It's Not You; It's Endo! with HerAnova

For years, women with endometriosis were told their pain was normal. By the time they try to conceive, the disease can have progressed to be a real problem.

Dr. Susan Fox sits down with Dr. Farideh Bischoff, Chief Medical Officer, and Penny Wan, co-founder and chairwoman of HerAnova, to talk about their new innovative blood test that can detect endometriosis without surgery.

You'll learn why 40% of infertility cases are linked to endometriosis.

Retrograde menstruation happens in every woman, so why do only some develop endo? Dr. Bischoff gets into what we still don't understand about this disease.

A big takeaway is to realize that pain is not normal. We talk about what happens when it gets dismissed and what that costs women later on.

We also get into what the HerResolve test looks for in your blood and why a 97% accuracy rate is a big deal.

And why catching this early, even in your teens, can change everything about a woman's reproductive future.

This episode is for you if:

• you've had painful periods and been told it’s normal
• you've had failed IVF transfers with no clear explanation why
• you've been bounced between specialists and still don't have a diagnosis
• you're heading into a frozen embryo transfer and wondering if your body is ready
• you're a provider who wants to offer your patients something more 
• you know someone who is suffering 

Support your fertility journey with Preconception Plan at Health Youniversity. Learn more here: https://healthyouniversity.co/programs 

HerAnova: https://heranova.com/

💻 About Susan Fox: https://www.healthyouniversity.co/about

Take your 5-Element Fertility Quiz:  http://yourfertilityquiz.com/

Detox to De-Stress:  View the FREE Masterclass on the importance of detoxification to prepare for a healthy pregnancy:  https://susanfox1.easywebinar.live/gentle-detox

Learn about our program entitled Your Fertile Health: https://www.healthyouniversity.co/programs

Schedule a Fertile Health Assessment: https://www.healthyouniversity.co/your-fertile-health-call

Let us journey with you as you navigate your fertile health. Connect with me:

🎧 iTunes: https://podcasts.apple.com/us/podcast/health-youniversity-with-dr-susan-fox/id1592763186 

🔊 Spotify: https://open.spotify.com/show/08U9QJf...

📸 Instagram: @dr.susan.fox

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Transcript

SPEAKER_02 0:00

Hello and welcome to today's episode of Health University, where we talk all things women's health from fertility, pregnancy, and postpartum to what I call the pre-perimenopause time frame, those very short steps across the with the bridge of a woman's life that sometimes seem to coalesce together. And today we're going to focus on fertility, and in particular, something that is I'm very passionate about and almost can get a little teary about because we have now finally a new opportunity to help identify and diagnose endometriosis. I learned about this just as recently as three months ago in an annual meeting of the Pacific Coast Reproductive Society, where I left a talk that was saying, oops, sorry folks, we actually still only have, you know, laparoscopy as the proven methodology. And then I went into the area where people were, the vendors were, and lo and behold, found her ANOVA. And in her ANOVA, the has designed a blood test, a simple blood test that is a yes-no blood test that will say we see evidence of endometriosis or not. And I have with me today two esteemed professionals. I'm going to spend some time reading your bio because it's what what you bring to the conversation, what you bring to the testing is so impressive. So bear with me. I'm going to turn my head for a second. I have Dr. Faraday Bischoff, who is a PhD chief medical officer and head of diagnostics at Huronova. Forgive me if I've missed anything. She brings more than 25 years of experience in developing non-invasive clinical assays for various women's health conditions, such as endometriosis, IVF, or other assisted reproductive therapies, prenatal testing, and oncology. She's managed several research projects, has published over 300 articles. Where do you find that time? And has mentored executives and medical students alike. Dr. Bischoff has been recognized with numerous rewards or awards for her research. She's a PhD in cancer biology and has received postdoctoral training from the M.D. Anderson Cancer Center and the Baylor College of Medicine. Welcome, Dr. Bischoff. And you had invited me to refer to you as Faraday, so I will, so we can just be conversational here. And then we have with us Peggy Waughn. Thank you, Peggy, for joining us. She is the co-founder and chairwoman of Her ANOVA. She is a global biopharma pharmaceutical executive, a board director, and a women's health innovator with more than two decades experience advancing therapies that improve and extend lives. As co-founder and chairwoman of Her ANOVA Life Sciences, she focused on closing critical gaps in women's health, particularly in endometriosis and fertility, translating cutting-edge science into patient-centered solutions. Under her leadership, Her ANOVA is redefining how women's health conditions are diagnosed and treated. Welcome, both Penny and Faraday. And again, I almost can get verklemmed. So for I and I might do that because I'm a little bit of an emotional human being. But I have been in this field for 25 years helping women struggle with their, you know, with their fertility struggles, whether they're trying to conceive naturally or going through assisted reproductive therapies and IVF. And time and time and time again, there has been this just like this suggestion, could there be endo? But the the diagnosis and the treatment have been so invasive that it's almost been like, well, you know, let's just not go there now. Let's just pretend that that's not a problem because the the signs and symptoms aren't as as severe enough to say, okay, we do we do need to do a laparoscopy and see if we find any. And I just shared with you off camera that I have just recently two patients who regrettably had failed IVFs, had no signs of endo in their symptom picture. And sure enough, they came back positive. So it it it just just matters so, so much to me and to the women out there who are struggling with fertility when endometriosis is is quite likely a something that needs to be considered. So I'm ever so grateful for this incredible simple test that will help identify that. So that that being said, welcome, delighted to have you here.

SPEAKER_01 4:50

Pleasure to be here. Thank you.

SPEAKER_02 4:52

Oh, my delight. So, of course, you know, we we we have our patient population, we tend to see them, I tend to see them in their mid-30s to early 40s, but they have been dealing with painful menstruation issues since teenagers sometimes. And they've been told, oh, well, that's normal, that's menstrual pain, you know, just just kind of take a Tylenol and grin and bear it. And it's not until they're in there trying to conceive years that this becomes a question that needs a deeper dive than grin and bear it, and or you know, take a day off from work. What do you say to that woman or to all the women out there listening in terms of um what they need to know about inquiring? Could this be endo? Taking agency over their over their um conversation with their with their uh reproductive health care provider, OBGYN or REI.

SPEAKER_01 5:57

Well, you know, I'll begin and Penny certainly can add more. Um, but Susan, what I see here is pain is not normal. And this is a coin phrase that we kind of toss around, but it's really the reality. It's it's not normal. And if it's not normal, we should be asking why, what's happening. And unfortunately, due to the lack of the ability to safely diagnose this condition, by that I mean non-surgical way, uh, it's been dismissed. And and therefore you have a population of women who have gone nearly a decade or more without a diagnosis, allowing the disease, which again is uncomprehensible, to potentially progress and become even more severe. So, why do we have this issue? Why don't we have a clear way of diagnosing? Well, the answer is the disease itself is very complex. Scientifically, we don't understand everything we need to know about this condition. What causes it? Do you inherit this? Is it genetic? Is it environmental? Likely it's a combination of all. So, therefore, the absence of being able to give a clear answer has led to we're not going to do surgery because it's expensive, there's risk, it's if you're very young, you don't really qualify to qualify for it. So you wind up with a delay. Or you have patients who then go to different doctors who wind up potentially being misdiagnosed as well. That it it could be something else, and now you're gonna get treated for a condition you don't even have. So the the reality is uh that today we now have a non-invasive blood-based test that is virtually risk-free. The risk is a bruise from maybe taking the blood, right? And you your answer then is very clear the disease is there or it's not there. And now your doctor can talk with you about what the precise steps are for you as an individual. Again, allowing for precision, and precision medicine is where we are today. This is what we focus on in every aspect of medicine to make it personalized. And the only way to do that is to now have a definitive answer so that you can answer or have those discussions with your doctor. So, again, the condition itself is very complex. Every woman's disease is unique, and I want to emphasize that the degree of symptoms, the degree of pain is not necessarily a reflection of how severe the disease is, which is what further complicates this condition. So, again, given the unknown and the way we've been classifying, a blood test gives you a clear path in terms of if it's yes, you can go down a path where you now discuss with your physician what the best next step is. And if it's negative, okay, now you at least know it's not endometriosis. I can look at other potential causes. So uh our goal at Herod Nova is to really bridge that gap and reduce that delay diagnostic window to a few months from the time you first experience your pain. And I want to emphasize to the listeners here that pain again is not normal. What you feel is pain, another woman may not feel. So that's why it's important to seek doctors who offer this type of testing that we now have made available. So yes.

SPEAKER_00 10:24

I think Faraday um captures it very, very well. You know, um, Susan, thank you for outlining the problem because you know it's structural. Because, you know, like it's not like we're not seeing patients who is showing up with pain. But then, you know, the continued um, you know, um uh normalization of that, you know, like makes it sometimes very difficult for women to continue to speak up because you know, you think it's just something that you have to deal with, menstrual pain is normal. Um, so at Heranova, as um Faraday outlined, our core really is to empower women, first of all, with the knowledge, with that awareness. And then, you know, we're really glad that you know um you know are leading um in doing this work, um, which you know helps in part making sure women understand what is and what is not normal. And then I think we then need to, you know, like be in a position to give them the solution. And as you saw, you know, the test that we have, her resolve, it's a very simple, accessible solution. So hopefully, you know, it will make you know that empowering step possible so that instead of guessing what it is that they have to deal with, it's a definitive condition, giving them the validation that they need to move forward.

SPEAKER_02 11:38

Absolutely, yes. And and truthfully, I think it it we're helping the reproductive endocrinologist as well, right? Because when he or she is presented with evidence that yes or no, endo is present, they can then make informed decisions as to, as you say, the next steps. Should there be a medical intervention, should there be even a lupron, like a suppressive three-month or two-month period time frame to get inflammation down before doing a next transfer, because otherwise they're going on the presumption that we don't see anything and we should just move forward. And that's and that you know, that we all know how precious any one embryo is, and the idea of transferring one when that body is not ready is um is precarious at best. And you make a very good point when you say, you know, pain is a signal, right? It's pain is not normal. Pain is a signal that says, let's look at this. There's something to look at here. And uh so often, again, patients and and that have come across my path and my in my clinic, they come through and say, I've spent 10 years undergoing the care of a gastroenterologist because my symptoms look like GI symptoms, because the endo is adhered to their colon. So, of course, their colon is going to have responsive symptoms, but that's because the you know, the endo is present and there's no amount of, you know, kind of taking care of a GI tract that's going to change the endo picture. And you also mentioned something that actually, again, it just puts a little lump in my throat, the timing. If we can get ahead of this when a woman is in her late teens, early 20s with a very simple intervention, so that by the time it is go time for having babies, she's not then dealing with advanced disease. I have a patient who is just now just had her embryo transfer and had to have, you know, she had stage four endo, and so had to have the whole laparoscopy and the healing procedure, and then um, and you know, fingers crossed, all goes well. She's been a true champ, but she's the perfect indication is, you know, 10 years ago, 15 years ago, her symptoms were there, but but there was no diagnosis for it. So tell us about the test itself. So I know it's a blood draw, uh, and and and you describe it as an AI assisted assay. What what are you testing? Because I know I've got fellow geeks out there who are saying, who are saying, what exactly are you testing in my process proving endo?

SPEAKER_01 14:32

Yeah, no, I'm always happy to talk about the science part. Um this is what I live and breathe. Uh what we've done at uh Hera Nova is something very unique. We combined markers that have a different indication, meaning we've combined proteins with nucleic acid microRNA, for those listeners who know what that is. Um these are um uh markers that are readily circulating in our blood. So you have these markers, I have them, everyone has them. But when you have endometriosis, the levels of these markers can be altered. They can be abnormal. And what we've done is developed a AI or artificial intelligence uh model that basically looked at the pattern of each of these markers in women with disease and without, and identified an algorithm that now detects that pattern to say, yes, this individual is positive, that pattern matches the positivity we see in the big population that we tested.

SPEAKER_02 15:50

Is it a threshold per se, or is it something different?

SPEAKER_01 15:53

Yes, it's a cutoff. So basically we establish a prediction score, and if you're above the prediction, you're positive, if you're below, you're negative. And we keep the report very simple by just saying detected, not detected. Yes, yes, uh, and it's intended to make it really simple so that you don't focus on the result, but on what the next steps should be for your pay.

SPEAKER_02 16:23

So I want to just thank you. I uh because I I you know I I heard microRNA and I was back back again when I was going through all of the exhibits, and I was like, I really don't know what that means, but it means something. So thank you. Thank you for sharing and thank thank you for conf uh sort of explaining that it is a threshold kind of um of assay that says if you are above this threshold, then then we are presuming we are no, no, in fact, it's not a presumption. Because tell me, what is the specificity again?

SPEAKER_01 16:52

Oh, the specificity today is above 97%.

SPEAKER_02 16:57

Yeah, so this isn't a presumption, this is data. So again, viewers, listeners, this it this is an important, important, important test. I wish every young woman who's going through, you know, any kind of discomfort with her OBGRI and could just automatically have it be, you know, the next step of testing. And I look forward to when that occurs. Please connect with us for a fertility assessment call at the link below. We'd love to learn a bit about you and share our resources. And make sure you subscribe to our YouTube channel so that you never miss an episode. Let me let me uh segue a little bit into how does endo affect fertility? Is that is that something you feel comfortable discussing?

SPEAKER_01 17:42

Yes. Well, I think you mentioned yourself uh up front. There are two main ways. One, it creates an inflamed environment, which is not suitable for implantation. The other is, which is the more severe, it causes malformation within the pelvic uh cavity. So as you gave the example, you have adhesions where you can now have organs adhering to one another, making pregnancy almost impossible. Uh and therefore, those individuals need to have excision in order to make that, you know, uh possible for pregnancy. So endometriosis, as you um, as your audience may appreciate, impacts at least 40% of women who are deemed infertile or unexplained infertile.

SPEAKER_02 18:39

I will repeat that, please, if I may, because I think that that that is a data point, a percentage that people are not aware of. And I know just in the recent couple of months, it seems like endometriosis is getting a little bit more of a highlight on it. But to repeat, 40% of infertility challenge can be attributed to this one disease pattern, complex as you say, endometriosis. So please don't overlook it as a possibility.

SPEAKER_01 19:10

Right, exactly. Exactly. And um, and again, these are women, 40% are women that are symptomatic, of course. Uh, when we look at the gynecologic setting, you now have probably um a higher incidence, but it's undetected because they're not necessarily symptomatic. So this is the real challenge of endometriosis is being able to identify it early accurately so that you're able to intervene and not get a misdiagnosis where you're then going to the wrong specialty uh in in order to understand what your next steps are. So um again, I think you hit the nail on the head with the fact that yes, endometriosis is a huge contributor to infertility, and uh and we can address it today. We can protect it early.

SPEAKER_02 20:12

Penny, I have a question. This is an origin story question, if I may, for you. What was the impetus that you said, I'm tech I'm taking this on? I'm gonna I there's an issue here that's not being addressed, I'm taking this on.

SPEAKER_01 20:27

Penny.

SPEAKER_00 20:28

Well, I I think you know, like um, as as we were talking about infertility, that's kind of late in the game. Um, when we, you know, like first um started the company, we had promising candidates that we thought will be helpful in treating endometriosis. But when we approach, you know, the process of trying to establish a clinical protocol, we quickly realize the biggest issue is in diagnosis. So if we can't you know like find a way to um uh satisfy that requirement in creating a trial, you know, we can't finish with a um a drug that we can bring to market. So, you know, that's what that's when we pivot to you know trying to find a diagnostic. And uh and then you know, then the second uh point is well, you know, like and we drives this, we haven't really heard about the disease. So people think it's actually a small population, but it is not, it's one in ten women. Actually, the latest um data that we have is it could be you know as many as one in seven women. Right. So it's a big population globally, it affects about 190 million women around the world and 6.5 million women in the US. So there are very few who are getting the diagnosis, but there are many who are suffering the disease in silence. Um we also learned is that you know, like they go from doctor to doctor, and you mentioned, you know, like not necessarily the OBGYNs or You know, the the uh more typical doctors that we fewer women would go to, you know, like if the doctor that they go to is not giving them a confirmation of a disease, they go and shuffle another doctor, and sometimes they go to the GI and sometimes they've been referred to a mental health doctor because they think it's all in your head.

SPEAKER_02 22:20

Yeah, exactly. Oi, that one that one actually just makes the hairs in the back of my neck stand up because again, the number of prescriptions for Lexapro for endometriosis is um it's actually insulting. It's insulting to the whole women's health movement. So I just heard, and and I'm I might be getting ahead of myself here because yes, obviously, you can't begin protocols with step two. You need step one, the diagnosis. Is there a step two treatment um in process? Is there something that we can be looking forward to for and um and what what might that time frame look like? I'm one of those who's always peeking under the Christmas tree in advance.

SPEAKER_00 23:03

Well, yeah, that's great. I mean, you know, like that's how we would like to see ourselves as well, because you know, the the whole drive in doing what we do in finding the innovation that makes a difference is so that we can find a holy grail. You know, what do our patients need? Um, it's gonna be a process, but it's definitely in our, you know, like scope and in our aspiration, as I shared with you, that's actually what motivates us in the beginning. It's like what is the biggest gap? And then when we looked at everything that is to do in women's health, we felt that, you know, the biggest, you know, and and a glaring um opportunity or a risk is not having a solution for endometriosis. Um but what we learned is, you know, like by you know, um if we kind of you know like find the patients early, there are things that they can already do in proactively managing the disease. Um and then, you know, on top of that, you know, like there is surgery, and then, you know, while we're out to find that, you know, solution, um, we feel that it's more important for us to have that conversation so that we can come together and first of all define how we can, you know, find those patients, create a protocol that we make it easy for women to get that validation. And therefore, you know, they went from kind of just guessing what they have to treat to actually treating the disease. Um, that's a big step. And then, you know, like once we get on that path, you know, are we treating the pain? Are we treating, you know, like uh the fertility challenges? And, you know, like what is it that we're trying to treat? Um, as we now know this is an inflammatory disease. Yes. Um, so in many ways, you know, it presents itself. And if you're looking for symptomatic treatment, you know, what does it look like? And then, you know, um, and because there is so we we still don't understand the disease in totality, um, I think you know, there is a lot more work that we can do together to find that, you know, true root of the course, uh, the the true root of the disease, the root cause, um, so that we can find the right um solution. We don't have that yet, but we're definitely actively working on it. So thanks for the question.

SPEAKER_02 25:10

Yes, of course. That makes me very excited. And you know, I'm uh in my way back machine when we you know, when I first started with patients, the the presumption was, or the the statement was uh endometriosis is is almost strictly caused by retrograde menstrual tissue. Let's let's talk about that and debunk that a little bit, if we may.

SPEAKER_01 25:33

Yeah, yeah. Uh yes, that that is almost the um textbook obvious, you know, answer that that people give. Oh, it's retrograde, but all women experience retrograde menstruation. I want to make that clear. All women do. It's only a small percentage, 10%, maybe a little bit higher in IVF setting, where the in you know, it's more pronounced. So I think uh what I'm looking at, and again, based on my scientific uh research and the work I've done in prenatal diagnosis, where I basically can identify fetal cells from a pregnancy in a mother's blood sample during pregnancy. I can predict aneuploidy, I can predict single gene mutations, I can predict all of these conditions genomically because these fetal cells are in blood. The same concept is true here with endometriosis. It's a systemic disease driven through inflammation. So by systemic, we mean it has to circulate. How else do cells go from the pelvic region to your lungs, for example, which is where you can also find endometriosis. So I believe with our diagnostic, we'll be able to better enable some of the more traditional discoveries that will highlight what the real underlying mechanism is, which is likely going to be not just one, it's probably a combination of different, you know, events, whether it's environmental, genomic, uh, or other factors that that could play a role. And that's this is what makes endo so complex.

SPEAKER_02 27:32

And what makes the potential treatment kind of so exciting for a scientist.

SPEAKER_01 27:38

Right. As a scientist, you know, I find understanding what causes the disease, what is that mechanism, that switch that happens that triggers this condition to start to behave the way it does, is very important to me. And I think we can address it now with a test that allows you to identify those individuals. My theory is women that are very young in their teens, maybe the first time they have their period experiencing pain, their disease is going to be different than perhaps a woman who develops endometriosis much later in life. So again, as a scientist, you have to think there must be different mechanisms involved that is driving this condition. And my job is to see what are where is the link, where can I ensure that when I detect disease, I'm not dependent on these different potential root causes that I can find the disease and then be able to look under the layers to determine what the mechanism is. And what are those layers? How young you are, when did you first have your period? When did your symptoms first begin? So these types of data will then help drive the discovery that we're all about to.

SPEAKER_02 29:10

I want to just repeat because again, these there are a couple of just salient points that that so bear repeating because it really just the the inaccuracy is sort of just so out there in the common conversation that it's hard to penetrate. People, almost every woman, and maybe I heard you say every woman will experience retrograde menstruation. So retrograde menstruation does not equal endometriosis. Something else is happening with that endometrial tissue and that person's immune system or genetic markers or whatever is the other fabric in the presence of this endometrial tissue outside the uterine lining that is triggering endometriosis. I I hope I said that slowly and clearly enough because once again, we we had come to just presume that it was this some kind of almost crazy mechanical thing, like, oh well, you know, the we could just gotta clear the pipes, so to speak.

SPEAKER_01 30:15

But it's but it's much Well I had women reach out and say, should I stop using tampons? Um, you know, some of the obvious things that you immediately think of. And the answer is no, you you should continue if you feel that that's right for you, that's fine. Because again, biology is far more complex. And uh what we see here is that again, we're peeling those layers of the onion and understanding how this disease behaves in a test tube, right? Being able to demonstrate detection and then working backwards and linking what we know about the patients with when disease occurs, how it occurs, and all the symptomology that goes with it.

SPEAKER_02 31:10

So the holistic doctor here just needs to but have a little a little asterisk saying, yes, yes, but don't use the tampons that are you know laced with all of the chemicals. Of course, of course, yes, yes, yes. But but my point was, you know, it's not it's not this mechanical thing. Yes, yes, yeah, you know, and I had mentioned again off camera the the the two women I have in mind who had their positive test didn't have any signs, their response was one of, you know, of was first relief. Like I have an answer, I have a direction. Then it's of course coupled with layered with, oh my gosh, what do I do now? But but but I but that you know, knowledge is power, right? So that first layer of response of, oh my gosh, I have an answer. I'm not just you know, kind of flying in the dark here, is so very important to the psychological profile, the mental health profile of these women who are otherwise dealing with pain, you know, the struggle of infertility, and and so on. So um the I'm I I I'm I I couldn't be more grateful for this for this test. And I have this idea, and I and I'm probably not that far off, thinking that the test is going to just kind of uh be become even more um uh specific for types of endometriosis and then treatments for the types. And so um I I look forward to the continued advancements that the Her Resolve test will provide.

SPEAKER_01 32:46

Certainly. We're working towards that. Currently, our data are beginning to show that we may be able to predict early versus late stage. So if you are positive, are you early stage or late stage? And ultimately, we want to be able to confirm whether you have superficial or peritoneal endometriosis as opposed to the other two common forms, which are endometriomas on the ovary or endometriosis that's deep within the uterus. So um, yeah, uh ideally this is our goal is to really give you the full information about the disease when it is present. Uh, but again, we start with yes or no staging and then uh disease type.

SPEAKER_02 33:38

Now I'm sure that the listeners, viewers are are asking this question: how do I get my hands on this? Who do I reach out to? So, Penny, do you want to step in? Is it available in all 50 states? Are there any states where that's you know that you're still waiting for um, you know, sort of whatever licensure or whatever else, lab licensure is available. So could you speak to that for a moment?

SPEAKER_00 34:03

Um, I believe there's only one state. Faraday, correct me if I'm wrong. Um, that's New York State because they have a very unique uh process of approval. Uh, we can assure um the listeners that in New York that we have, you know, done um all the steps in terms of making sure that the authority have our information. It is otherwise available, you know, in every other state. Um, and we currently are making them available in the IBF clinics where we understand, you know, um, like we just talked about, 40 to 60 percent of the patients who've gone through IBF, it's likely to have endometriosis. We believe in supporting, you know, and empowering that community so that they can you know move forward um with the goal to you know get conceived um you know in in the most um effective format, um, according to the physician and the patients. Um we believe there is huge value, you know, as we as we keep talking about, you know, to work upstream, meaning you know, the younger uh population would receive that early diagnosis early. So we are um working um to you know make sure that we are available in broader um terms. And then we have also received requests for our website where we're able to direct them to uh locations where the test is being offered. Okay, great.

SPEAKER_02 35:25

So people can start by going to Heranova, uh go drop, do the drop-down her resolve, um, and then and then seek you know a provider near me where I can get a blood draw because because the the blood draw at this point in time, as I understand it, correct me if I'm wrong, has to happen in office. It's not out there in the you know lab core quest, you know, larger um uh world. Not yet, not working very hard on it. Exactly. Um so so I'll explain how it happens, for instance, in my in my office, we have a phlebotomist in-house. So the patient will come in, get the blood draw. I've got the kit, and it gets packed up in in ice and sent right back to the Here Nova lab for processing. So that's why it's not yet going through the lab core, et cetera. Um, and at this point in my practice, it is a um it is it is uh a cash pay or you know, HSA kind of reimbursement. It is not yet um uh available through reimbursement through insurance. Is that still correct for across the board?

SPEAKER_00 36:32

Yes, it is. And we are very, very grateful, Susan, um, you know, to have partners like you who actually feel that pain and then you know see um early adoption, you know, being a way to help, you know, move forward with helping patients. Um and we love to be able to find more, you know, um converted, you know, interested, you know, like uh practitioners like yourself so we can help more patients until we have a border solution available.

SPEAKER_02 37:00

I can share with you that we that we just had one of your one of your um representatives speak to a group, and another one will be speaking to and doing a little course to a larger group. So I'm a doctor of Chinese medicine, and there are two groups. One is international with a huge population in the United States, and another one is more local, but I but I'm wanting as many of these providers who can either have the phlebotomy in-house or connect with another doc, you know, maybe next door down the street or something like that, so that the patients can get their their labs done. Because we are that we are a kind of unique in that we have we have time, right? We have time to do that sort of deeper intake before we send them off oftentimes to the reproductive endocrinologist. So if we can send them off armed with real you know data that they can then sit down with their IVF doc and say, okay, now what are now what you might you do differently? So I'm very, very, very excited to have it. And and and I'm I'm I'm looking forward to when it's in every you know, Obi Gyne's office, um, when when it becomes part of the standard of care for, you know, you get your first pap smear, if there are signs, then you get this simple blood test. Because I I'm recalling actually way way back, I had a patient who was 16 years old, who was struggling with painful menstruation. I fortunately have a professional friendship with a reproductive specialist. And I said, I think she has endo. Would you, would you consider? And she, this young woman was actually about to go off for a year to, you know, to um uh Southeast Asia for as part of her educational program. And I thought, oh, if she's in Southeast Asia for a year and she's suffering this way now, what's gonna happen in a year or two's time? Sure enough, she had stage three endo at 16 years old. She had a laparoscopy, she had the treatment, she was able to go, and it was thankfully within you know a few months prior to her having to take off for this trip. And she was able to take this trip without suffering for a year. And again, having disease progression. At this point, she's probably now in her you know late 20s, early 30s, and I imagine if if it's if that it is her desire to get ready for family planning. So that that level of intervention was a game changer. So and I so I want more and more and more young women uh to be able to just think about this as their first their first recourse.

SPEAKER_01 39:39

Oh, I couldn't agree with you more. I feel that a simple test like ours for endo should be offered as early as possible.

unknown 39:51

Yeah.

SPEAKER_01 39:51

And and even use potentially as a screen. You know, we do PAPA, you said it yourself. We're so focused on cervical screening, breast screening, we should be doing the pelvic screening as well with the blood test.

SPEAKER_02 40:08

Your lips to to the to the goddesses, the fertility goddesses' ears, and the powers that be. I want to be mindful of your time. You've been so generous. I know you're incredibly busy. And uh so if there's anything that we haven't covered, that points that you wish to convey, and I will I will inter intervene one for one second because Penny, you had said off camera, one message you really want to make sure that the viewers and listeners hear and take in is that this is not you. This is not your fault. You did not do anything wrong or create this scenario. It is a disease, much as if you just said, whoops, you know, all of a sudden everything's going along, you know, swimmingly, and now I have allergies, right? It's it's it's that it's that level of life happens kind of thing. So, but but with so so thank you for reminding me of that earlier because I want to make sure that I convey that as well on your behalf. But is there anything else that you want to say what might be coming down the pike, or you know, what other um viewers and listeners might want to consider before we sign off?

SPEAKER_00 41:18

Yeah, no, we can't wait until we can offer the test to you know anyone um or any physician who see the need to administer for their patients. You know, just give us a call, you know, we'll find a way to make sure that, you know, like those needs are met. Um we're here to serve. Beautiful and thank you for the opportunity.

SPEAKER_02 41:37

Oh, my pleasure. And uh yes, go Faraday. Faraday did I sit.

SPEAKER_01 41:41

Oh no, it's I've spent my whole career as as you know, focused on improving the lives of of women and young young girls, you know, and I'm very passionate about this. And and of course, as Penny said, we'll make we'll do everything we can to bring the test to you. Uh, I think it's very important that everyone have access to to a test like this. So thank you, Susan.

SPEAKER_02 42:11

I can feel the passion, I can feel the mission, I can feel the legacy in this conversation. And viewers, listeners, you know, if if this if this resonates with you, please reach out to Heranova, or you can reach out to me if you happen to be in the San Francisco barrier, because it kind of is zip code dependent. Um and if the if not for yourself, think of someone who you know and love, because again, and and and have the conversation, because oftentimes this particular conversation is had, well, it's not had, and so it's in isolation and it is in secrecy, maybe with the medical doctor, maybe with the psychotherapist, if if if that's you know the direction that that you're being led. But share this conversation because really it's time for us women to rise up, demand the health care that is available. We're not asking for something out of the blue. It is available now, and it is simple as a single vial blood draw. So so pass it along to at least 10 people, share and like and pass it along to at least 10 people. And then if the statistics or as statistics statistics show, you're likely to have helped someone who either knows or not that she's in pain and that she has endo. So, with that in mind, thank you once again. I know your time is valuable. Thank you for being here with me for the conversation, viewers, listeners, thank you for being with us for the conversation. And we close out every one of our uh recordings of conversations at Health University with the phrase class dismissed.