In this episode, I’m joined by two incredible guests: Dr. Steven Emery, a maternal fetal medicine specialist and director of the Center for Innovative Fetal Intervention at the University of Pittsburgh, and Dr. Joseph Sanfilippo, a renowned reproductive endocrinologist, past President of the American Society for Reproductive Medicine, and author of “Everyday Medical Miracles.” Together, we explore the latest advances in intrauterine surgery, fetal interventions, and fertility innovations that are changing lives for families everywhere.
In our conversation, we dive deep into the courage and hope that medical innovation brings to patients. Dr. Emery and Dr. Sanfilippo share real-life stories, discuss the evolution of fetal and reproductive care, and offer practical advice for anyone navigating fertility or high-risk pregnancies. We also touch on the future of medicine, from gene therapy to the impact of artificial intelligence in the embryology lab.
In this episode, we cover:
- A remarkable case of fetal anemia and the life-saving power of intrauterine transfusions
- What pre-implantation genetic testing (PGT) is: and what it can and can’t detect
- The latest interventions for fetal conditions, including twin-twin transfusion syndrome and fetal hydrocephalus
- How to prepare for pregnancy: lifestyle, medical, and genetic considerations
- The role of maternal fetal medicine specialists and when to seek their expertise
- New research and approaches to fibroid prevention and treatment
- The future of fertility and fetal medicine, including gene therapy and AI
Resources:
- Dr. Sanfilippo’s book website: Everyday Medical Miracles or order via Amazon
- Dr. Sanfilippo’s book Expert Guide to Fertility via Amazon
- Dr. Emery’s email: emerysp @ upmc.edu
- Dr. Sanfilippo’s email: sanfjs @ upmc.edu
- American College of Obstetricians and Gynecologists: acog.org
- American Society for Reproductive Medicine: asrm.org
Watch Past Episodes with Dr. Sanfilippo:
Full Transcript:
Dr. Aimee: Today, we’re diving into a fascinating and impactful area of medicine, interventions that help babies and parents before birth. The title of today’s show is Intrauterine Surgery and Other Interventions with Dr. Emery and Dr. Sanfilippo.
Our distinguished guests are Dr. Stephen Emery, a maternal fetal medicine specialist at the University of Pittsburgh and director of The Center for Innovative Fetal Intervention. He’s on the cutting edge of fetal therapy, including developing devices to treat conditions like hydrocephalus. Dr. Joseph Sanfilippo, a reproductive endocrinologist and former guest on The Egg Whisperer show, at UPMC, past president of The American Society for Reproductive Medicine, and author of an awesome book, Everyday Medical Miracles. You have to get it, trust me, it is so good, if you haven’t read it yet. Let’s get into a conversation where they’ll share their insights, stories of courage, and the exciting innovations transforming fetal and reproductive care.
Dr. Emery, you provided a patient story about a woman of uncommon courage whose fetus had severe anemia of unknown cause. Could you tell us about that case and how fetal intervention made a difference?
Dr. Stephen Emery: Sure. Fetal intervention saved that kid’s life. This was a woman who came in for her anatomy scan at 20 weeks, routine, and there was a mass in the chest. Routine tumor, easy to manage, outcomes are great, but we also noticed a little bit of fluid in the fetal abdomen and the chest, which was unusual. We checked for fetal anemia, which is an easy thing to do with ultrasound, looking at blood flow and a vessel in the brain. That indicated severe fetal anemia, so we did the workup. The workup was entirely negative and the doppler studies were consistently in the severe range, so we proceeded with sampling the baby’s blood in preparation for intrauterine transfusion, which is also a routine thing that we do.
This fetus was profoundly anemic. A normal hemoglobin for a fetus is 15, and this baby was at 3, really profoundly anemic. We transfused the baby, collected blood, and sent that for every kind of test we could imagine. We had the most experienced people at UPMC, hematologists, pediatric hematologists trying to find out what is wrong, and no one could find a problem. Every time we put blood in, in a week or so, that blood was gone and we had to do another transfusion. I think we did a total of eight to ten transfusions, just to keep this baby’s hemoglobin normal.
We never found out what it was during the pregnancy. Then at around 32 weeks, when we were going in for what we thought would probably be the last intrauterine transfusion, we felt that the baby would probably be better outside of the uterus than inside the uterus in these circumstances, we noticed something in the placenta that we had never seen before. It just took our breath away, it just looked very abnormal. We decided to withhold the transfusion and just proceed with delivery, which we did. The baby did fine and mom did fine. Then I got a call the next day from a pathologist who told me that there’s a mass in the placenta, and that mass is choriocarcinoma.
Dr. Aimee: Wow.
Dr. Stephen Emery: Cancer of the placenta, which you’d never think about in a million years. Now we have a problem. This is a serious cancer, so mom is at risk, and those cells could have passed over to the baby and the baby could be at risk, too. So, the plot thickened after delivery.
Fortunately, her workup was negative, she did not have cancer. The baby’s workup was negative, the baby didn’t have cancer. We eventually had the mass, the tumor in its chest taken care of, which is routine. The problems were solved.
Dr. Aimee: They’re routine for you. I have to tell you, when I hear mass in the chest, I feel it in my chest because my heart is jumping out of my body. I can only imagine how appreciative this patient was that you were her doctor and you were holding her hand through this. I think of patients elsewhere where they might not have been given the hope that you gave her. When a doctor like you says this is routine, there’s just so much comfort that comes with that. Do you think that if she was at another center that she would have received the same care, if it was another doctor?
Dr. Stephen Emery: There are a growing number of fetal centers in the United States. Magee has a lot of experience because we’re so big, we have such a large catch of an area and all the money is coming to Magee. But yes, there are other centers in major cities where she would have gotten similar care.
Dr. Aimee: That’s such an incredible story. I’m so glad to hear that mom and baby are okay. That’s a one out of a million kind of story, certainly.
Dr. Sanfilippo, let’s take a step back. For couples undergoing IVF, can you explain what preimplantation genetic testing involves and why it’s important? Before you do that, when you hear of a case of a baby, let’s say with a mass in their chest, some patients think that PGT and genetic testing of their embryos can actually detect things like that, but it can’t. I’d love to hear you explain more about what PGT is.
Dr. Joseph Sanfilippo: I like to say the advent of this PGT (preimplantation genetic testing) has really changed so many things in a very positive way. I think the best way to explain this is to step back and to say when we do PGT.
We do preimplantation genetic testing under a number of circumstances. We strongly advocate it if a woman is over 40. The reason for that, her chances of having a genetic problem, a baby with Down’s Syndrome and so on, are so much higher than for a 25-year-old. So, age becomes one.
Number two, let’s say there’s a family history. The family history, I don’t know, Huntington’s Chorea or sickle cell anemia, those things come to mind. We have the technology to look at the embryo before we transfer it to the uterus. You deal with this daily, as I do. It gives us the ability to identify an embryo that potentially will be normal, not have sickle cell anemia, etcetera.
How is it done? Audience, forgive me if you’re familiar with IVF. In a nutshell, basically, after all of the preliminary tests are done, which on average takes maybe two cycles, then we’re ready to roll. The way we do this is the patient will give herself self-administered injections. We don’t want one egg. I always say we want 10 or 12 eggs, whatever we can get. By taking these injections of the actual pituitary gland hormone, we’re stimulating the ovary to develop a number of eggs. We’ll monitor that over the course of 12 days, plus or minus.
What does that mean? Every several days, there’s a blood test, an ultrasound looking at the follicle development on the ovaries. We wind up the cycle, we give the final injection, and then they come to an IVF center 36 to 48 hours later. At that point, the patient is in what we call conscious sedation, I like to say twilight anesthesia. A vaginal probe ultrasound, which I’m sure your audience is quite familiar with, but this time it has a needle that’s attached to the probe. From the vagina, into the ovary, we take each egg out one by one. Again, the patient feels none of this.
If the plan is IVF, then immediately the embryologist fertilizes it with the male partner’s sperm or with the donor sperm. Then we keep our fingers crossed for fertilization and progression. Again, it’s a five-day window. At five days, we went from two cells to on average around 200 cells. The embryologists, I always say they’re the magicians, as far as I’m concerned. Us egg-suckers play a role, but the magic is in the lab.
What happens there is the embryologist takes maybe five cells, more or less, five to ten cells from these 200 cells. I want to emphasize that the location of this biopsy is where the placenta will develop, not the baby. It goes to the lab, and then it takes about three weeks to get the information. It comes back normal, or our term is euploid, or aneuploid for abnormal. Now we’re starting to even transfer aneuploid. Under certain circumstances, these are abnormal as embryos, but they turn out to be normal babies, so that becomes a possibility.
The other indications are, in the book that you alluded to, Everyday Medical Miracles, there’s a case of an individual, and the name is anonymous, of five miscarriages and then two babies that are normal. This preimplantation genetic testing in that case, one of them carried something in their genes. They were fine, but when they go to have a baby, it’s miscarriage, miscarriage, miscarriage. We can identify what we call structural rearrangement and, one more time, identify the non-affected embryo, and that goes in the uterus.
Like I said, there are other reasons to do the preimplantation genetic testing, but I think your audience needs to know that the technology has advanced so much and it has made such a positive outcome on, I think it’s now eight million IVF babies that are out there. It’s exciting. I’m sure you feel the vibration when I get to talking about, it gets me all fired up because it’s the ability to deliver this level of technology to our patients that years back we just really didn’t have.
Dr. Aimee: I definitely feel the vibration. I was going to say vibrating is one of my favorite words. I tell people to do something every day that makes them vibrate, to feel alive, because as fertility patients it’s like life is sucked out of you. I like that you used that word. I feel it, too.
Dr. Emery, tell us about other kinds of interventions that you can perform for problems affecting the fetus while in utero. What are some examples and why are they important?
Dr. Stephen Emery: Here’s a great one. This is my favorite. There’s a condition where there are monochorionic twins, so they’re identical twins, they share a single placenta, and then there are blood vessels that connect the two. Normally, there’s the same amount of blood that’s going from one twin to the other and there’s equilibrium and they get along fine. But about 10% of the time, there’s more blood flowing toward one twin than there is coming back, and that sets up the condition called Twin-to-Twin Transfusion Syndrome. If it’s a severe disease early, which it usually is, then the natural history is that you’ll lose both of them.
What we can do now is we can take a three millimeter scope, a scope the size of the inside of a ballpoint pen, and we can go inside the sac of one of the twins and find those blood vessels on the surface of the placenta, cauterize them with a laser fiber and effectively separate circulation so that now it’s as if the fetuses have their own placenta. The disease regresses, the sickness in each of the twins corrects, and they can go to near term.
The reason I love this is, in my opinion, this intervention has the best risk-benefit assessment in all of medicine. The outcome is intact twin survival. Think about that, intact twin survival, done under IV sedation and local anesthetic. It’s amazing.
Dr. Aimee: Wow. How long has that technology been available?
Dr. Stephen Emery: That technology really started becoming mainstream in the late 1990s, early 2000s.
Dr. Aimee: That’s incredible. Dr. Sanfilippo, the question I have for you is how should women prepare if they’re planning to get pregnant, are there guidelines or best practices they should follow before conception? I get this question all the time, and I’d love to hear what you tell your patients who ask you.
Dr. Joseph Sanfilippo: Absolutely. I put this in a category of preconception counseling, and it’s a very important concept. Let’s say a woman or a couple say, “I want to get pregnant in six months or one year,” and that’s what I hear. There are a lot of good ways to prepare, to make that as ideal as possible. Including your audience, you can go online to what’s called The American College of Obstetricians and Gynecologists or to The American Society for Reproductive Medicine, and they have a lot of information for individuals, but the key points are something like this…
Number one, lifestyle. Let’s clean things up. Smoking, alcohol, negative. Again, how much alcohol should you take when you’re pregnant? Zero. These kinds of things. Smoking can have an adverse effect on the fetal development, etcetera.
The next category is medical problems. Let’s say you have a thyroid condition, a thyroid problem. Let’s get that in tip-top shape. Diabetes comes to mind. If you’re a diabetic, you automatically know about hemoglobin A1C. Again, here, I defer to my maternal-fetal medicine colleagues, such as Dr. Emery, to say get that hemoglobin A1C to six or less. That’s what they tell me. Let’s take care of your medical problems. Vaccinations, are you up to date? You want to get that done before you get pregnant.
Then another good thing is called a carrier screening. It would be a good idea for you, the patient, if it’s not already offered to you to say, “Can I be tested to see if I carry the gene for cystic fibrosis,” because you would have no clue. If you’re a carrier, then your partner also has to be tested. If you’re a carrier and your partner is negative, the story ended. If you’re a carrier and he’s a carrier, you have a problem. That’s where your other question of preimplantation genetic testing can come in and identify that child that would develop cystic fibrosis.
The other thing is prenatal vitamins. I always say to a patient that I want you to get pregnant when you have good levels of folic acid. What are we talking about? Being on prenatal vitamins, folic acid, for several months before you even attempt a pregnancy. It’s clear that folic acid and spinal development are correlated. Again, Dr. Emery is a far better authority than I am when it comes to those kinds of things.
If you get all of your ducks in a row, you’re ahead of the curve. A couple of other things… Let’s say you’re attempting a pregnancy. It depends on how old you are. If you’re less than 35, theoretically, you can spend up to a year attempting pregnancy. If you’re 35 to 40, we shorten that to six months. If you’re 40 and you say, “I want to get pregnant,” you need to get to the doctor today. Not tomorrow, but today, because the sooner the better. Once you start trying to get pregnant, I always like to say if you see you can’t get pregnant, say something. Speak up. The sooner you get to your OBGYN or an infertility specialist, you’re ahead of the curve because there are so many things that we can do to make that pregnancy happen or make it as ideal as possible. We don’t promise you anything, you can’t do that in medicine, but we can set the stage for success.
Dr. Aimee: Right. Those are such great tips. Then some of our patients end up seeing a maternal-fetal medicine doctor. So many of my patients don’t even know what that subspeciality is. Dr. Emery, can you tell us what exactly a maternal-fetal medicine doctor does and when you are involved in a pregnancy?
Dr. Stephen Emery: Fortunately, most pregnancies are normal. But sometimes they’re complicated. They’re complicated because, for instance, mom has some kind of condition. She has Lupus, or she has diabetes, or she has a heart condition, in which case the chances of a complication during the pregnancy increases significantly. There’s a role for maternal-fetal medicine in managing those types of patients.
Then there are patients where there are fetal anomalies that require an extra level of expertise in managing the pregnancy, when to deliver, where to deliver, how to deliver, who to have on-hand. Then a fetus that’s complicated by either fetal or maternal infections, genetic syndromes, etcetera, anything that’s out of the ordinary that a general OBGYN would be comfortable doing, that’s where MFM comes in.
Dr. Aimee: So many IVF patients ask me, “Now that I did IVF, I guess I’m going to be high-risk now and I have to see an MFM doctor?” What do you think about that?
Dr. Stephen Emery: No. I don’t think that’s true. If you’re pregnant and you’re normal, stay with your OBGYN. You already have that relationship, and you don’t need to see an MFM. There are enough people that really need to see MFM that should be seen by that group of people. It’s a much smaller pool of providers, so you want to keep things equal.
Dr. Aimee: You’re developing an in-utero shunt device to treat fetal hydrocephalus. Can you explain what that is, how the shunt works, and what it could mean for affected families?
Dr. Stephen Emery: It’s a very interesting story. Back in the 1980s, the birth of fetal medicine, we had this new technology called ultrasound. For the first time, we could look inside the uterus and see what’s going on. One of the first targets for in-utero intervention was fetal hydrocephalus because it seemed like it was an obvious diagnosis, because the fluid shows up as black on ultrasound. You’d put the ultrasound probe down and you’d see black inside the fetal skull, then that baby has hydrocephalus. People started putting shunts in thinking that they could drain the excess fluid and get better outcomes. After a couple years of doing that, there was an international registry that looked at the results and found that shunting did not help and actually may have harmed, so there was a moratorium placed on shunting back in 1986. Since that time, there has been essentially no progress in this diagnosis. The way we manage them is we just watch on ultrasound, we get them to term, we deliver them, and then we manage the neurologic consequences.
Back in 2014, I had a patient whose fetus had hydrocephalus… Let me just back up and say what we’re talking about. Cerebral spinal fluid is made in the lateral ventricles, then it travels centrally to the third ventricle, and then out the brain through the aqueduct of Sylvius, then to the fourth ventricle, and then it circulates and bathes the brain and spinal cord. With aqueductal stenosis, that duct is obstructed, so cerebral spinal fluid continues to be made, but it has nowhere to go, so it just compresses the brain against the skull and it kills those brain cells. It fundamentally disrupts the way the brain develops, so they have really significant neurologic outcomes that are going to be lifelong. That’s why it was a target back in the ‘80s, because the outcomes were so bad.
So, I had this patient in 2014, and I thought this just can’t be right. I pull that original paper from the registry and read it, and there was the answer in black and white. Back in the 1980s, you couldn’t make the diagnosis of aqueductal stenosis, the ultrasound just wasn’t good. You compare how the world has changed, just think for a second how the world has changed since the Apple Macintosh was the coolest technology on the planet and Ronald Reagan was President of the United States. It’s a different world, especially in medicine. We have high-resolution ultrasound, we have MRI, they didn’t exist back then. We have next-generation genetic testing. We have all of these tools.
I proposed to the International Fetal Medicine and Surgery Society, which was the organization that put the moratorium on the shunt, I said it’s time for an evidence-based reassessment of this, and they said yes. So, I’ve been working on that since.
I developed a shunt with the help of a bioengineer. I told him the necessary performance characteristics. First and foremost, it has to be placed with ultrasound guidance, percutaneous with ultrasound guidance, so no incisions in the maternal abdomen, no incisions in the uterus, nothing like that because maternal wellbeing is paramount. We developed a shunt, we developed an animal model to test it in pregnant sheep. We achieved proof of concept about a year and a half ago. We got a 2.3 million dollar NIH grant that’s called an Incubator Grant, which the NIH provides money, but also expertise, the people that you need to do the engineering, validation and verification testing, the biocompatibility testing, all of that sort of stuff that has to be done for a medical device to go before the FDA.
We are in the process of developing our FDA application. After we have FDA approval, there will be the first in human trial, and then, hopefully, before I retire, this will be a thing. What we anticipate is that when we put the shunt in around 24 weeks gestation, it will take the pressure off of the developing brain, the brain will be allowed to repair from the damage that has been caused so far, and then also, hopefully, assume a more normal developmental trajectory so that these kids will be born basically normal and have normal lives.
Dr. Aimee: Wow. That is so cool. Dr. Sanfilippo, I learned that one of your research interests includes a trial for fibroid prevention. Fibroids are so common, so I know a lot of people will want to learn more about that. Tell us more about it. What’s the study focused on, who might it help, and why is it important?
Dr. Joseph Sanfilippo: Let me give an example of a patient that showed up at my office or on my doorstep one day. She was 16, and she was referred to by the cancer doctors, the oncologists. They had done a biopsy, and the good news was that it was benign and it was a fibroid. Here she is, 16 years of age, and one of the problems is that the fibroids were so large. And when I say large, they were basically up to her sternum. Unfortunately, for instance, in the middle of the night, she would have to get up many times because these fibroids compressed the bladder and the capacity was limited.
Fast-forward. We operated on her, removed the fibroids, the uterus was very normal, and it stayed normal for a while. Unfortunately, which is common with fibroids, they regrew. She’s been maintained on some medication to control the growth. The medicine works as long as you take it. In other words, you could never take this and get pregnant, that wouldn’t work. She actually graduated from pharmacy school, or whatever. Where I’m going with this is that her outlook to carry a pregnancy is reasonable, but fibroids are notorious for the fact that they can give you heavy vaginal bleeding, they can give you pelvic pressure, certainly can lead to getting up in the middle of the night because of the pressure problems.
With your permission, I have a little model here, if I can hold that up. This is a fibroid that’s in the lining of the uterus, the worst place to have a fibroid. This is going to equate with a lot of bleeding. Fibroids toward the outside or in the muscle are less of a concern – still a concern, but less of a concern. Location, location, location is the key thing.
Let’s just say this same person has fibroids and heavy bleeding, and she would like to get pregnant. Number one, it’s common to have miscarriages because it just is common sense, if your fibroid is in the lining of the uterus, it’s going to affect implantation and so on. We can treat that by operating in the uterus. We’re going to call that hysteroscopy, where we shave down the portion of the fibroid that’s in the cavity. That seems to work. The lining of the uterus, theoretically, would grow over, so we don’t have to take it out.
If that doesn’t work or there are other concerns, we can take these fibroids out. We can do that through a bellybutton incision laparoscopy, frequently accompanied by a small incision. We call that a mini laparotomy. Once the fibroids are out, we want to put that uterus back together as perfectly as we can, it has to carry a pregnancy.
If you have a so-called myomectomy, which is our name for removing the fibroids, you do run a risk of rupture during pregnancy. Very rare. I don’t want to scare your audience, but to just say if you get pregnant, there’s always a small chance of that. But, we can address these fibroids.
Now, research-wise, what we’ve been doing is looking at the genetics. If we can understand the genetics, in this day and age, maybe we can alter that somehow. There’s a number of what we call checkpoint aspects of the genetics. I won’t go into the details, but just to say for us, the research is let’s get a handle of the genetics and then see if we can in a positive way affect that and allow that patient to proceed with a term pregnancy or pretty close.
What causes the fibroids is unknown. There are very loose questions about diet effects, red meat. Again, it’s not black and white, but gray. If you’re on birth control pills early on, that can have an effect. Birth control pills, per se, can make fibroids grow because of the estrogen in the pills. Just to summarize, suffice to say the good news is they’re benign. It’s very rare that they turn out to be what we call a sarcoma, but that’s always a small possibility. If you notice heavy bleeding, pelvic pressure, urinate more frequently at night, speak up. Ask to get an ultrasound and make the diagnosis.
Dr. Aimee: That’s very exciting that maybe one day there could even be a cure for fibroids.
Dr. Joseph Sanfilippo: Sure.
Dr. Aimee: This question is for both of you. For listeners who might find all of this medical science overwhelming, what’s the key takeaway about how these advances give more options and hope to patients and families?
Dr. Stephen Emery: I’ll start. Like Dr. Sanfilippo, there are a lot of really brilliant, hard-working, dedicated people in the field of medicine who are trying to make things better for patients. Over time, it just always gets better. That’s always something to keep in mind for your patients. If your patients have questions, have them ask their doctor, their OBGYN. A lot of people of this generation get a lot of their medical advice from social media, which may not be the best place for obvious reasons. Just trust your doctor and keep the faith that medicine continues to get better.
Dr. Joseph Sanfilippo: I have and continue to feel very strongly that patients need to be informed, and we need other vehicles other than the internet. That was why I put together the book Expert Guide to Fertility, which was and is designed and continues to be a companion for anyone going through infertility. If you have endometriosis or you can’t get pregnant, or you need to get a surrogate carrier, or you don’t know how to finance the infertility, Expert Guide to Fertility boosts your chances for pregnancy. That’s one thing.
The other thing is, as you started our discussion in the podcast, Everyday Medical Miracles is designed to share our life as healthcare providers, our most interesting and challenging patients, what it was like. What it’s like to deliver a baby in the front seat of a car, that kind of thing is included in Everyday Medical Miracles.
The most important advice, and I echo what Dr. Emery said, but I’m going to do a little tweak on it. If you’re trying to get pregnant and it doesn’t happen, speak up. The sooner you speak up, the better. There’s so much we can do to help you. Every doctor and every OBGYN is attuned to infertility, and every infertility specialist is attuned to help you and deliver what’s state-of-the-art.
Dr. Aimee: Great answers. Finally, if each of you could point to one breakthrough that will most affect fertility and fetal medicine in the next decade, what would it be and why?
Dr. Joseph Sanfilippo: Okay. I’ll start. AI is going to change the face of the embryology laboratory, and it already is. Artificial intelligence is going to allow you to come into a doctor’s office and have the history put together, the doctor is going to have that readily available, so we’ve saved time, we can focus on the exam and advice. To me, that’s one of the most important advents, if you will.
Dr. Aimee: Great. I just bought the website DoctorAimee.ai yesterday, so hopefully I timed that well.
Dr. Stephen Emery: What I tell medical students who rotate with me is that when I was at their stage of career, the field that I am in didn’t exist.
Dr. Aimee: Wow.
Dr. Stephen Emery: Medicine evolves, it grows and it gets smarter. Like Joe said, with AI, it’s going to get even better. We’re really excited. I think there are going to be a lot of breakthroughs with gene therapy. For fetuses that have a genetic condition, we can actually go in and repair that genetic defect in the fetal stage to prevent that disease from ever happening. That’s on the horizon. That’s going to happen.
Dr. Aimee: How many years, what do you predict?
Dr. Stephen Emery: Five.
Dr. Aimee: Wow. That’s so incredible.
Dr. Stephen Emery: It always gets better.
Dr. Aimee: If people would like to find you and your work, this question is for both of you, where can they find you?
Dr. Stephen Emery: People don’t have a problem finding me. I don’t have a social network presence, that’s intentional. My email address is emerysp@upmc.edu is public, so that’s probably the best way to get a hold of me.
Dr. Joseph Sanfilippo: I would say two-fold. One is with the Everyday Medical Miracles, we put together a website. You can easily contact us at www.EverydayMedicalMiracles.com.
Similar to what Dr. Emery mentioned, mine is sanfjs@upmc.edu. We would be happy to help in any way that we can.
Dr. Aimee: Thank you for joining me today. I feel like I’m amongst some of the greatest minds in medicine. I just feel so lucky that you guys took time to talk to me today so that people who follow and listen to my show can just hear from you about some of the incredible things that you are doing to make things better for women and babies. Thank you so much. Dr. Emery and Dr. Sanfilippo, thank you both for joining and sharing your expertise and the hope that these interventions offer families.
Special note, Dr. Sanfilippo’s books, Everyday Miracles and Expert Guide to Fertility, are both available at Amazon and Barnes and Noble. For Everyday Miracles. He and Dr. Andrew-Jaja joined me to talk about this book, and we also talked about the Expert Guide as well. I’ll be sure to drop the links in the show notes if you’ve missed them.
Thank you all for tuning in. Don’t forget to subscribe to The Egg Whisperer Show on YouTube and follow us on Apple Podcasts or Spotify so you don’t miss an episode. See you next time.
