Miranda shares her five year fertility journey, from low AMH and multiple failed IVF cycles to an endometriosis diagnosis, immune support, gut healing, and finally a healthy natural pregnancy at 42. Aimee Raupp guides the conversation with clinical context, showing how the bigger picture emerged only after looking beyond standard IVF protocols.

We discuss why repeated IVF did not work, how endometriosis and inflammation showed up in Miranda’s symptoms and outcomes, and what changed once the team focused on root causes like uterine scar tissue, immune dysfunction, gut health, and environmental exposure.

Key Topics

* Miranda’s fertility journey began after marriage in her late 30s, with an initial AMH of 0.545 at age 37 and early warning signs that standard IVF might be a poor fit.

* She was told she had the egg count of a 50 year old woman and would likely need multiple retrievals, leading to a major financial and emotional burden as a cash pay patient.

* Her first IVF cycle was derailed when she ovulated through stimming medications, a sign that the standard protocol was not adequately suppressing ovulation for her body.

* A severe allergic reaction to a COVID vaccine, treated with prednisone, coincided with her second retrieval and may have influenced that cycle, which produced 7 eggs, 4 fertilized, 3 blasts, and 2 PGT normal embryos.

* Both transferred embryos ended in a chemical pregnancy, followed by a third retrieval with poor egg quality and no usable blasts, deepening frustration with the first clinic.

* A second RE changed protocols with estradiol priming, but Miranda experienced intense headaches and a severe reaction pattern that Aimee flagged as a clue for estrogen dominance and possible endometriosis.

* Miranda ultimately pursued a consultation with Dr. Check and then Dr. Vidali after recognizing that endometriosis, inflammation, and low ovarian reserve might be driving the repeated failures.

* Dr. Check encouraged timed intercourse and later IVF, but Miranda had repeated failures, including one cycle where no eggs were retrieved and another where she ovulated too soon and the cycle converted to an unsuccessful IUI.

Rethinking AMH and Ovarian Reserve: The Inflammation Connection

In this episode, Aimee Raupp challenges traditional beliefs about AMH levels and ovarian reserve, emphasizing how inflammation plays a crucial role in ovarian aging. She discusses groundbreaking research suggesting that ovarian decline isn’t solely about egg quantity but also the health of the ovarian environment.

Key topics:

* The history and misconceptions surrounding AMH testing

* Why AMH is not a definitive measure of total egg reserve

* The impact of systemic inflammation on ovarian aging

* The discovery of ovarian stem cells and the potential for new egg formation

* How chronic inflammation damages granulosa cells, reducing AMH

* The importance of understanding the ovarian environment in fertility

* The influence of autoimmune conditions, gut health, and diet on ovarian reserve

* Practical steps to identify and reduce ovarian inflammation

* The significance of current research outpacing mainstream medical guidance

* Encouragement to look beyond AMH numbers to understand true fertility health

Timestamps:

00:41 - Introduction and the history of AMH testing

01:09 - Why a high or low AMH isn’t the full fertility story

01:52 - Inflammation’s role in ovarian health and aging

02:22 - Limitations of AMH as a fertility marker

03:20 - The analogy of the factory to explain AMH fluctuations

04:16 - Women in menopause still have eggs: myth vs. reality

04:45 - Ovarian environment vs. egg quantity

05:13 - The American Society of Reproductive Medicine’s stance on AMH

05:48 - Challenging the dogma: Are we really running out of eggs?

06:16 - Recent studies and the impact of ovarian stem cell research

07:07 - Breakthrough research by Jonathan Tilly on ovarian stem cells

08:05 - Evidence supporting the regeneration of follicles in adults

09:03 - The lag between research and clinical practice

09:32 - The myth of running out of eggs and new findings

10:01 - The longevity of eggs in menopause

11:01 - Rethinking ovarian aging and the role of inflammation

11:32 - How inflammation damages the ovarian support system

12:02 - NLRP3 inflammasome system and chronic stress

12:29 - The destruction of granulosa cells and declining AMH

13:28 - How turning off the inflammatory alarm can slow ovarian aging

13:53 - Linking inflammation to conditions like endometriosis and Hashimoto’s

14:16 - Impact of diet and gut health on ovarian reserve

15:18 - Numbers are data points, not destiny

15:46 - Viewing AMH as a smoke detector for inflammation

16:10 - Root cause workup and anti-inflammatory strategies

16:39 - Invitation to explore part two of the series for practical insights

Resources & Links:

* Yes You Can Get Pregnant – Revised Edition by Aimee Raupp

* Jonathan Tilly - Northeastern University (search for his current publications)

* NLRP3 Inflammasome research

Connect with Aimee Raupp:

* Instagram

* Website

SHOW NOTES

This is one of the most remarkable fertility journeys I have ever had the privilege of witnessing in over 21 years of clinical practice.

Rebecca came to me as an acupuncture patient in 2012. Over the next decade I watched her freeze eggs in her mid thirties, improve her AMH and FSH through diet and lifestyle, navigate a demanding career in New York City, find her person, and then embark on one of the most grueling and ultimately triumphant paths to motherhood I have ever seen up close.

Seven retrievals. Two failed transfers. Two mock cycles. Hysteroscopies. Endometrial biopsies. Seven rounds of PRP. Two IUIs. A chronic endometritis diagnosis that changed everything. A clinic switch. And one sweet, perfect baby boy.

She was 45 when she got pregnant. She gave birth at 46.

In this episode Rebecca shares everything. The failed transfers and what we found when we dug deeper. The immune panel that finally gave us answers. The decision to switch clinics. The ovarian PRP. The Egg Quality Diet. The emotional work. The mantra she said to herself every single day. And what she wants every woman in the thick of this journey to know.

This is not a story about luck. This is a story about belief, about doing the work, and about what becomes possible when you refuse to accept that your biology is fixed.

What we cover in this episode:

Why the foundations you build in your mid thirties matter enormously even years later. How Rebecca's AMH and FSH actually improved between her first and second egg freeze through diet, acupuncture, and lifestyle. What chronic endometritis is, why it is so frequently missed, and how it was affecting her transfers. The immune panel that changed the entire clinical picture. Why switching clinics and moving to low stim and mini stim protocols made a difference. Ovarian PRP and what Rebecca noticed cycle by cycle. The Egg Quality Diet and how she implemented it fully. Managing a high stress career while going through fertility treatment. The emotional and spiritual work that held her together. Her mantra and why she credits belief as one of the most important parts of her journey.

Resources mentioned in this episode:

Yes, You Can Get Pregnant by Aimee Raupp, revised 2026 edition: aimeeraupp.com/booksThe Egg Quality Diet by Aimee Raupp: aimeeraupp.com/booksWork with Aimee and her team: aimeeraupp.com/coachingThe Fertility Authority on Substack: aimeeraupp.com/substack

Rebecca's mantra:

I am worthy. I prayed and it is coming. I am doing all I need to do. We are ready.

Ovarian Communication Meditation

Your ovaries are listening.

This 8-minute guided meditation is an invitation to slow down, drop in, and open a line of communication with your ovaries. Through breath, visualization, and intentional awareness, you will send love, energy, and healing directly to your reproductive center -- and learn to listen to what your body is trying to tell you in return.

This is the kind of practice that no protocol, supplement, or lab result can replace. It is you, your body, and the quiet wisdom that lives within.

Settle in. Press play. Your ovaries are ready.

I recorded this meditation for a program I am running and it felt too good not to share. It is short, it is calming, and it is exactly the kind of nervous system reset I think so many of you need right now, especially if you have been deep in the research from this series. Press play, close your eyes, and give yourself five minutes. You deserve it.