Inside Reproductive Health Podcast

Dr. Rachel Mandelbaum and Dr. Sahar Wertheimer, both REIs at HRC Fertility, try to solve the problems holding the fertility field back.

They agree on a lot, disagree on some and hold very little back.

They dive into:

• Why every clinic defines RN, MA, coordinator, and sonographer roles differently

• Whether a CRNA or anesthesiologist should handle IVF emergencies

• The PGT-P versus PGT-G debate (and who they refer out to)

• How clunky EMRs quietly create real patient safety errors

• Why insurance prior authorizations are killing time-sensitive IVF cycles

It’s hard enough to run one fertility center, let alone several of them. It’s even harder to change the way they operate.

We dive into this challenge with Dr. Amanda Hurliman, Medical Director of Pinnacle Washington. She shares what it took to implement the Pinnacle Operational Model, first in Oregon and then in Washington, where the process proved even more difficult when the entire surgery center team left.

We dive into:

• Why Washington's operational model rollout was harder than Oregon's

• Rebuilding a surgery center after the entire team left

• How care navigators take cycle coordination off the nurses' plates

• Inside Pinnacle's hands-on care navigator training program

• Why independent testing matters when patients choose supplements

What happens when carrier screening shifts from an opt-in choice to an opt-out default?

At Northwestern Medicine, opt-out carrier screening has become the standard. 

But how does it affect the clinic? The practice workflow? The patient experience? Should other fertility practices be doing the same? 

In this episode, Dr. Eve Feinberg, REI at Northwestern Medicine Center for Fertility and Reproductive Medicine and consulting medical director at Natera, explains why her clinic moved to an opt-out model and how it operates in practice.  She is joined by Jennifer Saucier, MS, CGC, VP of Women’s Health Product Management at Natera, who offers insight into how lab partners can support clinics through the operational demands of carrier screening.

They dive into: 

• Why Northwestern adopted opt-out carrier screening 

• Managing results as screening volume grows 

• Preparing patients for expanded panel findings 

• Standardizing and customizing donor screening panels 

• What genetic screening reveals beyond reproductive risk 

It’s working for Northwestern, and it might just work for you too. Have a listen and find out.

What does a fertility practice manager do when there is no formal training for the job they were just promoted into?

Peter Fuzesi, Jessica Medvedich, and Jennifer Straub, explain how the Association of Reproductive Managers (ARM) gave them the business education this field never built. They also preview the new Business of Medicine certificate and the ARISE conference.

They dive into:

• Why an MBA does not prepare you for IVF leadership

• The staffing ratio math that convinces physicians and investors

• The malpractice coverage gap most IVF programs miss

• What the Business of Medicine certificate will actually teach

• Why ARM is the go-to network for fertility managers

Patients are coming into fertility appointments more informed than ever.

They’ve talked to ChatGPT, researched their treatment options, and sometimes even come in with an idea of what they think their doctor should recommend.

So what does that mean for the REI?

That’s the question Dr. Maria Costantini explores. She’s a Partner REI and Medical Director at RMA, and she believes self-awareness may be one of the most important tools physicians have as the patient-physician relationship changes.

We dive into:

• Why patient self-education is reshaping fertility care

• How technology is changing physician decision making

• Dr. Costantini’s belief that self-awareness may prevent provider burnout

• The balance between authoritative and collaborative consultations

• RMA’s new AI and how it supports the patient journey

AI may be changing what patients bring into the exam room, but Dr. Costantini argues that how physicians respond may come down to something much more human.

“You’ll never be able to make it on your own.”

A challenge issued by a network CEO to this week’s guest, Dr. Shvetha Zarek.

She left anyway, built Arbor Fertility in St. Louis, and co-founded AIRE, the Alliance of Independent Reproductive Endocrinologists. Now, she’s one of the loudest voices challenging the idea that corporate consolidation is inevitable.

We dive into:

• The myths practice owners are told about going independent
• Why independent REIs often take home 3-4 times more revenue than their corporate peers
• What really happened when her venture-backed group quietly ran out of money
• The debate over whether owning your lab makes you truly independent
• Why AIRE is calling this a breaking point for corporate medicine

If this conversation resonates with you, leave us a review or share it with a colleague who's thinking about hanging their own shingle.

Behind every successful fertility journey is a team of nurses, administrators, and clinical staff working under intense pressure. 

Too often, the people holding the system together are the ones left without a safety net.

In this episode, we sit down with Dr. Debbra Keegan, full-time REI physician and Vice President of Clinical Partnerships and Strategy at CCRM, to discuss how to protect and empower healthcare teams from the ground up.

We dive into:

• The hidden cost of burnout on fertility clinic staff 

• How physicians, leadership, and staff can actively support their teams

• The impact of CCRM's new patient navigator system

• Why introducing mental health resources on initial visits elevates care

• How wearables and microbiome tracking are transforming patient wellness

Restorative Reproductive Medicine isn't just a rebranding. It's a legal and legislative strategy aimed at IVF. And it's gaining ground.

A surprising number of fertility doctors have asked IRH to cover this topic, so we brought in the right person: Matt Maruca, Inception Fertility's chief legal counsel for seven years and a key figure in the Fertility Providers Alliance.

We dive into:

• How Southern States approached IVF-hostile legislation in 2026

• What tort reform could look like for IVF providers 

• The donor-conceived community's growing influence on policy

• What legislation the FPA is actively working to advance

• How you can get involved, even if you don't work for Prelude or Inception

Is private practice making a comeback? More importantly, should it?

After five years at UCSF, Dr. Thalia Segal left academic medicine to launch Collab Fertility in one of the most competitive fertility markets in the country.

And she did it with no private equity and no venture capital.

Just a vision for building the kind of practice she believes both physicians and patients deserve.

We dive into:

• Why some fertility physicians are reconsidering private equity-backed practices

• Why Dr. Segal believes REIs should have greater oversight of the IVF lab

• The financial realities of running a 300-cycle practice (without outside investors)

• How she’s growing Collab Fertility and recruiting the next generation of REIs

• Her 21 headcount payroll and the operational challenges she’s encountered along the way

3 fertility specialists have built massive digital brands with millions of collective followers.

In this episode, Dr. Aimee Eyvazzadeh (The Egg Whisperer), Dr. Roohi Jeelani (CEO of Onto Health), and Dr. Lucky Sekhon (Partner at RMA New York) discuss how they embody the same raw talent but leverage their public profiles for very different aims.

They dive into:

• How fertility physicians build celebrity-level digital brands

• The strategies behind maintaining a successful self-pay practice

• Pursuing creative endeavors outside the clinic (like authoring a book)

• Scaling a clinic group and building a tech-enabled OB/GYN referral network

• Why Dr. Aimee added Juniper Genomics to her PGT roster