Kerry: 0:28

Hi everybody. Welcome back to the Get Healthy Tampa Bay podcast. I'm your host, Dr. Kerry Reller, and today we have Dr. Erica Bove. Welcome to the podcast podcast. Fun fact, before we get started about Dr. Bove, we both went to Notre Dame. Woo. Alright. But anyway, Dr. Bove is our guest today. She's a double board certified OB GYN and reproductive endocrinologist and infertility physician at the University of Vermont and the CEO and founder of Love and Science, thriving through infertility. She also hosts a podcast. Dr. Bove is deeply committed to supporting individuals and couples through the emotional and medical complexities of infertility. Her work uniquely blends evidence-based reproductive medicine with intuitive knowing, all grounded in trusting compassionate relationship. She has a special passion for empowering women physicians as they navigate family building, helping them move forward with confidence, self-compassion, and community. Her mission is to heal and support the healers and to create a legacy rooted in empathy, integrity, and hope. So, Dr. Bove, welcome to the podcast. Thank you so much for being here.

Erica: 1:37

Thanks, Dr. Reller. It's so great to be here.

Kerry: 1:39

Yes. So, I know we, that was a mouthful of an introduction, but, Why don't you tell us a little bit how you got into, what you do and what you specialize in.

Erica: 1:48

Sure. So my specialty is really infertility, and I did just like you, I went to medical school, I did a residency, and then I did a fellowship after my residency and really my passion has been helping people get pregnant who are struggling to to build a family and also helping them to stay pregnant. But what I'll tell you is I found that, you go through a training, you think, okay, I'm just gonna get out and everything's gonna be great. But I was in the clinical setting over the first couple years and really struggling to help people make their decisions at these very crucial points in their paths. When do we escalate treatment? When do we think about maybe something called third party reproduction, which is when somebody else's body, like donor egg, donor sperm is part of the equation. And so I was doing coaching for my own purposes during that time and started just experimenting. I wonder if my patients would benefit from some of these coaching tools to help them make better choices, and all of a sudden their fertility treatments were working better. It was like, almost like magic. And I know were like evidence-based I, there's something to it. But all of a sudden, not only were the patients more relaxed, but they were like, maybe what they were already doing was working better, or maybe they decided more easily to, to, change course from a treatment perspective. And so once I found that was working, I got the idea. I'm like what if I could be a coach? What if I could help people in this way? Still do my clinical practice, but then also, have, be able to help whoever, wherever they live, in whatever state, whatever country, to be able to make their best decisions and have the most successful treatment possible.

Kerry: 3:21

I mean, I think it's so hard to just do something in a clinical setting yet so much is more involved in that, right? Like we have all these outside of clinical setting things that could be, helpful and needed, but it's so hard to do in that, in, the limited amount of time that you get with a patient. So I coaching, like you're saying, is combining the best of both worlds You're obviously helping patients and having people have success, so that's amazing. What made you wanna focus on, or are you focusing on like the women physician, or is it just women physician, or is it also just

Erica: 3:56

Yeah.

Kerry: 3:57

busier women?

Erica: 3:58

So I call it really any high achieving person who really has a growth mindset. I think that's why what I do resonates with so many professional women is because, you gotta be in that zone of discomfort. We are, we're not gonna grow if we're just like, comfortable. People who are generally very high achieving. It's very interesting'cause I have a lawyer sister and an engineer sister, and so I'm like, okay, I'm gonna leave it open to everybody. And for some reason the physicians tend to disproportionately find my services and wanna work with me, and I have this like suspicion it's because part of what I do is I help people be better patients, and as doctors, we are often not very good patients. We don't prioritize our health. We're always helping other people first. We maybe are so focused on other things that we, maybe we make like mistakes in our medicines and things like that. And also it's really hard to relax into the patient role. It's like a more vulnerable stance. We're not good at it. I'm not good at it. And so I think that as I've learned how to do that better myself, that's something that I'm, I love helping people with is okay, how can reduce your hypervigilance when appropriate? Trust your care team, find your voice advocate when needed. And people really resonate with that because I think I think that, the adrenal glands calm down in that scenario. The physiology works better and then people also, like they all of a sudden they're like, oh my gosh, this next transfer worked. Like what happened? And I think it's because people are better able to be patients.

Kerry: 5:18

I would definitely identify with that. I'm a terrible patient and I know plenty of other physicians that are not good patients, and I get very anxious when I'm like under the gun and under fires, and I think the ability to, have someone working with someone like you to help, like you said, relax, that setting can make a big difference. Especially like with fertility, as, stress and everything can make that a harder journey. How did you, you I guess get into this niche in general?

Erica: 5:45

Yeah. So it really was born out of I was very happy in my clinical career, but I was just frustrated because. Just imagine like the patient encounter, there's a patient in front of you, and I was trying to say, okay, this is what I think your diagnosis is and why, and this, these are your treatment options. You can do this or this and I felt like there was like a block. And i'm an empath, so I pick up on these things. I'm like, okay, my patients are anxious. My patients are feeling hopeless. They're shut down. They're not absorbing like 90% of what I'm saying. I'll talk slower. I'll ask questions like, I'll do all the things you're taught in medical school to do for good communication, but it wasn't working in this patient population, and so that's when I was like, okay, tell me what being a mother means to you. Tell me what your greatest fear is, on this process. Tell me about you and your husband or partner and where you're connected on this and where the disconnect is, because maybe you started off with a sim, similar vision, but this is now driving a wedge in Your relationship, and I'm curious if you see this in the allergy world too, because I think a lot of the healing that we see a lot of people actually getting better. Yes, we need the science, we need the treatments, all those things. But when people are in a more receptive state, when they are active participants in their healthcare, when they're able to ask curious, empowered questions and we can meet them at a higher level, I just think everything works better. And so it was really born out of my own frustration of i'm trying everything that I was taught how to do, and I'm not reaching these people. And then consequently, I'll see them in six weeks and no progress has been made because they're still ruminating on the same choices. And so how can I help them get over that hump? To actually being, be able to help them. And that's where the coaching tools came in to calm the nervous system, to educate them about the science so that they felt like there wasn't, in the darkness. Especially if you're talking about female physicians, say it's a cardiologist, like infertility is so far from anything anybody learned in medical school. It's just People are like, oh, I should know this. And, but no, you shouldn't know this. That's why we're here. But that's when like these things started working in the clinical setting and I started connecting with my patients better. They felt better. Their treatments were working. All of a sudden they were pregnant and graduating and moving on, and I'm like, this is the disconnect. This is what the patients have needed all along. And if I can integrate those things, obviously my patients still get this, we might book a little longer appointment or something like that if I can do that. But the clients, I think that fertility care today is not designed for people to have all the time to go into those deeper issues. But I think when we can incorporate them, that's when we see the treatments that are supposed to be working, they actually start to work

Kerry: 8:23

I think all facets of medicine, if you were able to really dive into that and, the psyche part of it, I think people could heal quicker and better. What role do you think the fact that women physicians in particular kind of delay, even attempting at conceiving, plays all into this?

Erica: 8:40

Oh, I think it's undeniable. I think, if you look at, say somebody does four years of medical school and then has an 7, 8, 9 year residency fellowship. If you do the math, at best, people emerge in their mid thirties. From that sort of a long scenario. But I'll tell you, Dr. Reller, it's not just the age. So yes, deferred childbearing is part of it because a whole wing of infertility care is what we call diminished ovarian reserve. And we lose eggs over time and our quality goes down. And people are trying for the first time, maybe they haven't found a partner and they finish their training at 33, but then they don't meet their partner until they're 38 and then they start trying. I see these scenarios like every single day in my practice. But I think that if you take like a 38-year-old physician and you take a 38-year-old non-physician, the physician is gonna have worse fertility outcomes, they're gonna have worse obstetrical outcomes. And there's so many reasons for that. We really need more data. But I, my theory is that it's based in stress, that it's based in, nights shifts that are throwing the body off. There's so many factors for it. But I think that we know that female physicians have worse outcomes across the board, and that's something that I'm also trying to reverse with my coaching practice.

Kerry: 9:53

Yeah. So you care for many female physicians and high achieving women. What patterns do you consistently see in these groups?

Erica: 10:02

Yes, I think the nervous system is on overdrive. So with the fight or flight reaction, like people's nervous systems are just so activated, and I believe this is a trauma response like people have, already coming to a fertility clinic clinic, most people have already tried to get pregnant and it hasn't worked. And this is for many people what they want more than anything, more than their careers, more than anything in life. They wanted to be a mom and so they are already feeling threatened with either not having a kid or not growing their family. Which can be really stressful. And just understanding that then people start doing treatments. Usually treatments don't work the first time around, and so all this bad news piles up and people's nervous systems are truly just like incredibly activated and they're very stressed out. And so I think the first thing is really like helping people understand that they're safe, that I will take the burden from them because they don't have to do this. You know themselves that they're not alone. When we connect people with groups I have support groups. People hear their stories mirrored in other people's stories, and they, get support even outside the context of the meetings. We have a WhatsApp chat. People text each other that doesn't have to include me. And so people really get a community that they didn't have before. And so that's really helpful. I think that when our nervous systems are very activated, on and on, high alert. We tend to get triggered by things like, for instance, we're recording this in the holiday season, so a lot of baby announcements happen at family functions or the cards. Somebody you know, said that they were in church and they were in the row in front of them was a baby the same age as the baby who miscarried would've been that age and that was very triggering. And I think we just have to be sensitive to the fact that people going through infertility, the world is a minefield of triggers. And so we do talk a lot about like how to reduce those triggers, how to heal those wounds, how to navigate these situations with self-compassion and and really like healing from the inside out. But I think that's, it is, these are these very driven, high achieving women who are used to like working harder and then getting exactly what they want. That's like the pattern that we're taught, you and I both fall under that umbrella of high achieving women. But I think that infertility doesn't follow the same rules. And so it's helping people to control what they can and let go of the rest. And I know it's, sounds maybe unscientific, but it's really helping people surrender to the process and saying okay. I will validate your treatment plan. I will, maybe suggest some tweaks to it. Questions you can ask your REI. I will get on the phone and talk with somebody's fertility specialist. They reach out to me actually sometimes. They're like, oh my goodness, what do you think I should do? This patient too. You thought really hard about her. And obviously in this scenario, it's not technically medical advice, but I really partner with the, REIs, the fertility specialists so that the people can have the best possible outcome. It's really beautiful, actually. And yeah, unfortunately, if somebody has a negative pregnancy test, we share in that grief and then we make a plan. If the patient wants it, the client wants it, we make a plan together moving forward. Yeah.

Kerry: 13:00

You're absolutely looking at all the triggers in society that's going on,'cause everything that you just gave an example from, I'm looking back on our, Christmas holiday every single thing there, Would've definitely occurred in, my Christmas experience. So I can't imagine, with people who, you know, that very triggering and it is like trauma, like you said, like each and over and over, repeated every single time. So how do you, what are some like methods that you work with them to help, identify the trauma and or whatever it is and respond to it?

Erica: 13:32

So I think the first thing is really calming the nervous system. And so I do some like breathing exercises actually to help people go from being so cerebral and in their brains to in like truly in their bodies. And so we do breath work together. And I also help people learn how to feel their feelings. My running joke is that I'd rather clean a toilet than feel my feelings any day, but discomforts the currency of our dreams, right? If we can learn to tolerate the disappointment, if we can learn to process the shame or fear or whatever it is. Those emotions are gonna not take actually very long to leave our bodies, and then we can be in a different space. And so this isn't just think what you wanna think and everything will be better. It's not like this superficial thing. It's a very deep, like I am grieving. I teach them how to process the grief in their bodies and then let it go so that then there's room for like more joyful experiences and connection and those sorts of things. So I always see you're the wise leader of your inner world, and we're gonna learn how to navigate this complex. Landscape of the human emotions. And that just makes us better able to show up at the fertility clinic and not know what the result's gonna be and still be able to handle it with grace and all those things. And so processing feelings really important. And then we get into kind of the nuances of balancing trust and advocacy and like maybe setting boundaries where needed. Maybe people were working like a hundred hours a week and they need to, scale back and have a more manageable schedule, or they're going through these things and reduce their stress. Maybe people need to have a conversation with their partner, so that's where like the individual nuances come in. I do have a course that touches on a lot of these things, but the coaching, both the individual coaching and the group coaching. That's where we can really like work on people's individual situations. Like maybe somebody's in OB GYN and they're working with pregnant people all the time, or maybe, they're a pediatrician and they're surrounded by children. Every journey has like a little bit of a different flavor to it. But what we do is we focus on like the universal things. And I think once people start to feel safe, once they start to process their feelings, once they start to understand their treatment plan, a big thing, Dr. Reller, is confidence. Like a lot of people, especially physicians doubt their treatment plan. They're on the internet, they're looking at other protocols, they're comparing with their neighbor. Like they're just like comparing because they just so desperately want this to work and they're trying, their doctor brains are like going wild. And so part of it's let's get a treatment plan that we can be confident in and then stop the rumination loops so that you can just do the plan and enjoy so much more that life has to offer. So those are some things that we do to really get to the point of being able to trust the process and surrender. And then obviously like even a positive pregnancy test. I You'd think that once people finally get to a positive pregnancy test, they'd be like, cause for celebration and so much of this would melt away. I'll tell you my clients are more anxious when they have a positive pregnancy test because they're like, okay, now what?

Kerry: 16:16

Yeah. I'm imagining most have had loss already, right? So they're probably more anxious with the positive test.

Erica: 16:21

Exactly. So it's just saying, okay, this is gonna open up a whole new set of fears and anxieties, and how can we use the tools to navigate that Because it, it never ends. And if the goal is parenthood, then that's like a whole other slew of fears and anxieties when you're navigating being a parent and helping your kids and all those things. So this is really tools not just to help people have successful treatments, but then to help set them up for a better life with more tools to navigate life itself.

Kerry: 16:43

Yeah. I love the idea of turning off that doctor brain and stop, looking for all the answers and questions and comparing yourselves to other people. I think that is so important. And, and lots of different aspects of medicine, so clearly it applies here as well. Can you give us any stories or an examples of, clients that have had, an experience with you, whether it lead to a pregnancy or maybe it didn't.

Erica: 17:08

Absolutely. So I have one client I worked with for about a year and she had been doing lots of fertility treatments, IVF specifically, and the treatments weren't working. And it was so interesting because she was at the point where she was thinking of getting a gestational carrier. We coached a lot about whether she, they would do that to have a child or whether they would decide to remain child free. Like she really was thinking like, I've had so many embryo transfers, it should have worked by now. Something is broken. I think we're gonna have to be okay with like maybe not having kids. And it's so interesting because it sounds so like counterintuitive, but when people actually go there, they go to their worst case scenario and they like allow the feelings, they allow the possibility. That's when that attachment to the outcome is released. And that's usually when I see people start to have better luck. It's really interesting. It's there's data that when people decide to adopt that they have higher fertility rates than you would expect. Same thing when people make a first appointment at an infertility clinic. We see an uptick in pregnancies. It's so interesting and it, before we've even done anything, it's amazing. But I think there's that turning over the will. So this particular person was going to go on vacation with her family, like going to Europe for a month. And so she was like, you know what, I'm just not gonna do our fertility treatments this month, but I think we just won't use birth control and just the one month outta the last two years and we'll just see what happens. And it was so interesting because her period didn't come. It didn't come. She was supposed to have a procedure when she got back and I was like, you really have to check a pregnancy test so we know. And would you believe that after this entire journey, she checked a pregnancy test and it was positive. they got pregnant outside of IVF after so long of trying, and they were looking into gestational care, but I truly think it's because she truly gave it up. She truly was like, you know what, whatever my highest good is in this life, like it's gonna be okay. Either way. I'm gonna have a meaningful life. I have a wonderful husband. Like I truly release the attachment and that's when it happened, which is wild and I see this all the time. So that's one incredibly beautiful story. She's in her second trimester, it looks things are gonna continue and things are going well, so that's fantastic. Another client of mine, she had a positive pregnancy test after 20 years of trying. After 20 years, This is all very recent, right? And so we worked together for six months and then, during that time it was clear that she needed her fibroids removed and it was clear that, I suggested that maybe she go on like a gLP one that lose some of the weight that she had gained through fertility treatments. She really worked on her mindset, so she healed for three months over the summer and then her first embryo transfer back after so many IVF cycles and so many unsuccessful transfers. That embryo stuck. She's now almost in her second trimester, and she said to me, she's for the first time in over 20 years, I have a positive pregnancy test. This is amazing. And so it's just, I feel like I see miracles every day and I just wonder, I'm very grateful that I was given the gifts and the interest and the passion that I do to help women in this way. You just wonder what if any of those pieces would've been different? Would they have had these outcomes? And I'm not sure. I'm really not sure. And so that's, I feel very grateful to do it. And it's it's hard because how do you bottle it up? You can't just write on a prescription pad this thing but it's a process, right? It's a process of helping people come home to themselves. Connect with our deepest why, not be so incredibly attached to reverse that pattern of work harder now. It's actually working less hard is what people need to do and how to trust the process. So yes, those are some examples, but it's it's pretty cool. It's really amazing. I'd say most people are pregnant on their next embryo transfer after, working with me, which is amazing. And because people have like years long journeys and sometimes we do a lot of prep work to get to that point. Sometimes we gotta do things we gotta undo things but I say every single person who desires to be a parent deserves to be a parent. And we just have to find your pathway and how that little soul is meant to be yours. And when people do it, it works. It's amazing.

Kerry: 21:15

It's so interesting how that like happens, right? They just have acceptance and then all of a sudden. And, You see it, that it, it is not, I don't, it's things I've heard of before. It's it's so interesting how your body just relaxes and is ready, I guess,

Erica: 21:30

I I think on a very biological level, I think there are probably neurological physiological blocks that are released, but it almost feels like it has some sort of a spiritual quality to it. Like it's hard to put my, but I know I'm a participant in it, but it feels like bigger than me, if that makes sense.

Kerry: 21:45

I would think it's bigger all of us really with that. Yeah. Yeah. So for someone listening who's deep in the struggle right now, what do you most want them to hear?

Erica: 21:54

I want them to know that they're not alone. I want them to know that help is available. A lot of people feel like a number at their fertility clinics and I, it doesn't have to feel that way. Whether it's finding the right clinic for you or, knowing what questions to ask to advocate for yourself. Maybe getting a different clinic if that's, maybe having me as a guide or another fertility coach. There's so many resources out there that people just don't know about. People are never alone. And the other thing I tell people all the time is, it's not your fault. People always blame themselves. Is it because I ate from the taco truck on Tuesday? Is it because I, waited too long to try to get pregnant? Is it because I the list is just endless. And so I always tell people, you made the best decisions you could. Like 99% of infertility is not related to anybody that anything did'cause it's disease and one in six couples have it. And so how can we work with the facts and, make sure that we're making forward progress And so you're not alone. Help us available. Communities are available and if the desire is in your heart to become a parent, there is a pathway. We just don't know how long it's gonna be. We don't know exact the exact route, but that's part of this is just how we as humans try to figure out our purpose on this planet. It's a similar thing is like how are we gonna link the souls and how can we do that to help people have their best possible outcomes?

Kerry: 23:10

I love that your program includes a community aspect, because as health and wellness is all very much about inclusivity and community and just social interaction. So I think being able to, discuss with other people, going through the same thing, I think that's a really big important component that you offer. Mm-hmm. So are there any like gentle steps that someone can take today to protect their mental and emotional health so that they're ready to be on their journey of, trying to have a child in whatever way that is planned for them?

Erica: 23:43

Yeah. I think one of the very simple but not easy things that people can do is. Being in the moment. And so we do this at Love and Science, like we say, okay, let's take a hot cup of tea and really focus on like the heat and the steam and the scent and all those things. Like when we do a lot of the mindful self-compassion and one of the three components of mindful self, of compassion, per Dr. Neff is that mindfulness and being drawn into the present moment. And we think about we're critical of the decisions we've made in the past or we're in the past or we're like anxious about things that haven't even happened yet. We're always projecting, had the worst possible outcome. But if we can truly be in the moment, I can be like, oh my gosh, my sweater is so soft. Oh my gosh, my water is so cold and I love cold water. Oh, this pen is smooth and it writes so well, I get to talk with you, my beautiful friend, and just appreciate that moment. I'm not thinking about what happened this morning. I'm not thinking about what's gonna happen this evening. I'm like right here in that moment. And so the more we can help, the more you know, the more we can help our people draw into the present moment, whether it's running or yoga, or just truly savoring a cup of hot tea that does help with those like thoughts that just won't quit, right? Because we're really in the present moment. So that's one thing. I think that. Finding a safe person to talk to. Many people have not even told anybody other than their partners that they're going through this, and I think that, we are not meant to have our entire emotional burdens be on our partners. Like we need bigger communities. And so whether it's maybe a college friend you haven't talked to in a long time, just pick up the phone, let them know what's going on. If it feels like a safe space, Seek out opportunities to start gently sharing your story if it feels safe to do that. Because I think we don't even realize how much we're shouldering the burden alone, but when we can start to normalize that many people go through this and there are, there's just even like friendship this is what I need, Can you please, not invite me to your baby shower or whatever it is. I think just looking for options, opportunities for connection, for human connection is something that is. And then I'll say my podcast has a ton of episodes on like the science, like how to grade an embryo or like the things that people start going down Google Rabbit holes about. I really try to address that in my podcast. And also how to navigate the emotional side of things like when you have a fertile friend or when you're approaching the holidays or things like that and so I would say if there's something that is particular in, on your mind, and as you're listening to this, just look at that as a resource and see if something might answer the question that you have.

Kerry: 26:09

Yeah, I think, like you said, validating that you're not alone and sharing things, I think can really help. We see that a lot with pregnancy loss too, used to be a thing that nobody else discussed. Right. And now I feel like many more people open up about it and are able to share their journeys.'cause most people have experienced, miscarriages. Not everybody, but I don't know, you probably know the data, but it's kinda similar to that. So that's super important. Like you said, you're not alone, right? Definitely community support. Focus on the moments and find your podcast. And where else can people find you to work with

Erica: 26:43

Yeah, so my website's the most comprehensive place. It's called Love and Science fertility.com. I'm on socials, we can put'em in the show notes. Love and Science, fertility, Instagram Facebook. I think it's, I think the really important thing is to make sure that the connection with your doctor is a good one. Like I know Dr. Baller, you pride yourself on your connections with your patients, and that's why people love you so much. Because you take so much care with each person. I think a lot of people don't feel seen in their situations. And I think that's one of the best ways to reduce that hypervigilance is to make sure that there's a good connection. So I do have a podcast on balancing trust and advocacy that a lot of people really resonate with because it's like, how do you know if this is a good relationship for you? I'd say most fertility specialists in the country are, amazing, but it's not always the right fit. And so I think sussing that out and really advocating for somebody who, where it is a good match I think that's really important in this work.

Kerry: 27:37

Yeah, definitely. Definitely. You have to be wanting to work with your provider, doctor, whatever it is.

Erica: 27:43

exactly. Yeah. Yeah.

Kerry: 27:45

Is there anything else you'd like to share with the listeners today?

Erica: 27:48

No, I just, I'm really grateful to be here. I'm grateful that you exist and check out the resources. It's, there's so much bad information out there. There's so many bad blogs that where people just get into tailspins, and so stick to evidence-based sources. Stick to what you can trust and try not to compare. That's what I'll leave you with.

Kerry: 28:07

Absolutely. Very good advice. Everybody find her on Love and Science fertility website and podcast and thank you so much Dr. Bove for coming on. Go Irish, of

Erica: 28:17

Go Irish. That's right.

Kerry: 28:19

Okay, and get healthy Tampa Bay, everybody have a good rest of your week.

Erica: 28:23

Thank you.