The Keri Croft Show

Fertility Expert Dr. Jain Breaks Down Egg Donation, Genetic Risks & What Really Impacts Conception

• Keri Croft

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If there’s such a thing as a modern-day stork — it's Dr. Jain. 

Dr. Jain is an not just any reproductive endocrinologist and infertility specialist  — he helped create my family — and thousands of others — with a rare blend of brilliance, brutal honesty, and just the right amount of sarcasm.

This conversation is the opposite of clinical. We dive into:

 🧡 Egg donation and genetic curveballs 
 🧡 Why you shouldn't be so stressed about stress when it comes to infertility.
 🧡 The myths we’ve outgrown
 🧡 How fertility insurance coverage has made major progress — and where it still falls short
 🧡 And the truth about making peace with a Plan B that still leads to your dream

Dr. Jain brings the facts, the science, and the hope — reminding us that even if the path to parenthood looks wildly different than we imagined, there’s almost always a way forward.

This episode is for anyone navigating infertility, supporting someone who is, or just trying to wrap their head around the wild world of modern family-building.

🎙️ Listen to the full episode now — and share it with someone who needs a little less fear and a lot more clarity.

#TheKeriCroftShow #InfertilitySeries #InfertilityAwarenessMonth #1in6 #EggDonation #GeneticCounseling #FertilitySpecialist #IVFSupport #DrJain #InfertilityMyths #YouAreNotAlone #ModernParenthood #SayTheThing


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Welcome to the Infertility Series

Speaker 1

Welcome back to the Keri Croft Show and to the next episode in our infertility series. Today's guest is someone who's played a huge role in my story Dr Jane, one of the top fertility specialists right here in Columbus and the person who helped me create my beautiful family. But beyond his expertise, dr Jane is just a fun guy to talk to. He brings not only incredible knowledge but also humor and heart to a topic that, let's be honest, can feel really heavy sometimes. Our conversation was lighthearted, insightful and full of the kind of real talk I know you're here for. We dive into the fertility world what's changing, what people should know and how. Having the right team in your corner can make all the difference. And if you're in Ohio looking for a fertility clinic that leads with compassion and care, I can't recommend Pinnacle Fertility Ohio enough. Dr Jane and his team are the real deal, as always. If this episode speaks to you, or if you know someone who could use this kind of info and support, please share it, rate it, review it, send it to a friend. Every share helps spread the word and keeps these important conversations moving forward. To a friend. Every share helps spread the word and keeps these important conversations moving forward. All right, let's get into it. Here's my chat with Dr Jane.

Speaker 1

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Speaker 2

Yes, incredible.

Speaker 1

Or you go hey, chat, gpt. What's up? Motherfucker? How do I answer this question? Alright, here we go. Dr Jane, did you have a hard time getting in with all the paparazzi?

Speaker 2

is all I want to know. There's no paparazzi.

Speaker 1

It's on. Welcome to the Keri. Croft show it's been on. This thing is on. We got a lot of I got you. I got you like audio texts and the ladies. I got it all.

Speaker 2

I thought we're wearing like headphones or something.

Speaker 1

Do you want to wear?

Speaker 2

them.

Speaker 1

Uh, no, all the cool kids are done wearing the headphones. Yeah, you dropped your phone. You're going to need that, cause I know someone's going to call you. There's going to be some kind of awkward. Yes, there's going to be some kind of awkward text or phone call that you're going to take.

Speaker 1

I don't care, I actually like when you take calls. Okay, so I'm giddy to have you here because, number one, I just love you, I get you, I love you, I am reeling. We just started this infertility series. We dropped the first episode this morning and these women have just outdone themselves the first episode this morning and these women have just outdone themselves and I'm just very excited to shed light and bring space to a topic that makes a lot of people feel othered, uh, that makes a lot of people feel shame, and they want to kind of shrink in a corner until they can kind of fix what's wrong. So we're here to like bring, bring it out, bring it out, and you're here, the king of the king of columbus all right.

Speaker 2

So we're gonna. We're equal playing field. Yeah, you, you have an uncanny way of making people feel really good about themselves, and then I'm gonna walk out of here, get out in the real world, and someone's gonna let me know what a big loser.

Speaker 1

I am not true, you know, because the thing about me that I will stand by, is I speak the truth, like I don't just make things up. You definitely are known to like if you were a little turd and I didn't like you, I wouldn't be like, hey, dr jane, I'd just be like, hey, what's up, dr jane, I speak the truth, okay. So now, like I told you on my list that I have teed up for you I mean, we are teed up for this you're the modern day stork I should have prepared, but no, you not preparing is what the people need.

Speaker 1

They need you off the rip, the modern day stork. Do you think anyone has named their children after you, or maybe at least a middle name in honor of you helping them have their family?

Speaker 2

Okay, modern day stork. By the way, great movie If you've seen Storks.

Speaker 3

Yeah.

Speaker 2

I great movie if you've seen storks, yeah I love that movie. Yeah, um, and actually I know I'm not answering your question when I saw that movie I thought of, like so many of my patients, that I'm like man. If they're watching this, what does it feel like? Right, because you know it's all about trying to have a kid um I'll tell you what it feels like.

Speaker 1

It feels like shit. Anytime you see anything that has to do with trying to have a kid and you're trying to have a kid, you're like oh, here we go, yeah.

Speaker 2

That's what it feels like, and so many of my patients are like school teachers having to deal with kids all day, right Like it's. Yeah, it does mean a lot when someone does that.

Speaker 1

They did it. Have they done it?

Speaker 2

I mean.

Speaker 1

How many?

Speaker 2

people. I mean, ok, you give me, there's a ballpark, ballpark, yeah. So over the years, um, I can probably immediately think of like seven or eight. That's amazing but, that's but that's you know. Here's the thing I'm so fortunate, I mean. I mean I'm deeply connected to so many of my patients like you. Right, you don't need to name it, doesn't have to be Dane Jane Croft. That's a crazy way to name.

Speaker 1

by the way, you know what we really missed on that, didn't we? Dane?

Speaker 2

Jane For his sake, thank God, because you know. First off, jane's not even spelled right for most people I like J-A-I N. Well, you know, j-n-a is a very common name, right? Not common, it's a popular name, maybe nowadays, yeah, and that's got Jane in it. No relationship there.

Speaker 2

But I think once you use the name for that kid, it's a permanent thing. So these seven or eight kids out there, they're going to be like Mom. What's up with that? Why couldn't you spell it right? Because I got to clarify. Kids out there, they're gonna be like mom. What's up with that? Why couldn't you spell it right? Because I gotta clarify it for everybody, right? What's like? Oh well, you know, 15 years ago I had this fertility doctor and it's like I feel like as life goes on, the fertility thing gets smaller and smaller and smaller. Right, because a huge thing at the time. So I would highly encourage patients to think long term, not in the short term, you, you know, but those I, you know I'm in a weird way. As embarrassing as it is, it does make you feel like super, makes you feel nice. I mean.

Speaker 2

I think all of our patients appreciate us and I think that's awesome. That's obviously a next level. I mean, am I supposed to pay for their college? I don't know. I don't know where my responsibilities end, right? So I have a little fund I have to put on the side, just in case if they'll come back Like hey, time to pay it up, buddy, like oh really, you're so, it's so good. No, but they're great people. I feel like I caught you at a good time.

Speaker 1

Oh, I feel like when I caught you, you were already thinking a certain way well see, I had already resigned myself, um, that I wasn't gonna have kids like I'm. So when I started sos, it was like, okay, I'm not making a ton of eggs here and brady has a balanced translocation. So, like you put those two things together it's not not going. I mean, if you look, just statistically so.

Speaker 1

it wasn't until I so I was, I was knee deep in SOS and I was super fulfilled by that. And then I went to Bali for a week by myself to do yoga training and I was 40 and I just remember feeling and this was just my feeling Like I believe there are so many people who can just have a life and not be a mom and they're okay.

Speaker 2

Carrie Croft in Bali by herself, is a white Lotus episode waiting to happen.

Speaker 1

Oh no, you should have seen it Like that's a whole nother conversation that you and I would go on an ADD rate. We would go on an ADD rampage over. Can I have that as my entry song? I mean, I was like I was like up in a mountain by myself. It was so I had this hole inside of me and I was so like God, I just I, you know, I could never quite close the door on it.

Speaker 1

And then I started thinking like wait, I would do an egg donor in a second. Like it was like one day it just hit me I was like I don't care, like for Brady to do a sperm donor. Oh, we tried that. Like he was like what are they going to call me the uncle? He, he couldn't wrap his male brain around that. Right.

Egg Donor Journey: Carrie's Story

Speaker 1

But when I thought about it I was like wait a minute, I'm more than okay with this. So then I thought of it as like statistically, I'm like hold on. Then my business brain, my wanting to figure something out brain, also took over where I'm like okay, I know we can get normal embryos, I know we can get them. And it also became like a thing I wanted to solve and so I knew there was a little boy in the universe that was meant to be mine. I knew he was out there and I couldn't. I mean, as long as I was okay with the donor and and luckily, luckily, this, this donor that we found. I know who she is because they gave me a little too much information.

Speaker 1

It's not hard to find right and there were just a couple things with her?

Speaker 2

I can't remember. Is she from ohio? No okay, I was gonna say I don't remember that.

Speaker 1

But I really like her and like I still kind of keep tabs on her and it was so weird. One day there's a song that I loved and I would hear it every once in a while and it was just like eerie, hauntingly eerie song and whenever it would come on I'd be like who sings this? This is so cool, but you kind of just like let it pass. Yeah, and one day I went on her instagram and she had that song on her post and I was like there's so many things about her that align. But like I feel this like very deep gratitude towards her, like a kindred spirit yeah um, but yeah, I mean.

Speaker 2

So by the time we got to you, I think I had decided I was going to use a donor yeah I could be wrong about that, but I think that is what happened so I remember actually quite clearly, because I have memory for certain things right.

Speaker 2

I remember the very because I remember you were like just give it to me straight, give it to me straight. And I remember which I always do, even when not asked, unfortunately, or whatever you want to call it, um, I I remember saying specifically the the number of embryos we're going to need to get a balanced embryo we're not going to get from you at this age with this ovarian reserve and thus, if we're looking at doing like multiple and even without a guarantee you know cycles, but one donor egg cycle we should be able to get enough to have a couple of kids. And I remember like it didn't, it wasn't even like I was trying to convince you, because I never try and convince people about donor eggs. I just I remember making the statement. I remember you just like being good to go, so I think your mind was already there. It was just a matter of someone saying it, what you were already thinking and you were all over it and I remember. I also remember how motivated you were there's no hesitation and we were just go, go, go.

Speaker 1

And yeah, I'm excited to get into that conversation. I've been very hesitant to talk about it. I don't know. I think there's a couple things I haven't shared publicly about my journey. The first one is our first stillborn. We had Angel, so she had unbalanced chromosomes, so she had Dandy Walker syndrome. She was missing her cerebellum, she was in real, real bad shape and we chose to deliver early. And that's a very, very controversial topic and it's just one that I'm ready to talk. It's not like I'm sitting in shame Sure, it's. Of course that's a huge conversation, but I feel like with my story, there's like so much to bite off.

Speaker 2

Oh, yeah, that I, you know, I just sort of.

Speaker 1

You've gone through like the full spectrum, wait till Shepdog comes in tomorrow. Like she and I were at Hudson and she started talking about like my story, and she's like I've never had the cross section I don't know anyone that that has had the cross section of things and she started listing them and I was like hold on, let me get my popcorn out like it is. I mean all the way through to like the ruptured sack, the you know it was, it was wild. So anyway, it's not that I I wasn't coming out of the gate like hey, we chose to do this, but also it's like I've just been letting this unfold over time. So that's a conversation I have to tackle.

Speaker 1

And then the egg donor conversation is a huge one that people in my life who need to know know. But I have friends who don't know. I have, but it's not because I'm trying to keep a secret, it's just private. And I haven't really had. I don't. I'm not going to sit down with everyone, go, so listen. So four score and 20, you, four score and 20. It's a thing where to me in my life, it's no big deal because this is what we do and this is what we've done, and it's Dane and Kyle and I'm like I wouldn't trade them for anything, but it's a big topic for other people to digest right.

Speaker 2

Well, 99% of people who hear your story, they don't even know this stuff exists right. Translocations and what they mean and and getting pregnant, and oh, because of the translocation, the kind of abnormalities that can arise right because what they see with you is this really well put together. Smart, in control person like keep coming.

Speaker 1

You got more adjectives in there. I know you do. I know you do come on everyone.

Speaker 2

That's why they listen to your show Because you're incredible. But the reality is Incredible. People like yourself, who've tried to do all the right things, sometimes get handed this To deal with, and I think most people Would probably have given up or just said you know what? Not for me. I could all go as far as saying, knowing that, yes, you were advancing in age, but it was your husband who had the translocation. There's also a blame factor that a lot of couples have to go through right.

Speaker 2

I mean, your marriage is something that could have been at risk through all of this.

Speaker 1

It was at risk and we did. We separated for a year.

Speaker 1

Actually I remember you telling me that is another, this is another topic in this. I mean, the marriage topic can transcend through anything, right? So, like, whenever you put a life stress on a marriage, it's just going to exacerbate it. But the blame thing with Brady, that was another thing too. Like I wanted to be a mom, but I will tell you that when I would think about us having a family, the first vision that would come to my head always was Brady Croft with a kid on his on his shoulders, cause he's a teacher, he's a football coach, he was a football coach. He comes from like a very tumultuous background and he just deserved to be a dad and he wasn't going to take those steps. I mean, you know, men and kind of how you guys get a little stuck in your ways and like, of course, the shame factor, and so I was. I was just like for me too, but like for him, I was like I'll be damned if he can't have a healthy child.

Speaker 1

You know, and like again, you just mentioned the whole um, again, the balanced translocation here's another topic I can help people with. There are people at home that are going to hear this and go wait a minute. Balanced translocation, robertsonian, uh, like robertsonian or reciprocal, like I know way too much about this shit and don't tell me you have a 50, 50 like, don't give me the like google machine odds of having it's all different based on which chromosomes fucked up. And there's some woman in north or in upper upstate new york is the one woman who like deals with all these different like trans, and she like takes them and it's I know too much.

Speaker 3

So I'm here to help.

Speaker 2

Yeah, I think the awareness is huge, right? Yeah, and I think important that someone like you and I say you specifically because you're you're a person that people listen to you've had to go through it and you've not only survived it but you've grown your family from it, right?

Speaker 3

Yeah.

Speaker 2

Yeah, yeah, I mean that's, yeah, that's powerful stuff.

Speaker 1

And you know what kind of gets me uh, I don't know if excited is the right word, but it does give me a little adrenaline is getting. I want all of my stuff to be out there, public knowledge, and I just want to protect and help other people who maybe aren't as strong.

Speaker 3

Sure.

Speaker 1

You know so, someone else who has to make that choice of delivering early, someone who's sitting there grappling with, like an egg donor, but it feels so weird to them because they don't know anybody else, someone who would never in a million years think they could get a surrogate. I want to get pulled into those people. I don't care about the. You know, oh my God, did you listen to this episode? Carrie said she had an egg donor and she, oh my God, she delivered early. She's fucking like, oh, okay, fuck, all y'all Like like, truly, I don't care about that. I want those people that I'm supposed to help to get closer to me. And so, until I tell all of it, how am I going to, you know?

Modern Fertility Technologies and Innovations

Speaker 1

And another thing too, my, and another thing too I was really concerned. My number one, two and three concern was talking to Dane. So I'm starting to talk to him, very elementary, very here and there about it. But that was my real like the people who needed to know my core. Okay, fine, but Dane, and now Kyle, that was my priority, not like the phone tree, you know. Yeah, all right, enough about me, dr Jane.

Speaker 1

No that's great, though let's talk about you, okay, so I have a lot of questions here for you. Some of which I'm not going to ask because they're stupid One that I'm very interested in.

Speaker 2

Carrie, as you know, there are no stupid questions. Oh wait, sorry, only stupid people, no ivm in vitro maturation.

Speaker 1

I'm real curious about that and any other technology that you see on the horizon like what's coming up. Are we gonna have, like you know, these like manufactured uteruses growing kids? I mean, what's happening here?

Speaker 2

so two very separate things yeah yeah, of course. By the way, the manufactured uterus thing is starting to like pick up. There's like there's, there's actually research headed in that direction. I don't think it's going to happen for a while, because you think about what our uterus has to go through in pregnancy and what's involved. It's not like you just need to set up an incubator and say, here you go right um too many dynamic changes happening during pregnancy, but it's certainly possible, right?

Speaker 2

I think now we've reached a point in the world where nothing truly is impossible. It's just a matter of how long or how, or can we afford to those kinds of things right.

Speaker 2

But going back to IVM, it's been around for 20 years. I actually, when I practiced in Jersey 20 years I actually, when I practiced in Jersey, we did some of it. I wasn't the biggest fan because it sort of takes to me the more it takes out I think the better parts of IVF but leaves in the more challenging parts of IVF. So basically, what you're doing with IVM is you are taking either a low dose of medicine or almost no medicine and doing an egg retrieval for just the small follicles, right? So they're immature. And you get these immature eggs and then you put them in a media in your lab and then you mature them and once they reach maturity, you fertilize them in your lab and then you mature them and once they reach maturity, you fertilize them right. Well, you could do the exact same thing by taking six or seven more days of medication, right, like we do in regular IVF, and then doing an egg retrieval for readily mature eggs.

Speaker 1

So what's the point of doing it?

Speaker 2

So the point is really twofold. It was more popular when so like anything else, it's an option, right? And I feel like when you're in the fertility world, as you've gone through and we've talked about, if someone gives you an option, even if it's not right for you, it's oh. This is different. Maybe I should try this because that didn't quite work out for me, right? So I think in that sense it draws people in and we would get people coming to us simply because it's like, this is what I want to do. It's like, but that doesn't even help you, right.

Speaker 2

So what it does do is maybe helps you save some money on medicine, but the overall cost and then, on top of that, when you grow these eggs in the lab and you fertilize them, the embryo quality you get is never as good as what you would get in a good IVF lab, like we would probably say we have right. So if a patient came to me and says I want to do IVM, compared to IVF, like, your success rate with IVF and your ability to have many kids down the road with frozen embryos with IVF in the traditional sense is way higher than doing one IVM cycle, right? Also, with IVM, there was a time before we started doing certain types of medication and different types of triggers, when they did regular HCG triggers. You get some patients who would hyperstimulate, so by doing IVM you're retrieving those eggs early so that they don't get ovarian hyperstimulation syndrome. I hate to poo-poo anything, but I would simply say when you just compare the outcomes, ivm outcomes will never really touch what you can do in a good IVF lab.

Speaker 1

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Speaker 3

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Speaker 1

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Speaker 2

Well, so most of the things that are coming up are more on the lab side of things.

Speaker 2

Now there's tons of stuff that we market in our field, unfortunately to the patient. So the patient's like, ooh, I want to try this, because everything's really driven by what the patient wants. Right, and if you can market it a certain way, then they're going to want it right. I think, um, some of the things on the lab end, like, for instance, semen analyses right, they now have, you know, ai technology and these little desktop I mean, god looks like a big alarm clock, for lack of a better term. Well, people now don't even have alarm clocks.

Speaker 3

The old alarm clocks right.

Dispelling Stress and Thyroid Myths

Speaker 2

Those big old alarm clocks. You literally can put a semen sample in there and it'll do volume, concentration, motility and morphology, which is looking at shape of sperm, all through its own AI-driven way of reading it. And they found it to be very close to what a human does. But remember, even with humans, if the three of us are doing semen analyses on the same sample, we're not going to get the exact same number. There's always some variability there. So, in order to almost level that playing field, these machines do a wonderful job and it allows your embryologists and andrologists to focus on other things rather than just, you know, counting sperm a most common misconception about infertility that you'd love to set straight a lot of misconceptions about infertility, right.

Speaker 2

So I think one of the most common things that almost every patient brings up is stress, right, like, how much does stress affect? And we and we? I think it's, I think it's accepted now. Stress affects everything, right, but then, to like, to what tangible degree? Right, stress in some ways is good in some aspects of life.

Speaker 2

Me trying to get here on time so I don't get the kerry croft upset, that's a stress that you know. Maybe I broke the speed limit a little bit but I didn't stop to, you know, whatever. Go through the drive-thru somewhere, you know whatever. No, but, like, I think stress and infertility is a little bit overrated. I mean, anyone trying to get pregnant, there's a stress component to that, right. So the reality is the level of stress to cause, like physiologic changes that would actually affect fertility, is so high that your period would just go away. Right, that's when you talk about the really high cortisol levels and things that we don't really check. But we just know that in extreme, extreme ranges can cause side effects. Right, but I think that we often put undue importance on it. Right, like, a lot of times I'll be doing a consult and the husband will say well, you know, she just took on a new job and it's more hours and I just think she's really been stressed out and we think that's why and that could be, you know, could be some contributing factor, but I don't think it's usually the cause.

Speaker 2

That's where our basic testing and all that stuff comes in. What about thyroid cause? That's where our basic testing and all that stuff comes in. What about thyroid? Thyroid's important. I mean, thyroid affects everything. So there was a time, 2010, there was a landmark paper that looked at baby's brain development, so baby's brain development in pregnancy, and they tested 18-month-old infants. Cognitive testing on 18-month-old infants. You can only imagine how cognitive intact an 18-month-old is, you know. No, they're in diapers so it is what it is right.

Speaker 2

But they use that looking at maternal TSH levels thyroid stimulating hormone which is kind of the standard test for thyroid and they tried to correlate. At what point do we see a decrease in our cognitive testing on these 18 months old, and they found like a level of 2.5, right so 2.5 IU per liter TSH. And for the last 15 years we've like been stuck on this 2.5, right so you could be normal. And at 3.0, like oh, here's a low dose of thyroid medicine for you.

Speaker 2

I feel like I always felt that was overkill through all this time. Lately I think it was last year there's a paper that actually sort of debunks that and they've actually lowered that to four. I think it's like 4.5, which is good because now you have less people taking medicine for something that they didn't really need. There's no harm to it outside of, I guess, cost of med. But that's one of those things where all it takes is one paper and people jump all over it, um, and then you look back like, oh, that data really wasn't so great to begin well, I think that's what's scary about it like.

Speaker 1

Look at the look at the whole breast cancer thing with estrogen and the, the whole thing that that one uh study cause for for hormone replacement therapy. And so now we're finally swinging back because so many women are having problems. And then they finally debunked it to say, okay, this was like, it was like one in 1,000 or something crazy like that. But it's wild how the pendulum swings in medicine.

Speaker 2

Well, so much of medicine is based on, so we call it evidence-based medicine. It's like a little field of its own and all it is is all of the data and all the papers and all the things that we have. You know, are they evidence-based enough? And it's really, really hard because there's so much gets baked into statistics, right? So you have this data set. What statistical model are you going to use to evaluate that? And really, what's the ultimate goal? You know we all have the goal of trying to put good data out there. We all want to do something positive for the field and specifically for the issues that we're looking at.

Speaker 2

But the reality is the number one motivating factor when you're doing research is I want to get data and I want to publish right Now. Whether that's a low-level publication or a high-level publication, that is dependent on a lot of things. But a randomized, controlled, well-put-together trial, even with all the intention of being done perfectly well, there's going to be lots of bias baked into it. And when these studies get published, especially when there's the lack of any other literature that would say, oh wow, there's equal literature that would maybe combat this. Sometimes it's the only study on this issue that was done, well, you go with it. And I'm not saying those are bad things, because usually common sense does play into this. You're not going to just start doing something crazy because the paper said so.

Speaker 2

But on the other hand, there's lots of things over time that we've debunked just because it's like well, data's changed and certainly there's fields where things shift back all the time Dr Shepard is actually a great person because I know you're so tight with her asking about, like, when they close people up from C-section. So in my residency we were told single layer closure of the uterus is the standard. All the data said single versus double layer, no difference. And then later on I find that you know, I don't do C-sections, but oh, no, no, double layer closures are better. Or oh, they should close the peritoneum, that little filmy layer that kind of keeps everything inside just below the fascia. We should close that up too. So you have some docs who did, and they always did right. They always have that 70-year-old guy. This is the way I've been doing it my whole career. It doesn't matter what the data says. And look, I was right.

Speaker 2

But, then two years later, something else says differently. So that's just a very simple example of something that a doctor would do over and over again as an OBGYN. But the thought of what should we be doing, what's the right way to do it, it goes back and forth. You realize patients are different and things vary and your patient population is different. Maybe your operative skills are even a little bit different. And really it's not until you start practicing and you see patients and you go back in for that second C-section or third C-section that you start to see like hmm, this is how I did it in those patients versus these patients, and then maybe you get your own way of doing it Right.

Speaker 1

It is funny. And when you say you're practicing medicine, I mean you, straight up, are practicing.

Speaker 2

Yeah, Like I mean, I thought of it that way.

Speaker 1

Well, you are. I mean, it's like so and that's that's. There's nothing that's ever going to change with that. I mean it's like the beauty and the, the terrifying thing, because it's like. I mean I guess it's all for the. You know, innovation and the evolution of medicine.

Speaker 2

So there's always going to be innovation and evolution.

Speaker 1

Yeah.

Evidence-Based Medicine: The Shifting Pendulum

Speaker 2

And it should always get better. Yeah, when you look at IVF success rates today, if you looked at literally every single year for the past I don't know 15 years, the national IVF success rate has crept up by like half a percent, 1%, like it just keeps creeping up, which is nice to see, right, there's more IVF being done every year, but also the success rate has gotten a little bit better. I'm talking average across the board.

Speaker 2

So, I think those things are good to see. At the end of the day, the data is the data, right? Doctors still have to make commonsensical decisions based on what's best for their patient. So you know, after you said, I think WHI is a great example of like data saying, oh, estrogen is bad, it causes breast cancer, and then literally across the board. You see that was 2001 that that data came out.

Speaker 2

I believe I was on my menopause rotation with a doctor named Marjorie gas. Um, dr Gas uh is um, she's amazing, um, and she was like president of the North American menopause society for like many years. She's she's a leader in the field. But here's me doing a one-on-one rotation with her, literally the week after this paper comes out, and her phone was ringing off the hook of patients calling in saying what should I do? What should I do? Right? So I still remember.

Speaker 2

I'll tell you a really quick, funny story. So here I am, second year resident working with her, and I walk into a consult with a patient of hers, patients like 74, maybe like 78 years old, like a little bit older, close to 80. And I'm like, well, as you know, there's new, by the way, I was very young, so I was a 23 year old intern, 24 year old, second year, second year resident. So here I am, 24 year old young man, with a 78 year old woman who, by the way, looks amazing for her age. I still remember like I'm sure it was makeup and everything, but she just looked really, really great. Right, I'm telling her about this new data and how maybe we should think about taking you off your estrogen. And you know I'm doing what I'm supposed to be doing.

Speaker 2

I remember she looks at me. She goes Sonny, how old are you? She called me Sonny, how old are you? And she I don't think she was. We weren't in the South, Maybe she was from the South. I'm like I'm 24. And she goes I'm 78. Do you think? And she swore do you think I give a blah, blah, blah about what this new research shows? I'm doing fine, you know. And she was. I think her husband had passed. So she's like I'm by myself. I blah, blah, blah. I live my own life and I'm thinking like, yes, but the data says you know it's coming in my head. Like, yes, but the data says, you know, it's like coming in my head like this is common sense of this woman who's 25 years past, menopause is doing great. Don't mess with her Right. And obviously that comes with maturity and knowing how to deal with people and patients as I, as I matured in my career Right, but I think that's an example of, yes, the data says one thing, but it's not for everybody.

Speaker 1

I think that's an example of yes, the data says one thing, but it's not for everybody. I would give anything to see a 24-year-old Dr Jane and to hear some of the shit you said.

Speaker 2

Oh.

Speaker 1

God, oh, it would be unbelievable. Okay, so what are some things, though, that people can start doing today that you believe would positively impact their fertility journey?

Speaker 2

So a couple of things. I think information is vital. So a lot of people are sitting there worried about it. It's like anything in life you can sit there and you can worry about it or you can get the basic information. It may not be the answer that you want, but simply getting the information is helpful in terms of how you feel about it and your decision-making that comes from it. So, talking to your doctor, getting an AMH level, simple blood test, tells you you know nothing's perfect, but tells you a lot about where you are in the moment, about your ovarian reserve.

Speaker 2

Okay, but in terms of what can be, what can they do without seeing a doctor? I mean, if you're in an unhealthy situation, whether it be your, you know your blood pressure, your weight, your your, maybe your diabetic, maybe your uncontrolled diabetic, right? Those are all things we can get better. The reality is most of our patients are fine, right, most of our patients are already taking care of themselves, and that's the hardest thing is trying to tell someone who's already doing so. Well, you're kind of just fine, and those are usually the patients who want to know what can I do better?

Speaker 1

It's so beyond frustrating to, as a woman, to do everything possible to be healthy and then to not be able to do this thing and no one can get inside there to really understand. Sometimes there's certain things you can know, but then there's some things that are just unexplained. I mean, how infuriating.

Speaker 2

So you use the word unexplained. That's like 40% of our private practice fertility patients, right? So back in New York City, in my city clinic and my resident whatever my fellowship clinic that we used to run, it was mostly like tubal factor, right Women who had blocked tubes because of prior infections or things like that. Right, a ruptured appendix that wasn't recognized until too late, or something. In the real world, when you're dealing with patients like yourself and others, everything's already there, right, it's sometimes unexplained. There was a time when the standard in the field, besides doing a sperm test right, a semen analysis, an HSG they would go to laparoscopy. I mean, I learned how to do laparoscopy with the fertility doctor who literally would line up seven to 10 cases on every Friday morning, starting 7am, and we just put in scope after scope and say, yep, looks okay. Yep, looks okay, let's flush those tubes. You look back like we put all those women through surgery. I mean, I was in residency, what do I?

Speaker 2

know, we put all those women through surgery just to say it's okay or oh, here's a little speckle of endo. Didn't really explain anything, right. So, um, we've taken a step back from invasive things, but the basic tests are still what they were 20, 30 years ago in terms of how do you figure out why someone's having trouble getting pregnant. So I also think that's where fertility treatment has gotten so much better. So, even though there's no cause, there's still the ability to treat over it, whether it's with IUI or IVF. I think any time you have something that doesn't always work like clockwork, we're not cats where you let us out for one night and we have a litter. That just doesn't happen with humans. Maybe it does Unintended, who knows. I don't even have a cat. I don't know how I came up with that. Cats have litters, right?

Speaker 1

I just think you're just funny. That shit's great. Make sure we put that in somewhere we're more like pandas.

Speaker 2

We don't procreate well as humans.

Speaker 1

No, apparently not, my God, you don't have to tell me twice yeah, craziest fertility myth you've heard from a patient, like anything wild that people buy into or believe in that you're like, okay, that is wild.

Speaker 2

Believe in is hard, because I think there's looking to believe in anything that's going to help them. But I feel like every now and then you have someone where they pick it up online and there's some doctors out there who push this stuff and push treatments for it. But like things like natural killer cells, right, like I'm probably gonna offend someone by saying this, but I don't think that's a thing and I don't I've I've still yet to see a patient that that truly is the cause of their inability to get pregnant. There's so many other factors that go into it that don't there are. There are physicians out there. They measure natural killer cells and say, oh, yours is blah, blah, blah, we're going to give you this treatment or that treatment, and I feel like some of that is.

Speaker 2

I'll just say it. I think it's hocus pocus for the most part. I just say it. I think it's hocus pocus for the most part. I don't particularly agree with it. Actually, I don't agree with any form of treatment that's really expensive, that either has never been shown to work or for that patient probably won't work, Because you know it's always that risk reward, right, the reward is the pregnancy. The risk is, I guess, medical cost meaning like physical cost, risk or financial financial cost.

Speaker 1

So you want to kind of weigh that speaking of cost, do you see a world in which, like, fertility treatments are kind of standardized, like they're covered there's, there's not this, oh my god. By the way, not only can you not procreate, here's 15 grand to go over, and that's sexy. Here's another slap for you guys to deal with. Do you think there's a world in which it's just going to be part of your coverage? It's fine.

Fertility Coverage and Financial Considerations

Speaker 2

So I think it's going to have to work in two ways Costs have to come down somewhere and coverage has to go up. I don't think you can have costs up here and the coverage just meets it. I do feel there is a. Actually, we'll talk Columbus, ohio. I came out here in 2013. Probably less than 30% of patients had any fertility coverage. The other 70 plus were paying out of pocket. Today, I'll tell you right now, specifically, 35% of our patients have or I should do the reverse 35% are paying out of pocket or have no coverage.

Speaker 3

That's good.

Speaker 2

Yeah, the other 65% are working at companies or have jobs that give them coverage. Now, that's coming from the private world, right? I think what you're asking is is there a situation where we'll have almost government?

Speaker 1

No, not necessarily. I just think for the most part, like that 35%. When is it just kind of like any other bill that you're basically have, like I'm going to pay a grand towards this and everything else is covered, kind of thing. So I guess it's just going to be a matter of these other companies kind of jumping on board, awareness, continuing to have the conversation, more people going through this. It's wild. Like the cost portion of it is wild. So I'm glad to hear that a lot of companies have jumped on board for that.

Speaker 2

Oh yeah, a lot of companies have. And remember, if companies understand, if they want to hire good people, if you want to hire young people, specifically young women, you're going to have to have something that allows for, maybe, egg freezing or fertility treatment. Now, granted, that means higher premiums across the board for everybody who works there, but these companies are built to absorb that and we're very fortunate in Columbus, Ohio, to have this influx of companies and startups that are providing that coverage. You know, one of the things I've been able to do over the years is I literally know. You know, one of the first questions I ask is oh hey, where do you work? Right, and as soon as they tell me, I already know what their coverage is.

Speaker 1

Yeah.

Speaker 2

We actually in our office have a thing where, if you make a new patient appointment, you just text in or take a picture of your insurance card, send it in. By the time I'm even seeing the patient, we already have their benefits. So my conversation is geared towards not just what they need, but, hey, this is kind of what you're also going to be looking at in terms of cost. I'm not going to offer them something that I know is not going to be covered, unless if it's absolutely necessary let's say right, so, okay.

Speaker 1

So you are a pinnacle of you know, knowledge. You're a geyser of information. You are the king of of fertility treatments in the city. This is, I speak, the truth.

Speaker 2

So do you have? Any messages of hope there's only a couple of male fertility providers, I know, but still we'll just go with it.

Speaker 1

We're just gonna go with it. For anyone out there who's stuck are there. You know they feel like this is something, that is, they're looking down the road. They're like, okay, I have a feeling this is like this is. We're starting the journey, we're taking some steps. Anything you'd like to to say to them anything, any hope you'd like to offer any sort of words of wisdom, just knowing that you see this all the time.

Speaker 2

Yeah.

Speaker 1

And you're the guy.

Speaker 2

Well, I mean, I don't want to say I'm the guy, but there's in my mind're the guy, thank you.

Speaker 1

Thank you very much for saying that.

Speaker 2

No, I mean, obviously I, this is what I do, right? So I believe when I say something to a patient, I believe wholeheartedly in it. Um, you know I'm probably guilty of saying it like it is, but I feel like that's important, especially when you're dealing with things where people are putting their financial livelihoods at stake. Right, they're allowed to think with their hearts. I have to think with my head and help them sort of bridge that gap a little bit right. I think the most important step is just getting started. Right, just get the basics of where you're at. Once you get that sort of starting point, then you know what your potential is.

Speaker 2

I think the worst thing people can do is just wait Now. I'm not saying that you get married today and if you're not pregnant, you know, by end of summer, oh my god, I gotta see a fertility doctor. Well, I guess if you're over the age of 35, you don't wait too long, but you know, if you're, if you're younger than that, maybe give it, you know, six months or so, talk to your OBGYN. I think, ultimately, the thing that actually just today I saw a couple of patients as new patients, who were in their upper 30s, who literally just got married.

Speaker 2

Like within the past year, one's going to get married this summer. It's not like they could have done this years ago, right, but this is where life brought them and this is how they met and this is what they're going to deal with. They're probably going to need extensive fertility help. One of them, I can tell you, is going to need donor eggs probably. So, understanding as a patient, there's probably always going to be a solution. It may not be the solution you want, but it will be a solution. But you've got to get started to even know where you're at.

Speaker 2

And sometimes time in these matters can hurt. I think it also creates more stress, frustration, right. So I think we're past the point of having to wait a long time to go see a fertility doctor. There's enough of us now. You can call and make an appointment, be seen and get your information pretty quickly.

Speaker 1

Knowledge is power. Yeah, it doesn't mean you have to act on it or you feel pushed into it, but it would just. That would be my humble opinion to anyone is like you don't have to. It doesn't mean you have to rush and get pregnant, yes, it's just. Knowledge is power and understanding your baseline, and there's nothing wrong with doing that. And making an appointment with Dr Jane at RGI.

Speaker 2

Well, you said pinnacle, that's our new name.

Speaker 1

Well, pinnacle.

Speaker 2

Is that what you said, pinnacle?

Speaker 1

I said RGI.

Speaker 2

But initially when you said you're the pinnacle.

Speaker 1

Oh, you're the pinnacle.

Speaker 2

I'm calling you.

Messages of Hope and Final Thoughts

Speaker 1

Well, no, that just kind of happened to work well together. But, you are the pinnacle.

Speaker 3

And hence why the name is now Pinnacle.

Speaker 2

Yeah.

Speaker 1

Dr Jane, it is always an absolute pleasure having you in the studio. My cup runneth over. Thank you for being a part of this infertility series.

Speaker 2

It's totally my honor. I think you're doing an awesome thing.

Speaker 1

Thank you, and I think you're doing tons of awesome things. Can you come back again.

Speaker 2

You know, I feel like what I need to do is have an office close to here and we can just do this like a regular.

Speaker 1

I love you it's mutual, I love you if you're still out there following your girl, following me on YouTube, spotify, apple or wherever you get your podcasts and until next time, keep moving, baby. If you made it to the end of this episode, thank you. It means more than I can put into words. And remember, please tag me on Instagram, shoot, shoot me a DM, leave a comment, drop a review. I read every single message and your words remind me why this work matters. You can find more resources, ways to connect and everything I'm building over at kerrycroftcom. Thank you again for listening, thank you for holding space and thank you for being part of this conversation. And until next time, keep moving, baby.

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Keri Croft

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