Send us a text with a question or thought on this episode ( We cannot replay from this link)
In this episode of Endo Battery, we continue the Endo Reflection Series by revisiting two of the most impactful episodes of the year. We highlight key insights from Dr. Naomi Whittaker (Episode 77) and Dr. Sadikah Behbehani with Dr. Lora Liu (Episode 91), who share their expertise on infertility, endometriosis, and PCOS.
Listen as we explore:
- How excising endometriosis can improve fertility and reduce pain.
- The complex connections between PCOS, endometriosis, and infertility.
- Why addressing root causes is critical before pursuing treatments like IVF.
This episode is packed with hope and actionable knowledge for anyone navigating infertility or managing chronic conditions. Let’s reflect, recharge, and find renewed empowerment for the journey ahead.
Website endobattery.com
Navigating Endometriosis and Infertility Perspectives
Speaker 1
0:02
Welcome
to
EndoBattery
,
where
I
share
my
journey
with
endometriosis
and
chronic
illness
,
while
learning
and
growing
along
the
way
.
This
podcast
is
not
a
substitute
for
medical
advice
,
but
a
supportive
space
to
provide
community
and
valuable
information
so
you
never
have
to
face
this
journey
alone
.
We
embrace
a
range
of
perspectives
that
may
not
always
align
with
our
own
.
Believing
that
open
dialogue
helps
us
grow
and
gain
new
tools
always
align
with
our
own
.
Believing
that
open
dialogue
helps
us
grow
and
gain
new
tools
.
Join
me
as
I
share
stories
of
strength
,
resilience
and
hope
,
from
personal
experiences
to
expert
insights
.
I'm
your
host
,
alana
,
and
this
is
IndoBattery
charging
our
lives
when
endometriosis
drains
us
.
Welcome
back
to
IndoBattery
.
Grab
your
cup
of
coffee
or
your
cup
of
tea
and
join
me
at
the
table
as
we
continue
the
EndoYear
Reflection
Series
.
I'm
struck
by
how
quickly
time
has
passed
and
how
overwhelming
it
can
feel
to
fit
everything
in
before
the
end
of
the
year
.
That's
why
I'm
taking
this
time
to
reflect
on
the
episodes
and
guests
who
have
been
charging
our
knowledge
and
offering
moments
of
renewal
.
Today
,
we're
spotlighting
two
standout
episodes
featuring
three
incredible
doctors
Episode
77
with
Dr
Naomi
Whitaker
and
episode
91
with
Dr
Asarika
Bebehani
and
Dr
Laura
Liu
.
Before
we
dive
deeper
.
I
want
to
offer
a
trigger
warning
.
In
this
episode
,
we'll
be
discussing
infertility
.
I
know
this
topic
can
be
deeply
emotional
and
challenging
,
and
I
wanna
take
a
moment
to
acknowledge
that
.
If
you're
walking
through
the
pain
of
infertility
or
struggling
with
the
inability
to
conceive
,
I
wanna
send
you
a
warm
hug
and
extend
my
deepest
empathy
.
You
are
not
alone
in
this
journey
and
your
feelings
are
valid
.
Let's
continue
reflecting
.
Speaker 1
1:43
These
two
episodes
are
among
the
most
downloaded
and
listened
to
this
year
,
highlighting
their
significant
impact
.
I've
also
received
countless
messages
from
listeners
sharing
how
these
episodes
renewed
their
hope
.
Are
you
wondering
why
they
resonated
so
much
?
Well
,
in
episode
77
,
dr
Whitaker
shared
invaluable
insights
about
infertility
and
endometriosis
.
In
episode
91
,
dr
Bebehani
and
Dr
Liuaker
shared
invaluable
insights
about
infertility
and
endometriosis
.
In
episode
91
,
Dr
Bebehani
and
Dr
Liu
tackled
the
intricate
interplay
of
PCOS
,
endometriosis
and
infertility
.
Though
their
approaches
to
care
may
differ
slightly
,
their
passion
and
commitment
to
partnering
with
their
patients
and
addressing
endometriosis
head-on
unite
them
.
When
I
spoke
to
Dr
Whitaker
in
episode
77
,
she
emphasized
the
importance
of
thoroughly
reviewing
a
patient's
history
and
past
surgical
images
.
For
example
,
she
noted
how
blocked
fallopian
tubes
or
adhesions
in
surrounding
areas
often
impact
infertility
.
What
struck
me
was
her
observation
that
infertility
and
pain
are
rarely
caused
by
endometriosis
alone
.
They're
often
multifactorial
.
Here's
a
snippet
of
what
she
shared
about
identifying
these
complex
issues
.
Speaker 2
2:50
I
look
back
at
their
operative
reports
to
see
what
was
done
and
I
go
over
with
them
concerns
from
what
was
seen
,
including
the
potential
of
adhesions
or
if
they
did
appropriate
adhesion
prevention
.
If
they
check
the
tubes
with
chromoprotubation
they
may
have
missed
a
partial
occlusion
of
the
fallopian
tube
,
which
is
pretty
common
with
endometriosis
,
and
so
for
that
I
do
a
selective
hysterosalpingogram
which
is
more
accurate
than
a
regular
hysterosalpingogram
.
It's
where
the
x-ray
is
put
above
the
body
and
I
have
an
actual
cania
that
goes
into
the
fallopian
tube
and
I
have
a
pressure
gauge
and
it
measures
if
there's
a
partial
occlusion
.
So
I
don't
want
to
just
see
village
of
dye
,
I
also
want
to
see
that
the
pressure
is
very
low
and
so
that
that
indicates
the
tube
is
wide
open
.
So
I
check
each
tube
individually
and
then
if
there's
a
partial
or
complete
occlusion
I
have
a
guide
wire
that
can
run
down
the
tube
,
kind
of
like
snaking
a
sink
to
open
it
up
.
I
just
see
tubal
occlusion
with
endometriosis
period
.
Okay
,
more
like
or
within
fertility
period
.
Speaker 2
4:03
You
know
I'm
not
sure
what
the
risk
factors
are
If
it's
congenital
,
you
know
,
hereditary
someone's
born
with
it
.
If
there's
endometriosis
in
the
tube
,
if
there's
debris
in
the
tube
or
inflammation
related
to
endometriosis
or
if
it's
just
infertility
as
a
symptom
.
Uh
,
it's
hard
to
say
,
but
I
do
screen
almost
all
women
that
come
to
me
who
are
undergoing
surgery
.
I
offer
them
that
because
if
they
haven't
tried
to
conceive
it's
going
to
be
silent
and
then
they're
at
increased
risk
.
Speaker 2
4:33
In
my
opinion
,
if
they
likely
have
endometriosis
I
do
think
many
times
it
is
probably
congenital
and
treatable
and
it
goes
away
after
that
procedure
.
But
I
like
to
offer
it
to
most
women
undergoing
surgery
,
even
if
they're
not
actively
trying
to
conceive
,
because
I've
had
women
come
to
me
with
endometriosis
.
They
got
excision
,
they
got
a
lot
better
.
And
then
they
come
back
to
me
with
infertility
because
their
kids
were
occluded
.
And
if
we
had
just
checked
it
when
they
were
focused
on
the
pain
but
they
knew
they
wanted
children
later
,
I
regretted
not
offering
it
earlier
.
I
explained
hey
,
if
you
haven't
been
trying
,
you
may
not
want
to
do
this
procedure
,
but
I
like
to
just
offer
it
if
they're
going
under
general
anyway
.
Speaker 1
5:18
Right
,
because
it's
pretty
quick
.
Speaker 2
5:20
It's
very
quick
,
yeah
.
I
rarely
just
find
endometriosis
.
Typically
,
you
know
,
you
have
your
pre-op
and
post-op
diagnosis
.
My
post-op
diagnosis
is
very
long
.
It's
usually
four
or
five
lines
,
not
just
different
areas
of
endometriosis
but
evidence
of
inflammation
or
polyps
or
cervical
stenosis
or
tubal
stenosis
,
adhesions
.
I
look
at
the
liver
liver
,
you
know
,
and
I
see
if
there's
inflammation
of
liver
,
fatty
liver
.
So
I
tried
to
do
it
just
a
whole
assessment
of
everything
that
I
see
for
health
purposes
.
Because
,
as
you
know
,
women
with
endometriosis
or
pelvic
pain
or
infertility
,
they're
all
very
complicated
and
it's
usually
not
this
one
thing
going
on
.
Especially
by
the
time
they
present
10
years
later
,
after
they've
been
asking
for
help
,
things
have
usually
gotten
pretty
bad
.
Speaker 1
6:14
Dr
Whitaker
also
stressed
that
properly
addressing
and
excising
endometriosis
can
significantly
improve
the
chances
of
natural
conception
.
Hearing
her
perspective
on
this
was
both
enlightening
and
hopeful
,
but
don't
just
take
my
word
for
it
.
Listen
to
her
insights
.
Speaker 2
6:28
If
a
woman
comes
to
me
and
her
main
issue
is
endometriosis
,
even
if
it's
advanced
stage
,
I
mean
she
has
a
very
high
likelihood
of
success
.
When
you
do
thorough
excision
surgery
,
find
it
all
,
even
a
bowel
resection
,
it
really
improves
fertility
rates
when
needed
.
And
then
adhesion
prevention
,
especially
with
advanced
disease
.
But
unfortunately
these
women
often
have
a
lot
of
other
issues
going
on
,
especially
if
they
tend
to
have
other
risk
factors
,
like
if
they're
older
,
if
they've
had
a
lot
of
abnormal
bleeding
,
if
they
are
married
to
,
like
a
man
,
with
severe
male
factor
,
and
so
that's
what
I
talk
about
in
my
discussion
with
these
patients
.
First
we
do
need
to
find
answers
.
So
endometriosis
is
exciting
to
find
because
it's
a
big
answer
,
and
then
it's
a
big
process
to
overcome
.
That
Outcomes
are
really
good
,
especially
if
that's
your
main
thing
.
Speaker 2
7:24
But
it's
important
that
we
look
at
everything
,
including
do
they
have
an
ovulation
defect
?
So
we
screen
for
women
who
have
ovulation
defects
,
and
so
that
means
the
follicle
doesn't
grow
and
collapse
.
The
key
is
to
watch
it
collapse
as
well
and
rupture
to
make
sure
that
they're
actually
ovulating
and
releasing
an
egg
,
because
there
are
conditions
that
make
it
look
like
she's
ovulating
and
releasing
an
egg
because
there
are
conditions
that
make
it
look
like
she's
ovulating
,
but
she's
not
really
,
and
so
we
do
an
ultrasound
series
to
confirm
that
she's
actually
ovulating
.
Ovulation
defects
where
they
don't
actually
collapse
the
follicle
called
luteinized
,
unruptured
follicle
syndrome
is
increased
in
women
with
endometriosis
,
and
again
that
can
be
silent
because
their
hormones
can
go
up
and
make
it
look
like
she
ovulated
after
that
.
Speaker 1
8:08
Similarly
,
in
episode
91
,
dr
Bebehani
and
Dr
Liu
brought
a
wealth
of
knowledge
and
a
holistic
perspective
to
the
table
.
Dr
Bebehani's
expertise
in
endometriosis
,
pcos
and
infertility
helped
clarify
the
nuanced
differences
and
connections
between
these
conditions
.
She
explained
how
often
they
coexist
and
what
makes
treating
them
so
complex
.
Let's
hear
her
break
it
down
a
little
.
Speaker 3
8:34
Because
this
is
a
question
we
get
asked
often
in
clinical
practice
is
how
are
endometriosis
and
PCOS
related
?
We
have
to
remember
that
endometriosis
occurs
in
about
15%
of
the
population
.
So
not
looking
at
pelvic
pain
or
fertility
patients
,
just
in
the
general
population
,
about
15%
of
women
will
have
endometriosis
and
5
to
15%
of
the
population
will
have
PCOS
.
So
they
may
not
necessarily
be
caused
by
the
same
cause
,
like
in
utero
,
or
the
same
manifestation
that
created
the
disease
.
But
because
they
are
both
prevalent
and
common
,
it
is
definitely
possible
for
women
to
have
both
endometriosis
and
PCOS
.
So
I
often
get
asked
is
the
endo
causing
PCOS
?
Is
the
PCOS
causing
endo
?
No
,
there
are
no
studies
to
show
that
one
causes
the
other
.
It's
just
because
they're
both
prevalent
.
It
is
absolutely
possible
for
both
diseases
to
co-occur
in
some
Uncovering PCOS and Endometriosis Insights
Speaker 3
9:30
way
.
Speaker 1
9:30
Dr
Liu
also
shared
compelling
thoughts
about
the
challenges
of
diagnosing
and
managing
PCOS
and
endometriosis
,
particularly
in
the
face
of
frequent
misdiagnosis
.
Here's
what
she
had
to
say
.
Speaker 4
9:43
What
I
found
in
my
practice
is
a
lot
of
patients
are
diagnosed
or
they
come
to
me
and
they're
like
I
have
PCOS
,
I
have
really
painful
periods
,
I
have
heavy
periods
,
and
they
go
through
all
of
these
symptoms
,
saying
that
they
,
you
know
,
my
doctor
told
me
I
had
PCS
and
I
was
like
did
your
doctor
ever
mention
endometriosis
?
And
they're
like
no
,
I
,
you
know
.
I
kind
of
Googled
that
on
my
own
and
I
find
that
a
lot
of
patients
or
not
a
lot
,
but
there
are
patients
who
are
definitely
misdiagnosed
and
told
they
have
PCOS
when
actually
they
have
endometriosis
.
So
one
of
the
biggest
,
or
what
I
believe
are
the
symptoms
of
endometriosis
.
So
one
of
the
biggest
differentiating
qualities
of
the
two
diseases
is
PCOS
really
shouldn't
cause
pain
.
It
shouldn't
cause
pain
.
It
shouldn't
cause
pain
.
It
shouldn't
cause
bowel
symptoms
,
it
shouldn't
cause
bladder
symptoms
.
It
can
cause
,
you
know
,
difficulties
getting
pregnant
,
it
can
cause
difficulties
with
ovulation
,
but
it
shouldn't
cause
pain
and
I
think
that's
something
that
can
differentiate
the
two
.
Speaker 4
10:41
For
patients
who
are
kind
of
wondering
do
I
have
PCOS
,
do
I
have
endometriosis
?
Do
I
have
both
?
I
think
if
you
have
a
lot
of
pain
and
your
quality
of
life
is
impaired
by
your
periods
,
that
sounds
more
like
endometriosis
to
me
than
PCOS
.
Now
,
if
you
have
difficulties
conceiving
and
you
don't
have
any
of
the
other
symptoms
,
with
pain
or
anything
like
that
,
that
could
be
silent
endometriosis
or
unexplained
infertility
caused
by
endometriosis
,
or
it
could
also
be
from
PCS
.
But
I
think
if
you
have
pain
,
if
your
primary
symptom
is
pain
around
the
time
of
ovulation
or
periods
,
that's
going
to
be
endometriosis
.
Speaker 1
11:18
One
insight
that
resonated
with
me
is
how
Dr
Bebehani
,
despite
performing
IVF
,
doesn't
consider
it
her
first
line
of
treatment
.
Like
Dr
Whitaker
,
she
prioritizes
addressing
endometriosis
before
pursuing
IVF
,
doesn't
consider
it
her
first
line
of
treatment
.
Like
Dr
Whitaker
,
she
prioritizes
addressing
endometriosis
before
pursuing
IVF
,
as
this
can
sometimes
eliminate
the
need
for
IVF
altogether
and
addressing
endometriosis
can
potentially
prevent
further
pain
and
damage
.
Let's
hear
her
explain
why
this
approach
is
so
vital
.
Speaker 3
11:42
We
wouldn't
even
proceed
with
IVF
if
we
had
a
strong
suspicion
for
endo
,
because
the
surgery
may
save
them
the
cost
of
IVF
.
If
we
do
the
surgery
and
we
find
endo
and
we
treat
it
,
then
they
may
have
a
good
chance
of
getting
pregnant
naturally
without
IVF
.
And
if
they
don't
get
pregnant
and
we
still
do
IVF
,
their
chances
of
pregnancy
with
IVF
is
going
to
be
significantly
better
than
if
the
endo
was
still
there
and
we
hadn't
removed
it
.
And
I'm
going
to
add
one
more
thing
to
the
discussion
,
and
I'm
not
sure
if
Dr
Liu
does
that
or
not
,
but
when
I
have
my
PCOS
patients
go
in
for
surgery
for
endometriosis
,
I
actually
will
do
ovarian
drilling
,
Since
I'm
there
,
you
know
might
as
well
.
Speaker 3
12:21
Ovarian
drilling
is
a
surgical
procedure
that
was
done
very
often
in
the
older
days
when
fertility
treatment
was
not
as
available
.
So
we
would
go
in
and
surgically
poke
holes
in
the
ovary
.
Those
holes
are
meant
to
release
that
thick
layer
where
the
androgens
are
being
produced
.
Remember
I
mentioned
the
elevated
male
type
androgens
that
we
see
with
PCOS
patients
.
So
those
are
produced
by
cells
called
the
theca
cells
.
The
theca
cells
are
around
the
cortex
,
the
superficial
layer
of
the
ovary
.
So
if
we
poke
multiple
holes
in
the
ovary
.
That's
called
ovarian
drilling
and
it
actually
helps
women
ovulate
and
overcome
that
problem
of
elevated
androgens
.
We
don't
nowadays
take
women
to
surgery
just
for
that
,
and
20
years
ago
people
used
to
do
that
.
But
nowadays
,
because
we
have
so
much
more
advancement
in
medicine
,
we
give
them
pills
rather
than
,
you
know
,
take
them
to
the
OR
.
But
if
I'm
there
doing
their
endo-excision
surgery
and
I
know
they
have
PCOS
,
I
will
add
ovarian
drilling
to
my
procedure
.
Speaker 1
13:16
These
episodes
are
brimming
with
essential
information
and
hope
,
especially
for
those
navigating
infertility
or
managing
PCOS
and
endometriosis
.
The
overarching
message
I
took
away
is
this
Unexplained
infertility
is
not
a
diagnosis
.
There
is
always
a
reason
,
and
these
doctors
offer
tools
and
insights
to
help
uncover
it
.
If
you're
struggling
with
infertility
,
my
heart
is
with
you
.
It's
a
painful
and
often
isolating
journey
,
but
let
these
episodes
remind
you
that
compassionate
providers
are
out
there
to
support
you
in
every
step
of
the
way
Renewed Health and Wellbeing Vision
Speaker 1
13:52
.
To
hear
these
episodes
in
full
stream
episodes
77
and
91
on
your
favorite
platform
.
Speaker 1
13:58
As
we
close
out
this
year
and
prepare
for
the
next
,
my
hope
for
you
is
renewed
health
and
vigor
,
whether
in
finding
ways
to
build
a
family
or
simply
in
reclaiming
your
wellbeing
.
Make
sure
to
subscribe
and
turn
on
notifications
for
the
next
endo
year
reflection
,
where
we'll
continue
to
recharge
and
build
actionable
plans
for
the
future
.
Thank
you
for
spending
your
time
with
me
today
and
throughout
the
year
.
Remember
you're
not
alone
.
You
matter
and
so
does
your
journey
.
So
until
next
time
,
continue
advocating
for
you
and
for
those
that
you
love
.