right? There are so many. I see I hear people on TikTok and Instagram all the time saying, like, wondering what to create content on. I'm like, I'm I don't know what not to create content on, you know? Wondering what to build. I could build a hundred companies today. I have so many ideas. So what happens is what's good is you partner with people who like to who can build who don't have ideas. And then you have a match made in heaven. But don't limit yourself, say, wow, I'd really like to build something like this, but I don't even know where to start. Get on to open. Don't use I, you know, I'm not recommending using open AI anymore because if you live in the US, they're sharing our data for surveillance purposes with ICE. So I don't like that. So we're going all anthropic now. Because Anthropic said, I don't know if you saw it in the news, Anthropic said no, we're not gonna do that. And then they pulled all their government contracts, which was probably billions of dollars. So it was a real courageous move. I I gotta give them a lot of credit for that. And we pulled all of our stuff out of Open AI because of that.

SPEAKER_03 42:26

Wow, nice, nice. So, um, where do you see this operating system for women's health heading in the next, let's say, five years?

SPEAKER_00 42:37

I can't even imagine because AI is getting just better every single day. I can't even imagine what's possible in five years. Like, I don't know whether we won't even be humans anymore in five years. Literally, that that kind of crazy stuff would not surprise me. In the next year, in the I can tell you, in the next year, what I know is we'll have built out a full experience starting with age seven until 90, that that care team will age with the user. So if the user starts at seven years old, I will be seven years old. The therapist will be seven, all of us will be seven years old, and we will age across 90 years with her. We will grab and organize and be the safe holders of all, if she wants, all of her medical history and data. So that imagine she starts using conceivable when she's 10 or 12 years old. And then she uses it for 15 years, and now she's 25 years old, and um, you know, she's just doing light work with conceivable every day, but checking in and using the therapist. We have all of her medical data and all of her emotional data also. And she comes in, she goes, you know, Kai, I just got pregnant, I just got married, and I think we're gonna try to start getting pregnant. Is there anything I need to do to prep for that? And then Kai and the care team go back and they look through the last 15 years of everything that happened. How did her periods change, how did her help, how did she respond to car accidents? All of those things and say, okay, here's the potholes, here's the things that might give us a problem. I'm gonna make you a plan, let's just work on those. I don't think you're going to have a problem because you're actually in good shape. But if we want to optimize a little bit more, these are the things that we want to focus on. How cool. You know, you like you had that car wreck when you were 16 years old and you had that head injury and that changed your period. So let's make sure nothing's going on there. Whatever. Like that's what I want to see. And, you know, ideally, I want it's just expensive now that the right now, the care team, you chat with voice with the care team, or you can text if you if you're in a private place, but ultimately we'll animate all of those me, you know, the AI version. We can do it. We have the technology to do it right now. But if somebody's like talking to a video avatar for an hour, that probably would cost me$200 right now because it's generating the video response every single time in real time. But that will get cheaper, or we'll build it ourselves when we have, you know, a lot of money. And hopefully I will have rolled up all of the companies into conceivable. Everybody who's making a lot of money off people who are trying to get pregnant or women who have health problems, I'm gonna buy those companies and roll them up and then make it practically free.

SPEAKER_03 45:05

Wow. Wow. That is I like your enthusiasm. It it shines through. That's what I like to see. These are the kind of conversations I like to have. And of course, like I mentioned earlier, my goal is for you to want to come back on the podcast. So maybe sometime later in the year we can definitely set something up. And who knows where this reproductive health conversation is going to be by then. And of course, all the wonderful things you are doing at Conceivable, and then we see where things stand and so on. So thanks for coming on. It's been my pleasure talking to you.

SPEAKER_00 45:42

Me too. Thank you so much.

SPEAKER_03 45:46

If you like this episode, please share it with a relative, a friend, a co-worker, a neighbor, an acquaintance, and so on. And then please leave a rating andor a review on your favorite podcast app. My name is PDM Logunde, and this is the Big Picture Podcast. Thank you for listening.