We are thrilled to have Dr. Michelle Goldsammler join us on today's episode of the Fertility Forward podcast. Dr. Goldsammler brings a wealth of expertise as a board-certified Reproductive Endocrinologist Infertility (REI) Specialist and Obstetrician and Gynecologist. Her clinical proficiency spans reproductive endocrinology and all facets of fertility treatment, including IUI, IVF, and fertility preservation. She's dedicated to empowering her patients to actively participate in their reproductive journeys through education. With a commitment to individualized care, Dr. Goldsammler prioritizes the patient experience and delivers culturally sensitive healthcare. As a practicing Orthodox Jew, she brings a cultural sensitivity and valuable insights into religious considerations like family ritual purity; a law in their religion. In our conversation, Dr. Goldsammler shares how she integrates her religion into her work, her approach to counseling within religious boundaries, and the importance of collaboration and communication with religious leaders in her practice. For a truly insightful discussion on the religious aspects of the fertility journey, don't miss out on this episode with Dr. Michelle Goldsammler. Thanks for tuning in!
We are thrilled to have Dr. Michelle Goldsammler join us on today's episode of the Fertility Forward podcast. Dr. Goldsammler brings a wealth of expertise as a board-certified Reproductive Endocrinologist Infertility (REI) Specialist and Obstetrician and Gynecologist. Her clinical proficiency spans reproductive endocrinology and all facets of fertility treatment, including IUI, IVF, and fertility preservation. She's dedicated to empowering her patients to actively participate in their reproductive journeys through education. With a commitment to individualized care, Dr. Goldsammler prioritizes the patient experience and delivers culturally sensitive healthcare. As a practicing Orthodox Jew, she brings a cultural sensitivity and valuable insights into religious considerations like family ritual purity; a law in their religion. In our conversation, Dr. Goldsammler shares how she integrates her religion into her work, her approach to counseling within religious boundaries, and the importance of collaboration and communication with religious leaders in her practice. For a truly insightful discussion on the religious aspects of the fertility journey, don't miss out on this episode with Dr. Michelle Goldsammler. Thanks for tuning in!
Hi everyone. We are Rena and Dara and welcome to Fertility Ford . We are part of the wellness team at RMA of New York , a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Ford Podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
Speaker 2:Dr. Michelle Goler is a board certified reproductive endocrinologist and infertility specialist and obstetrician and gynecologist. She has clinical expertise in both reproductive endocrinology as well as all aspects of fertility treatment such as I-U-I-I-V-F, as well as preventative and medically indicated fertility preservation. She cares for patients at both the Melville and Lake Success locations of RMA, New York Long Island. And prior to joining the practice in 2023, Dr. Gold Sandler worked closely with minority populations at Bronx and Westchester County to achieve the reproductive goals and served as the REI residency site director at Monte Fury Medical Center, where she trained the next generation of OB GYN physicians and fertility specialists. She continues to educate her patients to empower them to be active participants on their reproductive journey, practicing an individualized treatment approach. Dr. Gold Sandler takes patient experience as a priority in the delivery of culturally sensitive patient care. Dr. Gold Sandler , we are really happy to have you on today. The first time we're meeting you.
Speaker 3:Happy to be here. Happy to talk to you guys.
Speaker 1:Well, we're super psyched. We found out from our team you are the only female orthodox reproductive endocrinologist on Long Island. Is that true? That seems like, but a needle in a hay stack ,
Speaker 3:At least from what I'm aware, I'm the only one currently here out on Long Island. Happy to help everybody with their orthodox or non-Orthodox religious needs. There are a lot of other Jews in the area definitely, but I think I'm the only female orthodox one here out on the island.
Speaker 1:That's amazing. So I mean, tell us first how you got into this and then we'll just say sort of we were directed for the content of this podcast to really sort of focus on religious aspects of a fertility journey and get your expertise in that. So we'll share that up front with the listeners. We're super excited to get your perspective, but tell us first how you got into your field.
Speaker 3:Sure. So I actually first thought about something like REI in medical school. So I had a really dynamic and energetic reproductive course teacher my second year of medical school who happens to be an REI and kind of approached it from that systems approach. And she really just was such an enthusiastic, you know, teacher that it really kind of peaked my curiosity. And I like working through problems. I like working through pathways and connections and hormones and reproductive hormones. Kind of just fit all of those bills. And since then I've kind of taken off and followed that trajectory through the rest of my med school career. And then went into OB GYN knowing that I wanted to be a reproductive endocrinologist and fertility doc and really just kind of followed along that pathway since then.
Speaker 2:It's so nice to, you know, hear how sometimes all it takes is having a mentor to really kind of put you in a path that maybe wasn't necessarily on your radar. So it sounds like you had interest in hormones and things like that, but having , uh, you know, someone who kind of really helped take that interest and teach it in a way that really wanted you to specialize in, in this niche field.
Speaker 3:I definitely think for sure it's all about who's there to guide you along your pathway and who's there at the right moment in time, you know, to really encourage you. I , I definitely think mentors, whether formal mentors or people that are informally there and don't even necessarily know the impact that they have on your life, I think those are really the strongest kind of influences that people have . I think it's fantastic.
Speaker 1:Hmm . Absolutely.
Speaker 2:It's interesting I had , you know, in school science was not something that was necessarily on my radar. It wasn't my favorite course to take. But similar to you, I had a professor in high school who challenged me and he made me really work hard and make me think outside of the box. And if it wasn't for him, I personally wouldn't have gone into nutrition. So it's so nice to hear that sometimes all it takes is, is someone who challenges you and brings things to your attention in a way that helps, you know, it really resonates with you that really can help jumpstart, you know , your career path.
Speaker 3:Yeah, that's
Speaker 2:Great.
Speaker 1:Tell us maybe some of your favorite things about your role as an REI , what really, you know, brings you joy in the position .
Speaker 3:I think what really makes me really kind of connect with REI and the REI patients is the patient population is so interesting. It's, it's these couples that are really motivated to kind of work with you towards their goal of building their family in a variety of different ways. And I, I kind of find that motivation and enthusiasm makes me also have that same kind of enthusiasm and motivation to kind of partner with these patients. You know, I know in REI , there's major ups and major downs that you have emotionally going through this and I kind of like having that connection with them , you know , throughout this process and kind of really feeling like I'm part of their journey and they , they're kind of including me kind of in that little family circle, at least for this portion of their life. I , you know, I get excited when, you know, I walk into a patient room and I'm able to give them good news. I'm happy to be there for them when I give them not so great news. But that we're all kind of supportive of each other and on the same page and you know, taking that as a stepping stone for the next part of our journey together. I like that teamwork aspect of REI that I , I don't think that you find in some of the other fields of medicine. Hmm . That's a great answer.
Speaker 2:Yeah, you make a great point that it's nice that you get to share in something with people and also I think it takes a specific type of person to be an REI , you know, I think compassion is a very important component and it's something clearly that I see that you have and that you can bring to the table to your patients. Yeah. To make their experience that much more at ease in a way. 'cause you're right, it can be very overwhelming and you know, I think it's great they have support from people like Rina , but you know, it's nice to have people in the team in general being there to really support whatever your , you know, the patient's going through. And it shows, I mean it shows in your , also in your excitement working with them, which is wonderful. So I'm really curious how you bring your religion to work, so to speak, in terms of the , you know, working with a specific, you know, population group, how you can make, you know, in some ways you're very unique in that way, that you have something that a lot of these other doctors don't have in terms of a knowledge and also in terms background. So I would love to hear from you like there must be a lot of, you know, specific considerations that are specific to people in the Orthodox community.
Speaker 3:Yeah. And so there definitely are some nuances that, you know, I definitely I'm privy to and can kind of be a little bit more sensitive to during this process that is specific for the Orthodox Jewish population. But even, and I definitely wanna share some of that because I think that it's very interesting both for patient's perspective and from clinician side, but before that even, I think just the fact that I am an observant religious person in general, I found even in the populations that I served before that aren't primarily orthodox and aren't primarily Jewish, even that I just have a sense of cultural sensitivity towards what some of the other potential religious or cultural conflicts may show up during this process. Or that there's questions to ask, you know, with regard to people's private practice and religious or cultural practice at home that , how that may be affecting their desire to seek treatment or different types of treatment, things like that. But specifically for the Jewish population, the Orthodox Jewish population, there are definitely some interesting things that happen when we're talking about fertility. And so the major thing that I think that I have a lot of background in a lot of information about is what's called family ritual purity or Tara Ham , which is a set of laws that kind of guide couples about appropriate times for sexually intimate activity and not around menses and around kind of bleeding and things like that. And so, you know, dealing with the mikva , the ritual bath and so the timeline about when a woman is fertile, but when she is allowed to be intimate with her partner sometimes are in conflict based on religious law . And so there are some women that actually have what I call religious infertility and that ovulate too early to be religiously appropriate timing to be sexually intimate with their partner. And so that's one of the first things that kind of is unique to this kind of orthodox community that there are people that ordinarily wouldn't have had an issue getting pregnant, but because they follow these, you know, orthodox guidelines about the mikva or or ritual purity, they now are unable to get pregnant because they're ovulating too early. And so ,
Speaker 2:Wow . I never even thought of that. I didn't even realize that was a , I knew that, you know, there's a certain time period and correct me if I'm wrong, you know, after a menes , you know, before they could be, you know, someone could be sexually active, there's a time where you have to go to the mikva, but I never came to realize that that may coincide with an ovulation window.
Speaker 3:Yeah. And so I'm not your religious authority, I'm not gonna make religious, you know, statements. But definitely there is a minimum timeline between when someone can get to the mikvah, assuming even the shortest menstrual cycle . And so for some women that have shorter cycles that are 21, 22, 23, 24, 25 day cycles, they're gonna be ovulating early. They may be ovulating before they can get to mikva . Hmm . And so for that particular population being sensitive and aware of that kind of concept, some people are even too afraid to mention it to their doc. They don't understand the nuances that when you're undergoing an ovulation induction cycle, taking Cole , taking Letrozole and your doc says, Hey, you're ready to ovulate, these couples sometimes don't even know that they should have mentioned, Hey wait, I'm not ready to go to MFA for another two days. This isn't gonna work out. And so I have some tricks and tips up my sleeve to delay ovation or to things differently . And definitely in the past work with you people to figure out how can best make it so that they're fertile at the time where , where it's appropriate for them . I was gonna ask that .
Speaker 1:Yeah. How do you advise someone on that? It sounds like you don't, the council is not to try and say, okay, well hey let's forego your religious considerations in your tradition because you really need to work with your ovulation window. But instead it's, okay, I acknowledge that this is important to you, so there are things that I can do on my end to acknowledge that time, help you be able to observe your traditions and your rules , but then also hopefully get you, you know, what you want and why you're here .
Speaker 3:Yeah. And I think the whole field of REI is about manipulation of hormones, manipulation of cycles. Yeah . And so having that background expertise, can I manipulate your cycle a little bit? Sure. So sometimes I can delay ovulation, I can give you estrogen in the beginning of your cycle so you don't start growing an egg until a couple of days later than you ordinarily would. So your ovulation is pushed off. Can I start medication like coter letrozole a little bit later than I would have normally to try to again push off ovulation time. You know, some people will need what we do, like an IVF cycle and is have complete control over ovulation where we actually prevent natural ovulation from happening and then trigger ovulation when we need it to happen. And so I can definitely do that for couples that are trying to ovulate on their own, but the timing doesn't work out depending on kind of what treatment they need. And so definitely there are ways to work within the law and ways to work within medicine and make them cohesive with each other.
Speaker 1:Wow. I love to hear that. I think too , the important takeaway is that people speak up and I, you know, work with couples, not just of the Jewish faith, but I've also come across a lot of individuals of the Catholic faith who face a lot of sort of religious considerations with fertility treatment. And so I think the overarching message is that it's so important to speak up. You don't have to lose yourself or your values or your religious observations in this process. And it really is collaborative and it's about sharing with your doctor and if you share and then you don't feel as though your doctor respects you, then find a new physician because they're hearing obviously from you, Dr . Gold Sandler , that there are physicians that understand this Right. And can work with you. So I think that's really important.
Speaker 3:I also, I like that idea of collaboration because you know, you don't want to have medicine and religion at odds with each other. And so even on a peer-to-peer level, I reach out to religious, you know, providers. I reach out to religious figures and I'm happy to say we as your concern, let me tell you the medicine and see where we can kind of have that compromise or kind of meet in the middle to make it work for both sides. Whether that's Judaism and I'm happy to do do it, you know, whether it's a different religion as well.
Speaker 2:See that's important. I was, I was actually gonna ask like, are you in communication with religious leaders? Because I also wonder, you know, I'm sure there are certain rules and regulations depending on, you know, your level of orthodoxy religion, even like within different sector there's , there's different nuances. My assumption would be there's different nuances depending on, you know, who you go to, who your spiritual leaders are. But the fact that you have communication with them, I think that's something that is wonderful because I think a lot of times there's just probably a lot of things that they don't know about. And also you wanna hear from your point of view what's important to them and what are their, you know, where can you meet in the middle. So both sides can be honored for the person, for the patient.
Speaker 3:That's very individualized. So there's some patients that like to be their own go between , between the doctor and there's spiritual figure and that's fine. But I'm always more than happy when a patient says, Hey, can you call so and so and just explain what's going on. And I actually had a patient, the rabbi, the rabbi figure thought one thing was happening based on the patient's report. When I got on the phone, I cleared things up and kind of resolved the potential issue that made that cycle, that treatment, you know, go much smoother. I'm, and I obviously, I am not a rabbi authority, I'm not any spiritual authority for anybody, but I'm happy to at least explain my side of it. And you're right, there is different levels of observance regardless of religion, regardless of mm-hmm . <affirmative> what group you're affiliated with. Mm-Hmm. <affirmative> . So I believe the judgment to the spiritual side, but just at least give them that knowledge.
Speaker 2:Is this something in school that, you know, is there any section in your education, medical education that spoke about religion at all?
Speaker 3:In my medical education, we definitely had like cultural competency, you know, sessions and things like that to be culturally sensitive. But if it was there something specific for a specific religion, not really. And definitely I've learned a lot from my colleagues from , uh, you know, about other religions. I've learned a lot from my patients and I ask them , I say, Hey, I haven't heard about that. Tell me about this. Tell me about this practice, you know, that you're comfortable with. Tell me about what your religious holidays are and what restrictions you might have on your religious holidays. I've learned about how to manage a patient who you're telling who needs to fast all day for Ramadan and shouldn't necessarily be getting blood draws every other day because they might be, you know, a little bit on the dehydrated side or that they shouldn't be taking their meds in the morning 'cause they really need to be taking meds in the evening to be appropriate religiously. And so things like that I definitely have learned over the time, but I wish we had something a little bit more formal in terms of education,
Speaker 2:But it sounds like you're learning a lot, at least from experience. Sometimes it , it works that way. We don't always necessarily , sometimes it works in reverse. Sometimes we have to come across situations and learn from it and then go back to the education system and say, okay, this is something that needs to be taught. Like even with like virtual , you know , bringing it back to myself in terms of fertility, nutrition, you know, we learn life cycles, lifecycle nutrition. But when you hone in, now that, you know, having, you know, Reis and , and having this whole nother area, this wasn't something that was in our space how many years ago, you know, in the seventies. So because it's new and we are more aware of things and I think we are more sensitive to these situations, I think it's the perfect opportunity maybe to work in reverse and now have the opportunity to teach people in our path.
Speaker 3:I definitely agree. I think that there's been specialization and , and people kind of finding, you know , where they wanna be and , and , and people kind of honing their knowledge in a certain area, which definitely, you know, introduces the gap in knowledge that everybody else has. But religion's hard because there's so much nuance to it. And I don't know that a formal course is necessarily gonna touch upon everything that you need to know. I think that experiential learning is really important for a lot of it. Could there be a construct where you have, you know, at least here some of the basics maybe, but I think because medicine is so specialized now, having that course too early on in your career is probably not gonna be enough.
Speaker 1:What about any sort of physician training? I mean, I feel like, and correct me if I'm wrong, but I would guess that, you know, obviously it'd be just because of your own personal background, you know, similar to how Darren and I bring our own personal experiences into our work, you know, obviously that shapes your understanding and your empathy with patients. But what about physicians that really don't have any sort of, any of this knowledge?
Speaker 3:I definitely think that there are some ways to kind of gain that knowledge and I , and I don't know for some of the other religious groups, kind of what some of those resources are, but I do know that for example, in the Jewish committee, there's actually a lot of external organizations that are geared towards helping patients or , or families that , uh, struggle with fertility issues and have a lot of educational material , uh, uh, you know, geared towards the public. And I think even if having a clinician join in on some of those can actually open, you know, their perspective to kind of what the community issues are and kind of start fine tuning their knowledge that way. And
Speaker 1:Just just to interject, how would patients find the organizations you're talking about? You know, I know about pua , PUAH . Yes . We had them on our podcast, I believe they're wonderful. We work closely with them at RMA. But for anyone listening, do you have any suggestions for how they could go about finding these organizations?
Speaker 3:Yeah, I mean, I think that depending on your ease of use in social media, there are a lot that are available to you. And I think a lot of them continue to arise. There are programs like pua , PU is , um, really important actually during a fertility journey as well for some other religious concerns that pop up. Uh , you know, some rabbinic supervision or or other supervision of , of treatment as well. But there are programs like Bonne ola , there are programs, there are actually a lot of support organizations that help for a variety of different things. And there's individualized ones as well. Not just fertility, but fertility preservation specifically for cancer patients. There's an organization specifically for that. And I definitely can get you a more comprehensive list as soon as I remember . But obviously , you know , thinking off the top of my head, it's always hard to remember their names.
Speaker 2:That's okay .
Speaker 1:Yeah. And plug too , just, you know, for people to, you know, perhaps find a therapist that understands this or, you know, even go to your rabbi or clergy person and speak to them as well.
Speaker 3:Agree. Agree. And I think a lot of these organizations have connections with one another, and so sometimes one leads you to the next as well.
Speaker 2:That's a good point.
Speaker 1:It's all about advocacy, research and, you know, standing up for yourself and, and speaking, you know, about what you want and what you need as the patient. Mm-Hmm. <affirmative> ,
Speaker 3:I wish all patients felt comfortable kind of advocating for themselves and for their individualized needs , but I know it's hard for some, especially when you're already overwhelmed by the world of REI . And so I think having a provider who at least is able to open the door to the conversation, you know Mm-Hmm . <affirmative> sometimes all that the patient needs a kind of open up and start, you know , sharing a little bit more .
Speaker 1:Absolutely.
Speaker 2:So true. Beautiful. Of course, my mind is spinning. I'm like, Ooh , she needs to be giving us all an inservice every year. It's like how we get , I mean, you're a very busy woman, but even like, you know , it's been, you know, many years, but I believe every year PUA comes to RMA to give us a little background of, you know , various ways of, of working through a fertility cycle and, you know, the nuances, the possible ways of, of really trying to give the utmost respect to our patients to make sure that, you know, they're falling within that framework and, you know , for us to be extra sensitive. But it's really exciting to see that now you're on board , you're here, you're not only compassionate, you know, to your patients, but also I feel like you can be a really great resource for people who may not be as sensitive or may just don't have the knowledge. So it's great that you're, I'm so happy that you're on staff. I'm gonna be coming to you with lots of questions. I'm , I'm super curious,
Speaker 3:Come with all your questions and those that I can answer, I answer those that I don't, I redirect <laugh> , I'm happy, I'm happy to be that resource .
Speaker 1:Well , we're so happy to have you on . Any final thoughts or advice considerations for anybody listening?
Speaker 3:I think my biggest piece of advice is, like you mentioned, marina , talk to your doctor. You know, share with them your concerns. They're not there to make life more difficult for you. They're there to make your life and treatment go as smoothly as possible. And so, you know, it may just be that we don't know and if we don't know what's going on, we can't guide you and help you. And so I think that's the biggest message I can send is that we're there to help you. We're there to try to be as culturally sensitive as possible, but sometimes we just don't know and share with us and we'll work with you to kind of make it all be a nice cohesive treatment plan.
Speaker 1:Mm . I think that is so important. Exactly. Always say, well, did you tell your doctor this <laugh> ? Okay, well they didn't let them know then , you know, you gotta give them a chance, right? They're not mind readers. So it's super important.
Speaker 3:And that's why, and we're all part of a team. There are many times where I have a nurse come out to me afterward and say, did they tell you that X, Y, and Z? I'm like, no, we should, you know, gather information from as many sources as we can. But obviously I'm happy to get everything that I can from a patient directly as well.
Speaker 2:Mm-Hmm , <affirmative> . Well, you are such an asset to our team and to the people you come across with. And very lucky to have you and to have you on to share your knowledge and your expertise with our listeners. So thank you so much. So how we end our session is with words of gratitude, so we're putting you on the spot. Okay. <laugh> , what are you grateful for at this very moment or today
Speaker 3:At this moment? I'm grateful for my family. I'm grateful for the people that love and support me and support me at home so that I'm able to come here to work every day and support my patients and help them build their families .
Speaker 1:Aw , that's so beautiful. I love that.
Speaker 2:Love that . So nice. Thank
Speaker 1:You , Darren .
Speaker 2:I mean, I feel like I've been saying this a lot lately, but I'm gonna keep on saying because I , I feel like I have a lot of gratitude, but gratitude to the mentors in my life, the people in my life who've really, and I feel like it's not just your typical, you know, like my high school, maybe I'll give a shout out to my high school biology teacher, <laugh> . Really? If it wasn't for Mr. Mosson, I'm not sure what he's up to these days or if he's still alive. I hope he is. But Mr. Mosson, he inspired me to take a path of science and nutrition and for him and all the other people who have influenced my passions and helped me grow as a person. So that includes family, that includes friends, that includes mentors. And you too, Rena, you're a great mentor and a great friend to me, and I'm , I'm very grateful for you. So what about you, Rena ?
Speaker 1:Let's see. I will go with, I am grateful for supports and just sort of people that really are there for you. You unconditionally thick and thin. I've been doing a lot of thinking lately about what really is unconditional love and just super grateful. I'll give a shout out to my mom, who I've had a really, people that listen know it , I'm a big runner, but I've just had a very rough few months with injuries. But my mom is really pushing me to train for the Boston Marathon and really pushing me to go for it. So thanks mom for believing in me and kicking my butt to get in gear for that. So a lot of gratitude.
Speaker 3:<laugh> , I commend you with that. I , I , I don't do anything close to running, so I commend you
Speaker 2:<laugh> . Me too. I feel you . We'll be your cheerleaders on the sidelines. I'm
Speaker 3:Really good at that. I'm really good at
Speaker 2:Other people , <laugh> . I'm good at making signs. But yeah, good luck with that, Rena . I'm excited to hear you know, how things go, how the training goes, and wishing you well on that. But back to you, Dr . Gold Sandler , thrilled again to have you on today. Again, I could feel your compassion through the computer and you know, people are so lucky to have you be an extra, you know, set of hands and you know, to give that extra care, you know, to a very sensitive time in their life.
Speaker 3:Happy to be here. Thank you so much for having me. I'm happy to talk to you guys.
Speaker 1:Well, thank you so much for coming on and taking the time. We're so grateful.
Speaker 3:My pleasure.
Speaker 4:Thank you so much for listening today. And always remember, practice gratitude, give a little love to someone else and yourself. And remember, you are not alone. Find us on Instagram at Fertility Forward . And if you're looking for more support, visit us@www.rmany.com and tune in next week for more Fertility Forward .