The Wholesome Fertility Podcast podcast

EP 279 Is “Unexplained Infertility” an Acceptable Diagnosis?

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On today’s episode of The Wholesome Fertility Podcast, Dr. Briguglio, a fertility health expert, shares her passion for empowering patients and addressing the challenges of unexplained infertility and overreliance on IVF. She emphasizes the importance of comprehensive testing and addressing root causes to improve fertility health. Dr. Briguglio also discusses the interconnectedness of physical and mental health and the significance of individualized testing in the initial consultation. Additionally, she highlights the importance of iron and ferritin levels and addresses the challenges of vegan diets and cholesterol.   In this conversation, Dr. Samantha Briguglio discusses the role of cholesterol and inflammation in health. She emphasizes that cholesterol is not the villain it is often portrayed to be and that it is needed for hormone production. Dr. Briguglio advocates for a balanced approach to diet and lifestyle, focusing on sleep, diet, and movement. She encourages individuals to find their own natural path to healing and emphasizes the importance of empowering people with information.   Takeaways
  • Comprehensive testing and addressing root causes are crucial for improving fertility health.
  • The physical and mental aspects of health are interconnected, and addressing both is important for fertility.
  • Individualized testing and a holistic approach are key in the initial consultation.
  • Iron and ferritin levels play a significant role in fertility health, and vegan diets may present challenges in obtaining necessary nutrients. Cholesterol is not the villain it is often portrayed to be and is needed for hormone production.
  • Nourishing the liver and eating enough fiber can support healthy cholesterol levels.
  • A balanced approach to diet and lifestyle, focusing on sleep, diet, and movement, is crucial for overall health.
  • Empowering individuals with information allows them to make informed choices about their health.
    Dr. Samantha Briguglio is a licensed Naturopathic Medical Doctor and the founder of Walk the Natural Path Hormone Health and Fertility Care.   Dr. Briguglio has a passion for helping women achieve their wellness and/or fertility goals, and she treats – and teaches – her patients from a mindset of natural healing that treats the root cause of their symptoms.   Website: www.walkthenaturalpath.com   Instagram @walkthenaturalpath   Facebook: www.facebook.com/walkthenaturalpath   For more information about Michelle, visit www.michelleoravitz.com   The Wholesome FertilityFacebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/   Instagram: @thewholesomelotusfertility   Facebook: https://www.facebook.com/thewholesomelotus/     Transcript:   Chapters   00:00 Introduction and Passion for Fertility Health 04:09 Passion for Empowering Patients 07:07 Challenges with Unexplained Infertility and Overreliance on IVF 11:03 Importance of Comprehensive Testing and Addressing Root Causes 16:35 Interconnectedness of Physical and Mental Health 24:06 Importance of Iron and Ferritin Levels 25:56 Challenges with Vegan Diets and Cholesterol 26:52 The Role of Cholesterol and Inflammation 30:05 Nourishing the Liver and Eating Fiber 35:03 The Importance of Sleep, Diet, and Movement 37:34 Finding Balance in Diet and Lifestyle 43:20 Empowering People with Information 45:30 The Inspiration Behind Walk the Natural Path   Michelle (00:00) Welcome to the podcast, Dr. Brigulio, right? Brigulio is how you pronounce it, or Sammy, right? Awesome. Dr. B, awesome. So first of all, I love your Instagram. I'm going to say that. You guys got to check out her Instagram. It's going to be in the episode notes. I kind of want to lead with that because she has fabulous content, really rich with information and tips.   Samantha Briguglio (00:05) Yes, you did that nicely. Or Dr. Bean. It's easier.   Michelle (00:25) for fertility care and health. And before we get started, I would introduce yourself and also share how you got so passionate in specifically fertility health.   Samantha Briguglio (00:39) Yeah, well, thank you so much. It's really fun to have a platform like Instagram to share all this stuff with and help educate people. But hi, I'm Dr. B. Virgulio, Samantha Virgulio. I actually just got married. So legally, my name, I just changed my name. Thank you so much. It's been really, really fun. But I am keeping Dr. B for business purposes. So you can always remind me, remember that.   Michelle (00:54) Congratulations.   Samantha Briguglio (01:09) I'm Dr. B, so you don't have to worry about any changes. But how I got infertility, I feel like it's kind of a long story, but I'll try to keep it as short as possible because this also has to do with how I got into natural medicine, which actually stemmed from when I was a child. I was pretty sick as a kid. And I was pretty sick.   Long story short, my mom really fought for me and found natural medicine. And I went from being on like oxygen treatments like two to three times a day. Yeah, it was pretty crazy to being a total normal kid who played a bunch of sports and just loved running around and just basically natural medicine changed the trajectory of my life. And so I became super passionate about it. Went to college, was kind of like, eh, I don't wanna go to med school. That looks really hard.   Michelle (01:38) Oh wow.   Samantha Briguglio (02:00) trying to find other avenues, but I always got brought back to natural medicine. I was like, this is just where I'm supposed to be. Actually wanted to go into pediatrics originally and ended up not doing that because I wasn't able to get enough training, like hands on, like one-on-one with kiddos. And I just felt like that was really irresponsible. It's like all of a sudden started a practice where I was working with kids and I didn't feel like ready or trained enough to do that. And...   In my last year of school, I actually found a fertility course. It was like an extra like, I don't know, $600 on top of all the other loans I was taking out. So I was like, oh, this looks fun and interesting. I fell in love. Like I just fell in love. I actually, the person who wrote the course is Dr. Jacqueline Chassie at the time. She just changed her last name. I guess it's a few years now. Seamonton, I think it is. If anyone wants to find her, her courses are great.   Michelle (02:44) Wow.   Samantha Briguglio (02:56) but Hello Fertility is her Instagram actually. But she is an amazing teacher and I went on to join her year-long mentorship in fertility after I graduated, which obviously kind of like changed the course of my life and career. And I just felt so in love with it. Part, I was actually really good at it, right? Like sometimes like you're just good at something or not. And I was like, I don't want to be a jack of all trades anymore. And I just felt like I...   Michelle (03:01) Mm-hmm.   Samantha Briguglio (03:25) my intuition just went very hand in hand with the fertility practices, treatment, and just diving into that and learning more. I loved it, I enjoyed it. And then later on, I'm talking to my mother and my grandmother, and I'm telling them how I'm so drawn to this, and I find out my mom went through her own journey with miscarriages and loss, and then my grandmother, took her 10 years to conceive, I'm like, no wonder I'm drawn to this. I'm supposed to help all these people. My family had this struggle, so like.   Michelle (03:51) Wow.   Samantha Briguglio (03:55) Now I get to help and get back. So kind of a long story. I try to give the most important pieces, but there it is.   Michelle (03:59) That's incredible.   Amazing. No, it's interesting because my mom had secondary infertility with me. tried for a while.   So she had a really hard time. She also thought she was going to lose me at different times, like lost a ton of weight. So it's kind of interesting that you say that. And it's pretty wild because it does kind of hit home.   I don't know, I do believe that subconsciously we can almost feel something in ourselves. There's just certain things that call to us and we just feel like this is it. This is what we're supposed to do. And I totally understand what you're saying. It really, really resonates with me. So that's cool.   Samantha Briguglio (04:38) Yeah, right, you just keep getting pushed down a path where eventually you're like, okay, I'm surrendering, this is what I'm supposed to do. Like that's basically what happened to me.   Michelle (04:48) Amazing. Well, you're so good at it and I can feel the passion. I really can. That's one of the things that I love Instagram. I have to say, I mean, with social media, it's like a blessing and a curse, right? But there's so many amazing things about social media because you're able to connect with people in a different way and get to know people. And people are able to share stories and information. You can get tons of information on Instagram, especially it's really big in the fertility world.   So I feel like there's just so much content, but you can really feel a person's passion and also just drive to learn and provide quality information. And I find that with your account, it's actually one of my favorite accounts, I'll be honest, because it teaches me and this is where I love it. I'm like, when I feel like I'm getting, as a practitioner, I'm learning so much, I'm like, I got to have them on the podcast. I got to pick their brain.   Samantha Briguglio (05:42) You're so sweet. Thank you. I feel like, yeah, no one's ever told me I run short on passion, that's for sure.   Michelle (05:42) For my guests and for me.   Well, it works for you and it works amazing. And so we were talking actually in the pre-talk about certain things that we feel really passionate about. And as practitioner, I find, and I know that you're great because we talked about it, that usually your passion, it's like the P, right? The P, because P for passion and P for pissed off. It's very fine line between the two because   Samantha Briguglio (06:15) R-heh!   Michelle (06:19) The things that we're passionate about, we've also been pissed off about. Meaning, for me, it's like I'm being told that you can't do something. I've always had that even in my life. I'm like, no, screw you. I can do it. Don't tell me I can't. I feel that passion with my patients. When people tell them they can't, and then I see that they can, and I'm like, I can't   why are you telling them they cannot do it? I don't like that. It pisses me off, but I feel very passionate about empowering. So you feel like that too. We talked about a couple of things. So I'll let you have the mic.   Samantha Briguglio (06:57) Yeah, yeah, we talked about two main things, right? I think the first one was the unexplained infertility. That diagnosis drives me nuts. Because I probably said a couple bold things about it on Instagram before, and one of them that I felt like it was lazy medicine. And I feel like that seems harsh, but it's kind of the reality of it, right? Because I'm like, you're being lazy. You're not doing any more tests, you're not trying to figure out like what could be this underlying cause, you're just saying like, oh, the things that are obvious are all good. So we don't know there's it's unexplained. And so that drives me nuts.   Michelle (07:35) It feels like you're putting it back on the patient. That's what it feels like. It feels like, oh, well, we don't know. So here you go.   Samantha Briguglio (07:41) Yeah, 100%. And then, you know, leading to the other thing that we kind of talked about is that then it's like, okay, well, we don't know, so IVF is your only answer. That drives me nuts. I think IVF is amazing. I think it has a time and a place. I think it has helped a lot of families, especially with, you know, certain diagnosis, especially anatomical ones, but like to be like you have unexplained, let's do IVF, or, you know, we haven't even pulled your progesterone yet, but we don't know what else is wrong. So like, let's just go to IVF. Like it just...   Yeah, talk about getting heated and passionate, which just drives me insane, because I feel like it's unfair and you're not doing your duty to your patients and it's at the end of the day, kind of lazy. Yeah.   Michelle (08:22) Yeah. And I'll tell you, um, I feel like there's this common misconception. I feel like that it's almost, I almost want to say it's due to marketing because we have been conditioned to believe that if we pay an arm and a leg for something, it's a guarantee that we're going to get the best of the best. And I think that that's what it is. People think that it's a guarantee to go through the IVF process. And I've actually found, and again, same as you, I completely agree.   Samantha Briguglio (08:39) Yeah.   Michelle (08:52) that IVF's incredible. It's an amazing thing to have. It's amazing. The technology's beyond. I remember going and doing acupuncture for a transfer, and every time I go, I'm beside myself on the incredible opportunity that so many couples have. So 100%, yes, for that. However, in some cases, I've actually found that my patients have had many failed IVFs.   retrievals and transfers. And then they went on and did better getting pregnant naturally at an older age in their forties. So like that kind of, it challenges that whole idea or mindset that it's a guarantee and it's like the only option for some people. So I'd love to get your thoughts on that.   Samantha Briguglio (09:40) Oh yeah, I've had many patients that have tried multiple IVF things like three to four even, and come back and get pregnant naturally. IUI same thing, a lot of IUIs and then they'll get pregnant naturally. And they're like, I don't really get it. I'm like, it's because we had to treat the root cause. Like one of them that really stands out in my mind is that they had actually got health issues and everyone was like, their hormones looked actually pretty decent. Even their A quality wasn't bad, but their gut was like not okay. Like   not okay at all. Like diarrhea episodes daily, which is that's, that's not a healthy gut. And I was like, Oh my gosh, what? And so we treated and we treated for a little bit and they started to heal and started to feel better. And then all of a sudden, like a couple months later, like boom, pregnant and healthy pregnancy. And I just tell, like, it's just a testament to like, the reproductive system can be fine. But if something like your thyroid or your   Michelle (10:10) Mm-hmm.   Oh wow.   Samantha Briguglio (10:40) your other systems that we have that make our whole body, right, is impacted. That can cause issues. Your body sometimes doesn't want to, you know, carry another life if everything isn't okay.   Michelle (10:54) Yeah, totally. And so you mentioned actually a really important one, gut health. Western medicine is amazing in what they're amazing. You know, everybody has their own toolbox and like things or specialties. And so that's not something that's typically looked at or like, you know, tested. They'll do like, they'll look at like ultrasound, they'll look at like   Samantha Briguglio (11:09) Mm-hmm.   Michelle (11:14) the tubes, they'll look at like the anatomical, they'll do the blood work, the hormones.   And obviously, when they come to you, it's a whole other detail of testing. So let's talk about some of the things that are often missed in conventional medicine that you look at that they may not know about.   Samantha Briguglio (11:36) Yeah, I'll definitely talk to that. I do also wanna say like some things are also best in combination. So I love natural medicine and I think it can do amazing things, but a lot of times also like a combination of like conventional and natural is also really amazing. I've won, like for example, endometriosis patient that it's been really beneficial for them to have both, right? They have like the laparoscopic surgery done and now we're working on inflammation and reducing all these other things, but.   Michelle (12:02) Right.   Samantha Briguglio (12:05) they're feeling so much better. So like I said, I can get heated about some things, but I also am very appreciative of all forms of medicine. It's just like, we all, we just have to stay in our lane and also know that it's okay if there's, if someone's taking from all different types. If anything, that's good, right?   Michelle (12:14) Yeah.   Yes. I always say like a team, a well-rounded team with all their different strengths.   Samantha Briguglio (12:32) Exactly. So I just wanted to say that too. But when it comes to things that I look at that are going to be different, I mean, who I feel like the list can be kind of long, actually. I mean, I asked from everything like, what are your bowel habits or your bowel movements to your, you know, what's your gum health like, do your gums bleed a lot to, you know, do you have headaches, musculoskeletal pain, we focus a ton on stress. And it's not like the type where it's like, oh, you're stressed, like, just don't stress, right? No, we like figure out like,   root cause of that stress. And if that root cause needs to be explored more, it's like, okay, do we bring another person onto this team? Obviously we focus on a ton of diet and lifestyle habits. I just ask about them. And then we talk about what we can improve versus what we don't need to improve. Thyroid health, like I said, the list can kind of go on and on, but it can be from anywhere from like your daily habits to environmental exposure, you know, a job at the workplace. I actually see a lot of blue collar men.   Michelle (13:14) Yeah.   Samantha Briguglio (13:32) I find that to be very common, either blue collar or very like high stress jobs are a lot of men that I see for like sperm count and quality. And you know, like I said, I feel like the list could go on and on. There's always kind of something and I kind of say there's like the most obvious things, which to me are like diet and lifestyle, gut health, like thyroid health. And then there's like the small things like anti sperm antibodies and you know, like an immune flare or   Michelle (13:48) Yeah.   Samantha Briguglio (14:00) you know, skin conditions or, you know, maybe some of the things that seem a little less obvious, like reproductive microbiome. Uh, and there's kind of almost tests for all of this now. It's just also, it can't be really expensive. So like I said, I like to start with like the really big layering things, make sure those are good before I move on to the smaller things.   Michelle (14:12) Mm-hmm.   Yeah, I mean, there's so many things that I definitely want to talk about with what you just said. Like one of the things, you know, it's interesting how people are saying, oh, just stop being stressed. Sometimes you're stressed because your body's stressed. Like if your body or your gut's off, it's going to impact your mind. Well, in Chinese medicine, we learn about how everything's so interconnected. So like how your body feels if your body's not getting the nutrients it needs, it's going to feel stressed. I mean, have you ever felt hangry? You know that like impacts.   Samantha Briguglio (14:41) Yeah.   Michelle (14:50) immediately or if you're not getting enough sleep, if you're not getting good sleep, that's going to impact your stress levels. So it's so intricately connected. And when you have that calm, or even your gut health is better, your mind starts to feel better as well.   Samantha Briguglio (15:06) Yeah, I love that analogy of have you ever felt a hangry? I think that's so perfect. I haven't heard it, but that's so good. Like, yeah. Like sometimes if you're not, no, you don't even know sometimes you're not even not feeling good, but it could be manifesting as an emotional response or something. I know I was feeling a little extra stressed out and I myself did a gut health test on myself and I was like, whoa. Like honestly, I would expect more physical symptoms, but I think mine were manifesting a little bit different. And I'm like, wow.   Michelle (15:14) It's like perfect example, right?   Right. Well, that is such a good point that you bring up because I think that, like for example, my patients who are sensitive to gluten, they end up feeling really well after removing gluten, but not for the reasons they think. Like they say, if I eat bread, I'm fine. I don't feel bloated or anything like that. But with food sensitivities, it doesn't necessarily have to show up as digestive discomfort.   Samantha Briguglio (15:49) Yeah.   100%.   Michelle (16:01) And I think that that's like, you know, so that's like one example of how things can impact you, you don't even realize that you could have something and that has nothing to, like, you're not going to feel it directly as that. It could show up as headaches or low energy. It could be so many things.   Samantha Briguglio (16:17) Yeah, brain fog, anxiety, joint pain. Joint pain's a big one that everyone just brushes off as like musculoskeletal issue. And I'm like, no, that's like an inflammation issue, right? Like, why are you? Like, so yeah, no, I, for sure.   Michelle (16:24) Right.   Oh yeah. Yeah, for sure. So how do you figure out like where you start with the testing? Like when you first see people, I mean, I'm sure it has to do with a lot of what they'll tell you.   Samantha Briguglio (16:42) Yeah, so, you know, initially, depending if I have like a single visit or I see a fertility for two. So I see, you know, people individually, but I see the couple together, which also I think super important. I feel like one person always seems to get ignored. Like there's never like, let's treat both. It's like, oh, there's a abnormal semen analysis. Let's treat the guy. And then like the female side's forgotten. Or, oh, so this person has endometriosis. Let's make sure we focus on that. And then to see the male sides.   Michelle (16:53) Yeah, that is.   Samantha Briguglio (17:10) forgotten. So it's like, I really like the fact that fertility for two. Honestly, it's mostly for affordability that I do the fertility for one just because if we can try to do something, but I always think, you know, treating both is the best. But when it goes, sorry, back to your question. So when I see people as either 60 or 90 minute visit, depending if it's one or two, and we ask   I mean, I ask a lot of questions. First, I just kind of give them the floor. I'm like, share your story with me. Like, tell me, right? I think intuition's so important. And a lot of times, like couples end up telling me what I need to hear in that first part, because they're just, they don't even know it's like this most important thing, but I'm like, whoa, like that was huge. Like, okay, writing that down. Then I ask a lot of questions that like, will branch off of what they share with me. And then we dive into, you know, family history, their own history.   Michelle (17:53) Yeah.   Samantha Briguglio (18:05) you know, general review of systems, which basically means checking in with every, from like head to toe, every single system of the body. And we have them answer questions like, are you bloated? Yes or no, right? On the female side of things, definitely diving into the menstrual cycle, like a full dive in. Usually it takes us like, sometimes 15 to 20 minutes just to talk about the cycle, which probably seems like a lot, but like, no, I ask a lot. I ask like questions from like, what size are your clots to   Michelle (18:27) Yeah.   Samantha Briguglio (18:34) how many tampons do you fill to tell me about all of your symptoms and like the timeline that you have them within your cycle. So we really take a deep dive into that. Um, and then, you know, from there I kind of compile, like all their symptoms, come up with the ideas for the labs that I want to draw. And then based off symptoms and labs, we form a treatment plan. Um, based off all of that.   Michelle (19:00) Are there some common labs that you usually, almost for everybody use, or one test that you typically feel like everybody should take? I know it's kind of like a one-size-fits-all, but...   Samantha Briguglio (19:12) Yeah, you know, no, for sure. Right? Yeah. Like, I know what you're trying to say. You're like, I know it's individualized, but what are labs that are for everyone? Yeah. So yes, and I tell a lot of people that right, because I'm like, you can go get all these basic labs, but I might be asking for you to get other labs based off what you tell me. So just be prepared to go twice. So a lot of time, they just have people wait to come get labs. So they're not going back and forth. Because that takes time. And I'm like, I'm like the person that like, I just want to do all at once.   Michelle (19:18) Yes.   Yeah.   Samantha Briguglio (19:41) Um, but there's going to be the classic, the day three of your cycle. So third day of bleeding and then seven days after a predicted ovulation labs, the day three ones are going to be like the estradiol, the FSH, the LH, the seven days after ovulation would be progesterone. Um, usually with like the day three lab, I also order, um, like a CBC, a CMP. So that's like your, your blood counts looking at red blood cells, white blood cells, the CMP is kind of looking at kidney, kidney liver.   Michelle (19:41) Yeah.   Samantha Briguglio (20:09) and then like lipid panel looking at like cholesterol. So just like those basics are always really nice. I do, I used to wait to order insulin, but now I'm just starting to do it more for everyone just because there's just been, like it's really hard to guesstimate who's gonna be having elevated insulin because I've ordered it on some people that I'm like, I just feel like I need to order it. And then it comes back super high. I'm like, okay, they are not a typical candidate for insulin.   Michelle (20:21) Mm-hmm.   Mm-hmm.   Samantha Briguglio (20:36) But like I ordered it and they have like an insulin of 24, which is like way over my range of what I like to see it in, right? So I kind of started doing that one a lot. Obviously a thyroid focusing on like the TSH, free T4, free T3, thyroid antibodies. And then another one I actually also really like, vitamin D, cause that can be in relation to like miscarriage and loss. So just making sure that's elevated in general.   Michelle (20:37) Bye.   Yes.  

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