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

Game-changing innovation doesn’t happen by accident. 

It happens when the best minds in fertility are constantly testing, improving, and challenging what’s possible. 

We dive into this notion with Dr. Rita Vassena, Medical Director of Fertility at CooperSurgical. She spends her time visiting high-performing IVF labs around the world, identifying the technologies, processes, and ideas that are shaping the future of reproductive medicine. 

We discuss: 

• What it will take to double IVF cycle output in the next five years 

• How vitrification can be performed up to 90% faster 

• CooperSurgical’s rapid blastocyst warming technology 

• Emerging concepts that could reshape fertility treatment 

• What leading lab directors are doing to maximize workflows and IVF supplies 

The next generation of fertility care is already taking shape - get a glimpse of what may be coming next.

Is PGT as we know it coming to an end?

Drs. Arlene Morales, Holly Mehr & Drew Tortoriello discuss what they see as the next evolution of PGT and why whole genome sequencing could reshape the future of embryo testing.

They dive into:

• Why all PGT could include whole genome sequencing within five years

• Concerns about PGT-P and direct-to-consumer marketing

• What they want to hear from ASRM and other professional societies about genomics

• What should be included in a large randomized controlled trial on PGT

• Why they are cautiously optimistic about Juniper Genomics (And what makes PGT-G different)

Third-party IVF is getting bigger, but are clinics actually getting better at it?

Or are some efforts to streamline the process creating new risks for patients?

Dr. Allison Bloom of Main Line Fertility and Dr. Daniel Shapiro of Reproductive Biology Associates (RBA) discuss what separates a clinic that offers third-party reproduction from one that truly excels at it.

We dive into:

• The push to streamline third-party IVF (and where corners may be getting cut)

• The technology stack donor & surrogacy programs need

• The gaps in today’s EMRs and what needs to change

• Emerging trends around known donors

• New thinking on anonymous vs. de-identified donation

• One thing each physician believes clinics should start (or stop) doing to become a third-party IVF powerhouse

As third-party reproduction becomes more common, the operational, ethical, and technological challenges become harder to ignore.

More than half of IVF patients never complete treatment. 

Stress, finances, and relationship strain may play a role, but are fertility workflows optimized for cycles completed over families built also to blame?

In this episode, leaders from Inception Fertility share how they’re using technology, workflow design, and operational strategy to improve the patient journey from first inquiry through graduation.

• What Inception uncovered by integrating their EMR with Salesforce

• Insights into no-shows and cancellations from patient data analysis

• Workflow improvements being implemented across staff and physicians

• How to evaluate which solutions can scale network-wide

• The build vs. buy debate around automation & more

How much friction still exists in your patient journey, and where could better systems make the biggest difference?