Welcome to the Brilliant Fertility Podcast. I'm your host, Dr. Katie Rose, and this podcast is this to help illuminate the path ahead of you. With expert interviews, clinical pearls, and real client success stories, my intention is to bring you hope for what's possible on this journey. And to give you tools and resources to navigate the ups and downs on the road before you. If you find this podcast helpful, don't forget to subscribe on your favorite listening platform. And I have a big request. If you have a minute, can you leave us a five-star review? And let us know what did you learn, what did you come away with, and did you leave with that spark of hope? This helps more people like you find the podcast. My mission is to support as many humans as possible on their path to become parents. And by you sharing and subscribing, you're part of that mission too. And I'm so grateful for you for being here. And part of the reason I'm telling you this is because holy crap, my nervous system has been flooded these last couple of weeks. The timing of the finishing up of this building, in terms of where we were with other things going on in life, with um trips planned and my kids' soccer schedule and like all the things. It was kind of like everything everywhere all at once and not in the fun movie way, but very much in the like, okay, all of it's happening, all of it's right now. And I have been needing to use all of my nervous system regulating tools. And I want you guys to just remember that, like, you're not alone if you have felt overwhelmed at any given time. Uh, I've had several people tell me, like, oh my gosh, you just seem like so chill all the time. How do you do it? I don't know how you do it all. Those types of comments are something I regularly receive. And I was not chill last week. And as a result, I'm I'm still like energetically recovering from that. And so here we are. But this also is really important to bring up because our conversation today is all around the role of the nervous system in fertility, specifically the role of the nervous system in the ovarian environment. I was really, really excited to learn that a study was published last week in the journal Science. And I'm a big nerd, you guys. I love a good study. I like science. I like when we can collect evidence, especially for something that we've intuitively felt for so long. And if you've been following me for a long time, if you've been one of my patients, then you know that creating a regulated nervous system is the foundation of the work that I do. Because when we feel safe, when our body is in that rest, digest, and heal state, we get better results. So this study that was done by Dr. Laird from the University of California, San Francisco was so fascinating because it used both the mouse and the human ovarian model to study the makeup of the ovary. And they created a way of looking at the ovary from this 3D lens instead of having to actually like extract an ovary, slice it into really thin sections. They actually created this 3D model, and I'm linking the study in the show notes so that you can see this picture because I thought it was really cool. So that they could really understand what was this ecosystem in the ovary. They used to think that the ovarian cells were kind of just evenly distributed. So the ucytes and the follicular cells that surround them were just kind of evenly distributed throughout the ovary. But what they found was that the uucytes actually existed in little clusters, and that with age, the concentration of the uucytes in those clusters declined. But what was groundbreaking about this study, not just the way that they could image the ovary, but was the other support cells that they found within the ovary, that was very surprising to the scientists. But I think also if you've been in the world of fertility for a long time, it's like, well, surprise, but not such a surprise because we know that there are so many factors that influence fertility. So one of these groundbreaking findings was the presence of glial cells. Now, glial cells are a cell that has been pretty well studied as part of the nervous system. Different from a neuron, which is like our main nerve cell, a glial cell is a support cell. So it helps with creating the myelin that covers a nerve. It helps to give nourishment to the neurons, helps with cleaning up the debris that accumulates throughout the day. And knowing that we have this type of support cell in the ovary gives us a much better understanding of what up what other important things are happening in the ovary. The other groundbreaking piece of this study was the finding of the sympathetic nerve endings. So the sympathetic nervous system is the fight or flight response, right? So we have our general nervous system and it's typically divided into that parasympathetic, rest digest mode, sympathetic, fight or flight mode. And knowing that we have these sympathetic nerves in the ovary also tells us that there's an influence of the nervous system, an influence of when we are in fight or flight mode. And specifically, what they saw in here was that when they ablated these nerves in mice, the animals had more eggs in reserve, but fewer eggs that matured. So this suggests that the nerves actually help decide when the eggs start growing. And this is just so interesting because there are absolutely patients that I've worked with over the years, myself included, who are very responsive to stress when it comes to ovulation. Meaning, like in my case, like if I am super stressed out, I don't ovulate. But for those who have felt like, gosh, I know that there's this connection to stress. I'm not sure if it's true because we haven't had good quality evidence for it. This is a piece of evidence that tells us we're not crazy. It certainly is a part of the picture. And there are some people who seem to be more sensitive to stress and ovulatory dysfunction than others. Maybe we have a higher concentration of these nerves. Maybe there's more flooding of cortisol into the system. It's that is has yet to be determined. I'm just kind of spitballing out loud like what my hypotheses would be. And as you can see, like I'm kind of excited about all the potential research that could come from this one study. So, what does that mean if you've now linked, okay, well, we've we've got these sympathetic nerves in the ovaries. We know now more than ever that stress plays a role in ovarian function. And you know, if we're not ovulating, it's certainly pretty difficult to get pregnant. So having that correlation between stress and infertility could give us more to work with. And it certainly is giving the scientists more information on how to develop treatments for people who have accelerated ovarian aging, who have high stress and anovulation. But what do we do about that now? This has been a foundation of my work for years now, as I realized at a certain point in practice, maybe around six, seven years ago, like we could be doing everything right in terms of eating well, exercising, taking the right supplements that we have evidence for, and still not getting the result. And what I observed in the majority of these patients was that they did perceive quite a bit of stress in their life, or even in the ones who would say, like, I don't know, I don't, I don't think I'm stressed, but we would either run an adrenal panel to see what their cortisol level, what their circadian rhythm of cortisol output was, or uh look at their heart rate variability or their carbon dioxide tolerance. It's their body was telling us it was perceiving stress. Even if they weren't consciously like mentally processing that they were feeling stress, their body was actually telling us, yes, help, I am stressed. And it's important to acknowledge that not everyone will perceive stress in the same way. And some people have adapted to this hustle culture that we live in in such a way that they're like, I don't know this is just all I know. So it's not a high uh stress subjectively, but objectively, their body is sensing that. So I observed that there were different types of how humans perceived stress, how that was affecting their body, and beginning to understand what were at the root causes of that stress. Uh, was there trauma? Was there um you know adaptations, coping mechanisms like perfectionism, people pleasing? These all can play a role in how we like what is our output during stress and how we how we gently unwind that. So with the nervous system tools that I use in practice, we have to really be able to match the situation and know that there's not any one perfect tool for every single person in all times. We need to have a whole toolkit. And within that toolkit, I have a lot of different practices and resources that I give my patients and my clients. And this is something that's woven throughout the work that I do. It's woven throughout the Brilliant Fertility program. And some of my favorites, I will link in our show notes today in the five quick and easy tools for regulating your nervous system. I almost couldn't believe that I hadn't done a podcast episode on the nervous system alone yet. But maybe again, it's just because it's woven throughout what I do, and I was just waiting for this study to come out. I didn't even know it yet, proving that there is this really important link between the nervous system and the ovaries. But let's talk a little bit more about what's happening when we are in that fight-flight mode physiologically. So when our body acknowledges that we are in a stressful state, we see an increase in adrenaline. So the neurotransmitters epinephrine and norepinephrine and the hormone cortisol. We see a shift in blood flow. So the body is preparing to flee. Then we're gonna see a shift to blood flow going to the skeletal muscles, going away from the reproductive system, away from the digestive system. It's gonna prioritize like the heart, the skeletal muscles, the brain for that short-term, like narrow-focused, like go mode, right? And because we are such a unique species, we're the only species that can have our sympathetic nervous system activated by something like an email or a text message. And you know, different from other animals, other mammals who activate that mode only when there is a true threat, we have adapted to perceive threats in different ways. And this, and we and we also remember trauma in different ways than animals do. So when we have a stressful event happen, even when it's done, it's like part of our brain is still in that mode looking for the danger, right? Whereas a zebra, it's like, you know, the lion jumps out of the bushes, the zebra sees it in the peripheral and it's gonna bolt. And then once it's safe, it's like, oh, okay, I'm good. But it's not constantly scanning for the danger. Whereas humans can adapt in such a way that we will start constantly doing that. And it can be unconscious to save us some energy in some ways, but it's also just using energy in the background. If you think about in your computer operating system, and if you have 50 tabs open, your computer just runs a little slower because there's all this energy being used behind the scenes, even if you weren't consciously aware of it. And that's part of what happens with trauma and why people who've experienced trauma tend to be in this fight or flight state or freeze or fawn. I am like grossly oversimplifying it for the sake of a podcast, but we will trend in that direction as a form of survival. And so when we are in that survival mode, we see a change in the blood flow, we see a change in inflammatory cellular activity. So the different inflammation markers that are released when we are in chronic states of stress can eventually change cellular function, it can change how our immune system functions. And so for my patients who have experienced a lot of trauma, and some of them, the trauma has come from their fertility journey, from you know, all of the different ways in which unfortunately our needs are neglected in reproductive health care, that we tend to build up with more stress. And again, not all of that is something that we are conscious too. We're not constantly thinking, oh my God, I'm so stressed out. But there may be other patterns that we can begin to witness and observe that give us clues as to what our state of stress looks like. And this is why I believe that having another pair of eyes on your picture and really having deep long conversations with my patients has been so helpful because we can't see our own blind spots. We don't always hear ourselves. We we don't always notice how we're saying something, how we're believing something, but someone else hears it and they go, hmm, I am noticing how you talk about this situation. I I noticed that you said it in this way, and I'm wondering, you know, what's underneath that. So the other half, the other part of that nervous system is the parasympathetic, right? The rest, digest. And I'm gonna add in heal to that side of things because when we're in fight or flight, we also tend to be in this metabolic state where things are being broken down. Whereas when we're in the parasympathetic mode, when our body feels safe, when we are able to rest and digest and assimilate our nutrients, we are also able to rebuild and heal. So I'll be so interested to see the direction that this research with uh the sympathetic nervous system and the ovaries goes because I am deeply curious about the role of both parts of the nervous system. The other reason I'm not super shocked that they found the sympathetic nerves in the ovaries is there's um a little bit of research that has been done mostly by that branch of, if you go back to a few episodes ago, the restorative reproductive medicine side of the world. Within that modality, that group of physicians who has focused on restorative reproductive medicine, uh, there's a physician out of New Jersey named Jerome Check who has done a little bit, not vast, research into sympathetic tone, and especially in women who've had autoimmune issues, mental health issues, recurrent pregnancy loss, and actually prescribing these women ADHD medications like vivants and adderall to increase their sympathetic tone, which creates more cellular stability. And you know, this this physician in New Jersey was uh reprimanded for using these medications because the board there was essentially like, hey, you're a reproductive endocrinologist, you're not a psychiatrist, you shouldn't be prescribing these medications. Like this is way off label. But the women he helped have spoken out about the results that they got. And in the case studies that they've published, it's very interesting to see what a difference that made for them. And now that we know about the presence of the sympathetic nerves in the ovary, it maybe we'll get more traction in that research. I have a few patients who've reported, and these have these are patients who have actually been diagnosed with ADHD. And of course, there's so much wariness around using those medications in preconception and in pregnancy, because it's very difficult to study things in pregnancy. We typically just observe so much caution with medications in pregnancy. And the belief has always been that if someone is trying to get pregnant or gets pregnant, they should be off of their ADHD medications like Adderall and Bivants. But I've had a few patients report that when they were on their ADHD medications, their ovulation was the most regular it had ever been. They felt the best, like the best well-being that they'd ever noted. And that when they were taken off of their medication leading up to conception or at the very beginning of pregnancy, it was just like a complete crash of their nervous system. And now I'm wondering what the connection is there and where we might actually see better support and better care for people who have actual diagnosed conditions like ADHD, but also observing who may have a lack of sympathetic tone and what else we can do to support that. And this is where acupuncture comes in. And not I'm biased about acupuncture. My mother's an acupuncturist who specializes in reproductive medicine. I've used acupuncture in my practice my entire career. It was actually one of the one of the main things that drove me to build this new building was to have a very safe zen-like environment to do more acupuncture. But one of the things we know about acupuncture is how it improves sympathetic tone, how it regulates the nervous system response. So we we don't want over-stimulation, we don't want to be in fight or flight all the time. But we do need, like our body needs to know when and how to respond to stress appropriately. And the research that has been done on acupuncture and the nervous system is really promising. And the research that has been done around acupuncture and fertility is also really promising in showing improved ovulation, reduced stress hormones, uh, better ratios of LH to FSH. There, there's just a fair body of research around acupuncture now. And that's just confirming, I think all of us who have been in this field for a long time, what we see in our patients, feeling like they have better vitality, that they have more capacity to deal with whatever's coming their way, that you know, if they have had trauma in the past, that they're able to face that with more capacity and process their emotions uh with greater ease. I'm not saying any of this is really easy and really simple. No, like it's actually pretty complex, it's pretty nuanced. I it's why I don't think we should just be DIYing our health and well-being, but we have tools and we have more research. And I'm just so hopeful that we'll see more of this marriage between Western science and holistic care, traditional Chinese medicine, homeopathy, nervous system regulation, somatic therapies. There, the the opportunities are endless. But while we're waiting on that research, I want you to know that there are things that you can start with today to support your nervous system. And I'm gonna cover a few of my favorites. And then again, I will link my five quick and easy tools. This is just a very easy video series. It's five short videos, five minutes or less, that give you tools to regulate your nervous system, build your capacity for anything in life that is feeling stressful. So, number one, journaling. I know some of you are resistant to journaling. I am too. I actually have to kind of force myself to sit down and do it. I've I've had people give me a range of reasons why they don't want to journal, whether it be I'm judging myself, I'm afraid someone else is gonna read it, I just want it to be perfect, I want to make sure I'm writing the right thing down. The reasons are endless. But what's so important about journaling is that it just gets it out of your head and out of your body and onto paper. And you don't have to keep it. You can rip it up, you can burn it safely. I don't want to be responsible for anyone's house burning down, so please do that in a safe manner. You can scribble scrabble it, you can turn it into art, or you could keep it, tuck it away, and come back to it so that you can learn more from it later. But journaling can be so impactful, especially when we have good prompts. And I'm gonna do a separate episode about journaling prompts for resolving, reducing stress, building capacity for stress on the fertility journey uh later on here this year. Um but in the meantime, I'm just gonna give you a couple of prompts to go on and see where they take you. Okay. I'm gonna drop these in the show notes, so make sure you check that out for your general prompts for this episode. Number two is tapping. My love for tapping is boundless. If you've never heard of tapping before, it's also uh called EFT or Emotional Freedom Technique. This is a tool that utilizes accu pressure points and like literally physically tapping on these points. If you're watching this on YouTube, um you've probably seen me do some tapping before. I've got a couple videos that are open to the public on tapping. And you use, you can either use a script or I honestly just kind of intuitively just talk through, but I've I've practiced tapping quite a bit. So you talk through what's going on, and you don't have to sugarcoat it. You don't have to use toxic positivity, you can just say things as they are true for you. And notice how the intensity of your feelings around them change as you're tapping. Tapping has been such an effective tool for me personally, within the Brilliant Fertility Program. This is something that we have done on an almost weekly basis. I have dozens of tapping recordings specific to the fertility journey. And I've had patients say tapping has saved my life. And I don't take that lightly. I mean, that's that's really impactful. There's so many free resources for tapping. The Tapping Solution Foundation is one. You could drop about anything into YouTube and find an example of tapping for that. Brad Yates is one of my favorite YouTube tappers. He has been tapping on YouTube for like 20 years, which is just wild to think about. And I use this because it is free, it is easy, you really can't mess it up, and the impact can be almost immediate. Like if you are feeling really intensely around something, really stressed about something, you can shift that within five to 20 minutes. Time has been on a real crunch for me lately. And I, as I mentioned at the beginning of this episode, um my nervous system was flooded. And I typically will go for walks like every morning with. My dog after I drop my kids off for school. And that's when I do my tapping almost every day, regardless of what's going on. Well, as our building was getting finished up and we had these trips, like we're totally out of routine. So I'm not going for my dog walks when we're out of town. And my tapping is totally thrown off, but I still have that tool. And because I've used it really regularly, it doesn't take much for it to have a positive impact on me. I don't have to tap for an hour to have a result. It can happen very quickly because my nervous system is like, oh, we've used this tool over and over and over. We know how to utilize this to reframe this situation, to rewire our brain activity. And the more you do something, the more it accumulates its benefits for you. So tapping would be number number two. And number three is somatics. Uh, I don't, I have not talked about this enough. You can go back to my episode with Stacy Ramsaur from earlier this year regarding somatic therapy. But in the very simplest term, somatic is just noticing how you're feeling. Noticing if you are going 100 miles an hour 24-7, and you're feeling stressed and you're feeling crappy and you don't know why, and you don't know why nothing's working, or you're in that victim state where it's like, why is this happening to me? Why am I the only one? Just the simple act of slowing down. And as Stacy's episode, it's just, you know, I still crack up about this. I think about it at least weekly, like, where is my ass? Where are you in space right now? Where are your feet? Where is your butt in the chair? What can you notice around you? And then if you have further capacity, you can notice how you're feeling. So if I were to pause and say, like, okay, I'm feeling really anxious, I'm feeling that in my heart area. If I were to be guiding a patient or a client through somatics and I'm sitting there with them, co-regulating, guiding them through this process, I would then ask, you know, if you could drop down eye to eye with that sensation, imagining that it was separate from you, you can see it, you get a better vantage right now. What color is it? What shape is it? What are the characteristics does it have? Is it large? Is it small? Is it dense? Is it soft? Is it hot? Is it cold? What does it want to say to you? That's a bit more advanced and maybe really uncomfortable or even feel confusing to DIY. But this is one of the most powerful tools that I use in my practice all the time. It's one of the ones that, you know, people we wrap up a session and they're like, oh my gosh, I did not realize how much was in there. And like those are the breakthrough moments that I live for. Right. Like you might think that the moments I live for are getting the positive pregnancy test pictures, you know, when I wake up in the morning, and like that is amazing. Of course, I love that. But truly, my goal is not just to help people get pregnant, to help more babies come to the world, it's to help people live while they are hoping for that baby, to help people truly feel like themselves again. Those are the moments I live for because we don't have control over the rest of it. And when we can really learn how to live, how to fully be in this human experience and the ups and the downs and feel connected and whole, that's what I'm here for. And that's where I think the nervous system tools, learning how to regulate your nervous system, learning how you respond to stress and what your body needs to respond to stress are absolutely vital foundational pieces of any fertility journey. So as we wrap up here, I just have a question for you to sit with. But how do you perceive stress? What is your relationship to stress? Just sit with that, see what comes up. Check out the show notes for some journaling prompts and a uh link to the five tools to regulate your nervous system. We are we are so, so very close to taking new patients in the new space. I am still seeing people virtually and I'm seeing all of my um OGs who have been with me throughout this past year of limbo for acupuncture. Thank you. Thank you for being with me. I truly love you all so much. I'm so grateful for you. And I'm so excited for this next chapter. I'm so excited for the next chapter of research into the reproductive system. I'm so excited for this new building, which we have started moving into. Um so many good things. And also, sometimes life is a lot. I hope these tools give you some more ease in life. I'm sending you so much love as always, and I'm here for you.