Noor: Super honored today to be talking to Dr. Roohi Jeelani, one of the world renowned fertility physicians, and, you may be, you may have seen her on Instagram as well, so super excited to have you on the podcast today. How's it going?

Dr. Jeelani: Good, how are you? I'm so honored to be here and very excited.

Noor: Yeah. So great to to have you.

So I think that you have a really exceptional story. So do you wanna just talk people through, um, you know, your journey of, you know, how you even decided to become a fertility doctor? Because I don't think most people know as young and uh, or as determined and as you were.

Dr. Jeelani: Yeah, it is a very interesting story.

So I actually didn't know there was such a thing as a fertility doctor. Um, I always knew I wanted to be a doctor, but I think that was the, just being brown, the South Asian part of me, right? You grow up and you're either a lawyer, doctor, an engineer. I don't think you have a choice outside of that. I picked doctor, um, and when we moved to Chicago.

My parents got divorced and I was not getting my period and I was 14. So from 12 to 14 I remember my mom talking to me about it and she would ask me every month, every month. And finally she's like, you know what, I'm gonna take you to a doctor 'cause I think something's wrong. And she kept, she went to a pediatrician and then they told her it was because I was anorexic.

So I remember. Every day she would take me to Burger King. I would get like this large Dr. Pepper, a Snickers bar, a croissant egg sandwich on my way to school. And I remember like at the three month follow up, she goes. This is not working. She's not getting her period. Still, I think something's wrong. And I literally remember going from like doctor to doctor and no one had an answer.

Mm-hmm. And my uncle, which once again, south Asians don't talk about anything. Finally was like, you know, my wife had infertility and we sought fertility care. Um, so you should take her to a fertility doctor. 'cause they also do hormones. And I remember my mom took me to who I love, and she's still alive, not practicing, but is amazing, Dr.

Rena Jabon. And I was sitting in her waiting room in this super high strung, very emotional waiting room, and I remember there was like crying. There was tears of joy. I mean. I cannot describe that emotion in that waiting room at that time. Um, so she finally, they like called my name, they took me back and then she just started asking me questions.

And I remember at that point she goes, oh, you have, it's very common. You have PCOS. It's very common and South Asians. And I was like, I don't know what that is. And I literally said, I don't know what that is. And she goes, oh, that just means when you're trying to have a baby, you are gonna pop a pill. To have a baby.

And I was like, okay. I was like, what do you do? And I remember that was my next question, like what do you do? And then her follow up answer was, I make babies. And my world was rocked because not only am I South Asian, but I'm from like a conservative Muslim family, right? Like, you're like, God made babies.

What do you mean you can make a baby in a laugh? And so I was, I had her, she sat me down and she was like, this is how it happens. This is what you do. It's not, it was a one year fellowship at that time. And I was like, I don't care what happens, but I wanna be you. And every year at my follow up I'd be like, please don't retire.

Please don't retire. I wanna be you. How do I be you? And every year she would sit down and be like, it's a two year fellowship. It's gonna be a three year fellowship. Um, and I still remember when I went off to college, she was like. I'm not gonna be here practicing when you come back. Uh, I'm gonna retire by the time you're done with school.

It's a 15 year journey, honey.

Noor: Yeah. That's such an amazing story. And you know, what a gift because, um, you know, if you hadn't met her, then you wouldn't have been able to help all these people on their journey who really needed, you know, not just a, you know, super smart doctor, but also someone who's approachable, who's kind of walked the walk and been through the journey too.

So. I think that for a lot of people, they, they don't really understand this stigma that there is associated with, um, you know, fertility or sexual health or just disease in general in the South Asian community. So could you kind of break that down, like, you know what Yeah. What it is, where you think the stigma comes from and how you navigated it.

Dr. Jeelani: Yeah. So there is a big stigma that we don't, as South Asians, we hide everything. Mm-hmm. And I, I think that it's perceived as a sign of weakness that if you have something that you must be weak. That's what I think. So every, especially health history is just hidden.

Noor: Mm-hmm.

Dr. Jeelani: You suffer silently. You're struggling because you don't know the right or wrong answer, but you also don't feel comfortable enough to ask.

Right. Like, you don't know. Who to ask how to navigate this, what's right, what's wrong? And I think it is actually, um, it's, I it's really sad.

Noor: Yeah. It really isolates people and I think, um, I. Yeah. I, I, that's why I'm super curious because now I think the, the platform that you've built is sort of the exact opposite.

So creating community. Yeah. And, uh, normalizing and de-stigmatizing it. But, um, I think it's even more impressive because, you know, you came from a background where it was okay, don't talk about it. Be quiet. Um, so yeah, I'm, so, I'm so curious how you're able to, to buck the, um, the cultural dorm there.

Dr. Jeelani: Yeah. So when after I had my son, I remember at Delivery, it was crazy because my husband and I were so overprotective over him.

Mm-hmm. And it was literally, I had like a, you know, a postpartum meltdown and my mom's like, I just don't understand why you guys won't and let anyone touch him. And we're like, because we worked so hard. He was like, my ninth transfer. Right. And I remember it was like, I did not think it was gonna work and it was around my birthday.

'cause we transferred in March. Then in April when we found out we were pregnant, I was like, oh, it's gonna just end a miscarriage. And it like kept trending up. So we were so guarded and so just aggressive when it came to like how to manage him, how to hold him one. It created a lot of conflict between us, but also a lot of conflict.

South Asian don't, like, there's no boundaries, right? Like

Noor: mm-hmm.

Dr. Jeelani: Everything's like, we're always over. We're gonna do everything. We're gonna meddle in your business. And when I had the breakdown, I told my mom like, oh, you know, I went through a lot of infertility and like a lot of miscarriages Oh. No, I didn't.

I mean, like she knew I was doing something because she would see the shots when I would come home. Yeah. But I, I just wouldn't talk about it because you don't talk about, you just don't talk about this. And I think it started, honestly, like I remember in fourth grade or fifth grade when they start talking about your period and they take you to health class.

Yeah. And I remember my mom like, yelled at my teacher and said. She's too little to talk about this. I want her out of this class. And I like, was like, what is this class and why does my mom not want me there? And like from that point on until she figured out how to get my, even actually. Dr. J he had told my mom that I need to be on birth control.

Mm-hmm. And I remember like, going back to it, my mom was like, no, she can't. She's not gonna be on birth control. We don't do that. We're we're Muslim. Like we don't get on birth control until you're married. Mm-hmm. And then I had this episode where I was bleeding in med school and I needed surgery and no one was around.

Yeah. And Dr. Jman was like, I told you, like, she needs birth control because it's gonna become a cancer, it's gonna be really bad. Yeah. So it's just like little things like this where I, I do think that stigma comes from being ashamed that something's wrong with you and not being openly talking about it.

And these are just like some instances where I've had to deal with it and I've also been victim of it, and I've kind of fed into that because I suffered and it took a big toll on me. Yeah. Because I just didn't.

Noor: That's horrific. I mean, I mean, you're, you're, you are denied medical care by your mom, the person who's supposed to love and protect you most because she was more afraid of the stigma than of the damage that was gonna be caused by to you.

Her daughter, who she loves it, obviously wouldn't want to inflict that pain of fraud. So,

Dr. Jeelani: yeah. Yeah. It's, it's crazy and Right, and it's so crazy to me because. Like she at least proactively took me to the doctor. I see so many people where it's the first time they're like, especially South Asians, like, well, yeah, I just never get my period, but now we wanna have a baby.

So like, how do I do this? So, so this is crazy.

Noor: So you became a physician and then not only a physician, but a physician scientist got your PhD as well. Um, so what did, um, what were kind of those, those first couple of, you know, years, like, you know, going from, you know, being a patient all the way to, um, becoming a provider and, um, doing research and stuff yourself as well?

Yeah.

Dr. Jeelani: So I actually never finished my PhD because I couldn't handle the politics. So kudos to you for doing that. Um, I was on my way out. I couldn't do, they wanted more time and no one was willing to graduate me or listen to my thesis. So I was like, you know what? We're gonna cut the cord. This is not my future and I'm leaving him.

Um, although it's very interesting and it actually, there's only one thing, like, I want good patient care. I wanna provide. Excellent patient care and I wanna solve the problems as to why not everyone gets pregnant and what's going on. Is it the embryo? Is it the uterus? And that's actually why I wanted to be a PhD, to be able to do transitional research to optimize our outcomes.

Um, when it no longer served that purpose, I knew it was time for me to leave and then become more of a clinician instead of a bench scientist, which I love. Nothing wrong with that, but I wanted to actually do something within, I was. I was, I was being limited. Yeah. But that's what caused the shift. Um, but it has been a journey because being, knowing you wanna do this and knowing I wanted to do this to help others, or, you know, help create life, I never in a million years thought I would have to do IVF, right?

Because in my head it was ingrained. You're in a pop a pill and you're gonna get pregnant that this, this isn't gonna be me, it's everyone else but me. So when I actually had to do IVF or why it took me from 27 to 32 to have rayon. Mm-hmm. A lot of it was because I was in denial. I just didn't think I needed IVF and that maybe something was wrong and maybe we're missing something.

And I remember literally. Going from doctor to doctor, seeking opinion after opinion, not because anyone was wrong, but mostly because I just wanted to know what else, like what was I doing that was wrong and what was it that I wasn't understanding? And I think it was just, I mean, I love my, I love Dr.

JavaOne and I love, and I'm grateful that she said you'll need help. But I almost wish she didn't say, you're gonna pop a pill and you're gonna get pregnant, because that was stuck in my head. And when someone else differed from that. I couldn't, I couldn't have it. I couldn't take it.

Noor: Yeah. So could you explain, um, how birth control works?

Because I think that people, uh, think it's sort of a magic field. There's a lot of misconceptions around it. So, you know, as reproductive technologist, this is your expertise. So could you explain what it is and then. Um, yeah, maybe why there's so much, uh, stigma around it. I think that we all saw, uh, unfortunately Elon's tweet saying that, you know, birth all makes you fat and you know, all these, uh, the different types of things.

So, um, yeah. Would, would love to hear your, uh, your, your response to, to all of that.

Dr. Jeelani: Yeah. I think it's a shame that there's so much stigma on it. 'cause it can help.

Noor: Mm-hmm.

Dr. Jeelani: It is a medication, so I'm gonna focus on just the pill 'cause there's. Various different forms of birth control, which also we do a bad job in counseling about.

Or just the pill. So in particular in A-P-C-O-S patient, one of the problems is you have a lot of unposed estrogen, because you don't ovulate. So you have a lot of X, which make estrogen, which then go to your lining and cause a lining to get thick. So in A-P-C-O-S patient, you don't want that 'cause that lining can eventually outgrow and then turn into something bad like a hyperplasia or a pre-cancer.

Mm-hmm. And that's why as A-P-C-O-S patient, you're at high risk of uterine or endometrial cancer. So in order to avoid that, or in order to not have unopposed estrogen, you go on birth control. To then shut down your own estrogen and protect that lining and then not that lining. So you can, there's different forms of pills.

There's a progesterone only pill, there's an estrogen progesterone pill. Um, so there's different forms of birth control and just like any other medication or hormones or side effects, but. Pregnancy has side effects too. So if you're not on birth control, a lot of the side effects he mentioned like weight gain.

Mm-hmm. Pregnancy causes, weight gain, clotting factors, same thing happens when you're pregnant. You're at high risk for them. Anytime you change your hormonal state, you're at risk of any of those factors and variables. So it's not, it's not a bad thing. It's like, you know, taking something out of context and just.

Highlighting it and a scare tactic.

Noor: Yeah. So could you explain some of the side effects? Because I think for a lot of people, they just think it's wizardry, right? They're like, why would I'm on birth controls? Does my skin clear up? Or why do I get more acne? Or why did my, why does my, you know, breast size change?

Or why am I attracted to different people? Like, it's all just seen as sort of wizardry. So could you kind of demystify some of that? Like why does Yeah. Birth control cause uh, the pills specifically cause these changes, uh, in some women.

Dr. Jeelani: Yeah. So it depends on your, so say I'm PCOS

Noor: mm-hmm.

Dr. Jeelani: That means I have a high level of testosterone.

Mm-hmm. So what birth control does is it suppresses my testosterone levels. So my skin clears up because high testosterone cause causes oily skin, which then causes clogged force. And acne. Mm-hmm. PCLS also causes hair growth and that's testosterone driven. So birth control also then shuts down that testosterone component so you don't get new hair growth also.

Right. There's a lot of misconceptions. Like, I did birth control, it didn't work because my hair didn't go away. Can't, it's not gonna disappear, it's just gonna prevent new hair growth.

Noor: Mm-hmm.

Dr. Jeelani: Um. Birth control is hormones, right. They're, it's estrogen and progesterone most of the time. Mm-hmm. So it does cause water retention, so you don't necessarily gain weight, it's water weight.

So you see a fluctuation plus or minus, no more than five pounds. Mm-hmm. But it's very comparable to like the weight gain you would have around ovulation, around your period. You see, I always say like. I can tell I'm fluffy 'cause I'm about to get my period. Mm-hmm. That's very similar to what birth control does.

Noor: Mm-hmm. So for, for women who don't have PCOS who are using the pill, uh, you know, as a form of, um, contraception, like why, why does, uh, what is the relationship between, uh, hormones and breast tenderness or breast size or. Um, personality or, you know, I think the thing that people, I think are probably think is most interesting is who they're attracted to.

Like the men that they're attracted to changes based on whether birth.

Dr. Jeelani: So when you are not on birth control mm-hmm. Your body goes through waves when you are ovulating, like you have a surge in estrogen. Mm-hmm. And you become atra. It's not necessarily you're attracted to different people, but you're looking to mate, because that's what we're meant to do as humans.

So you're attracted mm-hmm. And you're sexual tension or. That levels goes up until ovulation. So it's not necessarily that you're attracted to different people, it's just the how your hormones fluctuate and vary.

Noor: Mm-hmm.

Dr. Jeelani: So same thing with the breasts. Sorry.

Noor: Yeah, yeah, yeah. So how do your, uh, hormones fluctuate and vary throughout your, your natural cycle, and then how does that shift with birth control?

Dr. Jeelani: Yeah. So naturally what happens is once you get your period,

Noor: mm-hmm.

Dr. Jeelani: That's, I always call it my baseball analogy. You're at home base.

Noor: Mm-hmm.

Dr. Jeelani: And then you're gearing up to hit a home run. 'cause your body's trying to get you pregnant. So your estrogen level spikes as your eggs grow. Mm-hmm. After a certain level, when your estrogen gets high, it signals to the brain that, hey, there's a mature follicle here.

Release. So then you get a spike in lh. That's when you get like the mucus and then that's when you feel like that sexual tension, you feel really attractive, um, because your body's getting ready to release the egg. And then that,

Noor: is that when you can get the most work done or what? When is, how does this like affect your

Dr. Jeelani: creativity

Noor: and

Dr. Jeelani: all these other I think estrogen's good.

I think estrogen always, yeah. Yeah, because your body's like. You know, it's like very productive. It's working, it's super efficient. And then as soon as you get that spike in estrogen

Noor: mm-hmm.

Dr. Jeelani: Your egg releases and then 24 to 48 hours later you ovulate. Mm-hmm. And then it's becomes, and it's resting phase.

That's when the progesterone comes in. And that's when you're lazy and you're tired and not lazy, but you're sleeping early. 'cause now you're nesting or trying to give all your. Energy to this egg who then becomes an embryo to then implant. Mm-hmm. So you're sleeping a little bit more, your progesterone's high.

So your breasts are more sensitive and big because you're getting ready to get pregnant.

Noor: Mm-hmm. And

Dr. Jeelani: then if you're not pregnant, everything drops. And then that's when you become really moody and irritable because you have low estrogen, low progesterone, and you come back to home base.

Noor: Got it. And then when you're on birth control, uh, what happens?

Dr. Jeelani: When you're on birth control, you don't have any of those fluctuations. So it's just one standard. Mm-hmm. So you can see some people say that I don't feel myself on birth control because everything's kind of shut down. So if you're really in tune with your body mm-hmm. And you can feel those changes, um, then when you start birth control, it becomes like one level.

Noor: Mm-hmm.

Dr. Jeelani: And then. They don't feel as comfortable.

Noor: Yeah. Yeah. I think that the other thing that I've been hearing a lot about, um, again related to stigma is, um, breastfeeding, right? So there's been this obsession with breast is best and this, uh, pressure on women where you have to breastfeed. If you don't breastfeed, your child's outcomes are gonna be.

Um, worse than if you do breastfeed. And then now, um, you know, there's been a ton of randomized controlled trials looking at this and they see that that association that they used to say, um, was between, um, breastfeeding and outcomes is, is now, uh, has been disproven that actually, you know, formula fed and breastfed, um, you know, are basically fed as best is sort of that, sort of the guidance there.

So, um, what is, what is your thinking? I mean, I think that, um, a lot of this stuff, there's a lot of pressure. I think. To, um, to conform to a specific standard? Like what, what do you, what is your opinion on, um, breastfeeding and, you know, how to, you know, maximize, uh, both the bond and the health of mom and baby?

Dr. Jeelani: Yeah, I think it's do what's best for you. We put so much pressure on a female, right? Like get pregnant by a certain age. Have this number of babies recover by this time. Go back to work here. I don't think that pressure is necessary, especially like always go back to the literature. Like no matter what you do, just go back to the literature.

And if the literature showing that just fed is best, no matter what, whether it's breastfed or bottle fed or formula fed, um, do what's best for you and your family. 'cause at the end of the day, your mental health matters the most.

Noor: Yeah. So the other thing I think that there's a lot of, um, stigma and silence around is miscarriages.

Can you talk about Yes. You know, what that is and, um, you know, how, how it happens and, and you know, what, what, uh, you advise your, your patients to do to, to deal with it.

Dr. Jeelani: Yeah, I think miscarriages are really tough. Um, I've unfortunately suffered from them as well. I think we're always looking for the answer, why we miscarry and when we miscarry every week that you make it further, the risk of miscarriage goes down.

But unfortunately, I. We know the common things that cause a miscarriage, uh, but we don't know, like when you have a tested embryo and a beautiful uterine lining with no other uterine components and there's no clotting factors that we need to worry about, there's no chromosomal abnormalities in the parents like a translocation.

You can still miscarry that embryo. And I think that's what becomes hard, that when you go through all of this. Testing and treatment and you get pregnant after IVF and then you miscarry. It becomes disheartening. So I always tell my patients like, it's not your fault. Um, perfect embryo doesn't mean it functions perfectly, right?

Because it can be chromosomally normal, but doesn't mean it implanted, right. It divided, right? It still has a lot of work and job to do, um, and that risk of miscarriage is not zero. Even with the. Beautiful embryo. Um, but outside of fertility, for my patients who see me, I always get that like, oh, I'm not here to see a fertility doctor.

I can get pregnant, but I can't stay pregnant. I think that's also a real common, um, theme. But I always say, you know, it's fertility. It's not just getting pregnant, but it's getting pregnant. Staying pregnant and delivering. Mm-hmm. So if you can get pregnant, can't stay pregnant, it goes back to egg health.

And I do think that. Yes. The number one cause is chromosomes, but there's a lot of things we don't quite understand.

Noor: Yeah. So I think, um, just going back to the stats, what are the miscarriage rates?

Dr. Jeelani: Yeah, so these are all before week eight. Once you pass week eight, the risk goes down significantly. Mm-hmm.

Um, if you're in your, so. And your age extremes is when the risk of miscarriage is higher, actually. So if you're younger than 21, the risk of miscarriage is much higher. Mm-hmm. And then 21 to about 30 28 is anywhere from about 15 to 20%. And then in our early thirties, it goes to about 20 to 25% risk of miscarriage.

And then after age 37, it's actually not 35, but 37 mm-hmm. Is when it goes up dramatically. It can be high as anywhere from. 30 to 40%, and then after 42, take home baby rate, actually for spontaneous conception drops down to less than 10%.

Noor: Wow. Okay. So this is a com, the causes of miscarriages, it's a combination of genetic factors, immune factors, uterine factors.

Could you, could you break down some of the causes that, that we Yeah, we know about.

Dr. Jeelani: Yeah. So form the number one cause is chromosomes, meaning wrong egg, wrong sperm. Mm-hmm. Number two, cause that we look at is uterine. So septum, um, any uterine abnormality. So that's where you house the embryo. It should be a nice empty space without any.

Factors in it.

Noor: Mm-hmm.

Dr. Jeelani: Number three variable that we look at is autoimmune or clotting factors. So we look at your clotting factors and we look at autoimmune components. And number one culprit is a lupus anticoagulant. Mm-hmm. Um, and beta to glycoprotein. So anything that can cause thrombosis or microthrombi and prevent the pregnancy from growing or the baby from growing.

And then there's less than 5% fall in what's called the balance translocation. Mm-hmm. Meaning when the parents were formed, they formed perfectly, but a little piece of it them chipped. So now when they're going to recreate and reorganize to make a new baby, this chip is getting exposed and causing an abnormality to where you miscarry.

Noor: Got it. So for those uterine factors, is the evaluation, uh, like when you go in for that ultrasound or how, how are those uterine factors determined if there, if there is there.

Dr. Jeelani: Yeah. So you start, um, between cycle day six and 12 before you ovulate. Mm-hmm. We put water in your uterus and we inflate it and we make sure.

That it's nice and empty. So I always use a balloon analogy. I'm like, typically your uterus size is like a balloon. It's flat. Mm-hmm. And then we need to put water inside to make sure that there's nothing in there where the baby's gonna grow. 'cause if there is, then that's taking the blood away from the baby.

Noor: Yeah. So could you talk a little bit about sort of the, um, emotional factors here? Because I think that that's also really under addressed. I mean, how do you, um. How do you recommend people cope with it?

Dr. Jeelani: Yeah. For me, I'm a control freak, so I will say next steps are super important. Like I hated waiting the waiting game and you have to wait.

So I always tell my patients like the worst part's gonna be when you miscarry, that I can't let you start until your body resets. And that resetting can be anywhere from. For four weeks to six weeks to a couple months, depending on how far along you were. Mm-hmm. And for me, that was the hardest 'cause I'm like, I'm a planner and I like control and I wanna know when and how and what I'm gonna do next.

Mm-hmm. Um, so that was the hardest. I think also finding support and actually grieving the loss is very important. Mm-hmm. Um, which. Because I'm a control freak. I always failed to do until I reflected back on the what ifs. Um, so I think that's really important, acknowledging that, hey, this is a actual loss and I need time to heal and I need time to, you know, like do what's best for you.

Mm-hmm. Um, but that is very important to acknowledge that.

Noor: Yeah. And then I think, um, just I guess moving forward, you know, once people, you know, do have that successful pregnancy, moving to the delivery, I think, um, I dunno, there's also just some kind of alarming stats there, right? I think it's something like, um, 90% of women experience vaginal tearing of some sort, whether that's.

First degree, second degree, third degree or fourth degree. Um, do you have any, um, exercises or is there any way to minimize the degree of tearing or is it just fully genetic or, or what, what's, what's going on there? How do you get your delivery? Um, or as, as, as seamless as possible.

Dr. Jeelani: Having a really patient doctor, it's really, most people tear when you're like not letting the body.

I mean, there's obviously, there's situations where you need that baby out or the heart rate, but otherwise, truly our body's meant to stretch the vagina's. Truly like magical because how it bounces back and how a female heals that quickly. Mm-hmm. To me it's just insanity. Mm-hmm. Uh, but if you let your body kind of brace itself and go through the process, most people won't tear.

Noor: Mm-hmm.

Dr. Jeelani: Also good genes. A lot of it's genetic.

Noor: Yeah. So, I guess speaking of genetics, I mean we are, we're super honored to have you on our, um, medical advisory board and um, yeah, also really proud to just offer this. Um, you know, next advance to, um, you know, to all patients who are going through IVF of whole genome sequencing.

So being able to look at not just chromosomes, but micro duplications, micro uh, deletions, um, all of these monogenic causes of both. Birth defects and heart defects and pediatric cancers and adult onset cancers and neurodevelopmental disorders. So all these things that previously we weren't able to find out until baby was born.

Um, so yeah. What, what are, what are some of the things that excite you the most about whole genome sequencing for embryos?

Dr. Jeelani: I, I love the fact that, you know, right, like truly I'm a control freak, and the more information I know, the more prepared I can be. And I, I mean, I talk about your test all the time, believe it or not.

Like the more you practice, you realize like how much we don't know. I have a couple who kept miscarrying it, but not at the normal time. They would get discharged and they would miscarry like 17 weeks, 18 weeks, and they found out that when they did whole genome sequencing, that they're actually from the same village back in India and they have an overlap on their genes and that.

No matter what, they're gonna miscarry at that time because this baby will be abnormal. And we were like baffled because she's like, it's PGT normal. I don't know what's happening. And it took all of these geneticists extra testing to be like, oh, this is the problem. Like you need donor X.

Noor: Mm-hmm. But

Dr. Jeelani: like.

I feel like genetics is Pandora's box, but I love solving the puzzle and I love that you're chipping away at it. I think it's so fascinating.

Noor: Yeah. Who are the types of, uh, patients that you think, uh, could benefit most from whole genome sequencing for their embryos? I.

Dr. Jeelani: I think everyone, because you don't know until, you know, like I am in Chicago, so a lot of my patient demographic is older, and so they're well educated.

Like I have patients who've done egg freezing in the middle and they're like, oh crap, like now I'm BRCA positive, what do I do? I've had that happen to me multiple times. In fact, that hap has happened too. Me where we have a strong, my mom's one of five strong family history of breast and ovarian cancer.

Everyone kept saying, no, there's no link. There's no gene, there's no link. We are testing you Until we got better and better. And just last year, they're like, oh yeah, you guys carry the ATM gene. Hmm. Um, but like I would've loved to have tested my embryos of two little girls. You know, it's just, I wish stuff like this would progress a little bit faster.

Mm-hmm. But I think everyone can benefit from it.

Noor: Yeah. Do you think that, um, I guess how do you, do you think people, um, deal with or, uh, accept, uh, like information overload? Do you think that there's certain people where there's, it's too much information or, um, I don't know. What are your, what are your thoughts there?

Dr. Jeelani: So I did a paper with RGIA long, long, long time ago when, um, HLA matching first came out and PG T four, pg d at that time. Mm-hmm. And we did it on non-disclosure, like how many people actually didn't wanna know, but wanted to assure that they had a healthy child. And believe it or not, not a lot of people opted to not know.

Most people wanted to know so they can prepare for it. And they thought knowing would mentally, whether they're positive or negative, really ease. The burden on their counterpart, their significant other, and their life. So they were well prepared going into this is what I'm gonna expect. Um, so I think truly, yes, it's overwhelming.

A hundred percent. I think it's overwhelming. Mm-hmm. But I think whole genome sequencing, like imagine like I have patients. Miscarried because PGT missed like a duplication and now they don't believe in PGT and now they're on these forums like, I don't believe in PGT 'cause it missed it. And really what I wanna say is what didn't really miss it, but, you know, one of the limitations, um, like, so I think everyone, I.

Could benefit from it. I do think it's how we counsel and how we educate our patients. So that's important.

Noor: One of your story is that you had this dream of being a, um, in beauty pageants and there was a stigma around that yet, yet again too. Um, so yeah, can you talk a little bit about that?

Dr. Jeelani: Yeah, I was always into modeling and fashion and my mom is, um, brilliant, but also very pretty and got married at 1516, so I was always, I had a young mom who was very fashion forward and progressive.

Mm-hmm. Um, for South Asian culture. Mm-hmm. So I always grew up around that and grew up around, like, watching movies and wanting to be a certain way. Mm-hmm. So I think. If I wasn't, not that I was ever forced to be a doctor, but it was ingrained in my head, you're gonna be a doctor. Mm-hmm. I always on the side wanted to be a model.

I'm like, I love modeling and I love did fashion and I love makeup. It was actually an accident. Uh, I was walking on campus at University of Illinois. Yeah. And someone stopped me and said, Hey, have you ever tried pageants? And I was like, no, I've never thought of it. You know, I always wanted to model, but I never actually thought of it.

Noor: Yeah.

Dr. Jeelani: I entered for fun. I won. And one of the things surprises. I love it. Yeah. It was a modeling contract. Yeah. And then it just took off. I think you could do, live out all your passions. I have a lot of dreams. I wanna be a lot of things. Yeah.

Noor: No, I love that message because I do think that people, uh, really put themselves in boxes more than they need to be.

I mean, I feel like you're just an, an awesome example of Yeah, you can be a. Uh, you know, high powered physicians. See lots of patients also do, uh, modeling and fashion, and I think that people need to hear that message more because I think that they feel like they have to fit into this box 'cause that's what they've seen before.

Um, so yeah, I guess how did you have that strength of spirit and that, um, you know, determination to, yeah. To, to, to be able to be independent and, and brave enough to, to do it all at once.

Dr. Jeelani: Yeah, I think it's, I'm very goal oriented. Mm-hmm. And up until very recently, it's so crazy. No, I never let anyone define me because I always knew I needed to get to a goal and I was so foc laser focused on that.

Everything else was noise around me. Like, so when I started modeling and I got into fashion and started traveling when people would be like, but you're not gonna be a doctor. That to me, I was like, what do you mean? Like, to me, this is like going to a party. I'm laser focused on that. That is what I'm gonna be like that, that is not a negotiable.

Mm-hmm. Um, so I. To me, I just couldn't comprehend it, I guess, and whether it was ignorance or whether it was determination, I don't know. But to me it wasn't mutually, like I knew that being a model doesn't mean I'm not gonna be a doctor.

Noor: I think for a lot of people, not just women, but women and men, I think that I.

If people continually show up and say, oh, I don't see you as as this, or I don't see you as that. I think that, um, yeah, it, it destroys their confidence, but yeah. For, for you, it didn't for you. Yeah. You, you're like, well, I don't care what you think. So I mean, that, that's, yeah. That's an amazing quality. You think that that's just something that you kind of had from a young age or to get something that people can, can cultivate.

Dr. Jeelani: I think it's something people can cultivate. 'cause I, I definitely don't think, um, as I'm getting older, I'm starting to lose it because I do think it's a little bit of, um, ignorance, truly because I couldn't, I truly couldn't comprehend that there was a good, big disconnect. Mm-hmm. And then. Two. I think it's because I saw my mom go through it.

My mom's like a young South Asian female who chose to like leave her husband because he was abusive. And her whole family was like, you're not gonna do that. That's not gonna happen. You've never gone to school, you've never had a job. And for her, she was like, well, I'll get one. Like, well, what are you gonna do?

She goes, I'll figure it out. And you know, they made it very difficult for her. It. You know, like normally it'd be like, come in. Like I remember one of her brothers really helped her. He like took us in and guided her, but for her, I saw her do it. So I guess seeing that made me feel like, oh, well you can do whatever you want.

Look at her. She like went from this housewife with zero education to working in pharma. Mm-hmm. So I could be her. Um, so I think I had a really good role model and an example of somebody who didn't let. Outsiders kind of dictate her future. Um, so I think that helped, probably that's what shaped me and ignorance not understanding truly what people

Noor: were telling me.

That's really funny. So do you have any, um, sort of, um, just advice for people who are kind of on that infertility journey and who are basically feeling a lot of stigma? Like what are some of the next steps that you think they can, um, they can take to get some more information and um, hopefully help to start building their family?

Dr. Jeelani: Yeah, I think asking questions. I think one of the things I didn't do was I didn't ask questions. And you, it sounds really silly saying it out loud because you're probably thinking like, well, you're a doctor. What do you mean ask questions? Yeah. But everything's so intricate, um, that you wanna know, right?

You wanna understand, you wanna understand why certain things are happening and why they're happening. And I think a lot of the time. Being a doctor and a patient, I shied away from it because I'm like, well, I should know this. So if I ask, I'm gonna embarrass myself and I don't wanna embarrass myself, so I'm not gonna ask it.

Mm-hmm. And then it actually created like a lot of conflicts. My husband would ask me why we're doing what we're doing, and then I wouldn't know. And I'd say the doctor said so, and he's very interrogative. He's like, well, why did he say that? Why did they, and he, it is because he is really self-reflective.

So he also likes to like figure out the why and. I, but, and it's truly because I was so scared that I was gonna make somebody mad if I asked. So I always tell my patients like, please ask me. Right? Like, otherwise, you're gonna go down a rabbit hole of Reddit and Google and Instagram and Facebook and everyone's journey's different.

And why maybe doing something on you is gonna be very different than why I do it. And someone else, and the same hormone can elicit a different response depending on when I use it in your cycle. So. I think it's hard not to compare, but don't compare.

Noor: Mm-hmm.

Dr. Jeelani: But to ask, like, and if you are in a situation where you don't feel comfortable asking, then that means you need to change the situation.

'cause I've been there too, where I almost felt guilty, like I was breaking up my, like with my doctor. But doesn't have to be like that. Like if you're with a good doctor. They understand. Like I always tell my patients like, just because we like each other doesn't mean like I have the magic. If you think someone else has what you need, like I want you to go there.

Noor: Yeah. And yeah. Now that you're a, a mom to both a son and a daughter, how are you thinking about having that conversation about reproductive health and periods and. Uh, eggs and ovaries and all that type of stuff, but I know it's, she's still quite young for that. But how, how are you thinking about that conversation?

Dr. Jeelani: The good thing is, well, my middle child eight is very inquisitive, um, because she's like my husband. Um, they've been so exposed to all of this, like they. They know about it. They know like what injections are. They know what embryos are, they know what eggs are. They know that not all transfers equate to baby.

They know what a uterus is, so they're really advanced. Okay,

Noor: so when your daughter or your son asked like, you know, where do babies come from? You started explaining like, like literally.

Dr. Jeelani: Well, you know what's so funny, my daughter, so my son's IVF and then my second, my second child, who's my daughter was.

Spontaneously conceived while I was breastfeeding, so I didn't know I was pregnant with her. And then my last daughter, Elia, the baby's IVF, so she, yeah. Um, was like, so was I in a lab too? Was I frozen? Like ran and Elia? And I was like, no, baby. Like. God gave me you. Mm-hmm. And I was like, that's why your pro, your name means proof of God's existence.

Mm-hmm. And she was like, I'm so sad. And she lit, literally cried, no, I wanted to be born in a lab and why can't I be in a lab like everyone else? And I was like, wait.

Noor: That's amazing. That's so cool. Well, yeah. Thanks so much for, for taking the time to chat with us about. Uh, so many pieces of reproductive health all the way to, uh, parenting advice.

So, uh, really appreciate having you and, um, I hope I, this is awesome that we're able to share all this, um, all of this information with, uh, our, our great listeners. Thanks so much.

Dr. Jeelani: Thank you for having me.

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