Taco Bout Fertility Tuesday

Mark Amols, MD

This podcast presents an in-depth exploration of fertility concerns and inquiries straight from those undergoing fertility treatment. Standing apart from the usual information found online, we dive headfirst into the real science and comprehensive research behind these challenges. Amidst all this, we never forget to honor our cherished tradition - celebrating the simple joys of Taco Tuesday!

  1. 5d ago

    Why Is My Fertility Clinic Giving Me Different Answers? Who You Should Ask

    Send us Fan Mail Have you ever asked three people at your fertility clinic the same question—and somehow gotten three different answers? It can feel like nobody is communicating. But sometimes the explanation is more complicated. In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols takes you behind the scenes of a fertility clinic to explain how the care team actually works. Front desk staff, medical assistants, nurses, nurse practitioners, physicians, embryologists, billing teams, and office managers all have different training, experience, responsibilities, and access to information—and that can affect the answers you receive. You'll learn the important difference between knowledge gained through repetition and experience versus knowledge built on a deeper medical foundation, why the most confident answer isn't always the most individualized answer, and why a physician saying “it depends” may actually reflect more—not less—understanding of your situation. You'll also learn a simple way to figure out who should answer your question: • Administrative questions • Billing and insurance questions • Medication and treatment instructions • Clinical interpretation • Individualized medical decisions • Embryology and laboratory questions Dr. Amols also explains why yesterday's answer may legitimately be different today, how new ultrasound findings, hormone levels, embryo development, or other information can change your treatment plan, and why not every member of your fertility team may have the newest information at the same moment. Plus, we tackle the difference between communication and customization. A clinic where every patient follows the same pathway may appear incredibly consistent, while individualized fertility treatment creates more moving parts—and a greater responsibility to explain why the plan changes. Most importantly, you'll learn two questions that can prevent a tremendous amount of frustration during IVF or fertility treatment: “Did something change?” and “Who is the best person to answer this question?” Sometimes different answers really do mean there is a communication problem. Other times, the answer changed because your care changed. If you've ever felt confused about who to call, who to trust, or why you're hearing different information during IVF, IUI, fertility testing, or embryo transfer treatment, this episode will help you navigate your fertility clinic with much more confidence. Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols. If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen. Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes. Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

  2. Aug 19

    ERA Was Supposed to Improve Embryo Transfers—Could It Actually Make Them Worse?

    Send us Fan Mail Does the ERA test actually improve your chance of pregnancy with IVF—or has endometrial receptivity testing been oversold? Patients often receive completely different advice. Some fertility specialists say the Endometrial Receptivity Analysis, or ERA, can identify a personalized window of implantation. Others say research has proven the test does not work. The truth is more complicated. In this episode, Dr. Mark Amols revisits ERA in light of newer randomized trials, meta-analyses, and research on recurrent implantation failure. He also examines statements from his earlier episodes—including why he would no longer confidently tell patients that an ERA “cannot hurt.” Topics include: How ERA attempts to identify the window of implantationWhether ERA improves live-birth rates during routine IVF treatmentWhat the major randomized trial actually foundWhether that trial was adequately poweredWhy the data do not support ERA before a routine or first embryo transferThe unresolved role of ERA after recurrent implantation failureWhy results differ between untested and euploid embryo transfersWhether changing transfer timing could potentially lower successConcerns about test accuracy and cycle-to-cycle endometrial variabilityWhen ERA might still be discussed as an optional, unproven interventionThe current evidence is reasonably clear for the average IVF patient: routine ERA testing does not improve live birth. For patients with repeated implantation failure—particularly after failed euploid embryo transfers—the answer remains uncertain because the adequately powered randomized trial needed to settle the question has not yet been completed. This episode separates what ERA has been proven to do, what it has been proven not to do, and what fertility medicine still does not know. Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols. If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen. Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes. Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

  3. Aug 12

    Chronic Endometritis & IVF: Could Silent Uterine Inflammation Affect Implantation or Miscarriage?

    Send us Fan Mail Could chronic endometritis—silent inflammation in the uterine lining—affect IVF implantation, miscarriage, or embryo-transfer success? In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols explains what chronic endometritis is, what it is not, and when it may actually be worth investigating. We break down CD138 biopsies, hysteroscopy, cultures, EMMA, ALICE, and vaginal microbiome testing—and why these tests are not interchangeable. We also discuss antibiotics before embryo transfer, what ASRM says about routine antibiotic use, and why finding bacterial DNA does not automatically mean treatment will improve live-birth rates. The takeaway: chronic endometritis can be real and treatable in the right patient, but not every borderline result explains infertility, miscarriage, or a failed IVF transfer. Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols. If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen. Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes. Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

  4. Aug 5

    Empty Uterus, High hCG: What the Discriminatory Zone Really Means

    Send us Fan Mail What does it mean when your hCG is above the “discriminatory zone,” but a transvaginal ultrasound still shows an empty uterus? It raises concern—but it does not automatically diagnose an ectopic pregnancy or miscarriage. In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols explains what the discriminatory level can—and cannot—tell us about an early pregnancy. He explores how this decades-old threshold became part of medical practice, why it represents a probability rather than a biological boundary, and how viable pregnancies can occasionally remain invisible even when hCG has crossed the expected level. You’ll learn: • The usual ultrasound sequence from gestational sac to cardiac activity • What “pregnancy of unknown location” actually means • Why PUL is not the same as an ectopic pregnancy • Why one hCG result should not automatically trigger methotrexate • The difference between a probable gestational sac and intracavitary fluid • How IVF dating, multiple gestations, symptoms, and follow-up change the interpretation The key lesson: hCG provides a biochemical signal, while ultrasound provides anatomy. Neither one, by itself, tells the entire story. Severe abdominal or pelvic pain, shoulder pain, dizziness, fainting, weakness, or heavy bleeding requires urgent medical evaluation. This episode is educational and is not a substitute for individualized medical care. Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols. If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen. Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes. Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

  5. Jul 29

    My hCG Didn’t Double: Miscarriage, Ectopic—or Still Normal?

    Send us Fan Mail Your first beta hCG is 100. Two days later, it rises to 150—but it didn’t double. Does that mean miscarriage? Could it be ectopic? Or could the pregnancy still be progressing normally? Before Google diagnoses you with three different pregnancy complications, take a breath. In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols explains why the familiar rule that hCG must double every 48 hours is outdated—and how that rule grew from a 1981 study involving only 20 patients. You’ll learn: • What hCG does during early pregnancy and which cells produce it • Why we call the test “beta hCG” • Where the 48-hour and 66% rise rules originated • How the expected rise changes based on the starting hCG level • Why IVF pregnancies may occasionally progress with much slower rises • Why a slow rise does not diagnose miscarriage or ectopic pregnancy • Why even a perfect rise cannot confirm that the pregnancy is inside the uterus • Which symptoms require urgent medical evaluation regardless of the latest beta The bottom line: hCG is useful, but it is not a pregnancy report card, a crystal ball, or a GPS. It provides one piece of the story—followed by another beta, careful symptom monitoring, and eventually an ultrasound. If you have severe or worsening abdominal or pelvic pain, shoulder pain, dizziness, fainting, weakness, or heavy bleeding, seek urgent medical evaluation. Do not wait for your next scheduled blood test. Next week, we’ll continue the conversation by discussing pregnancy of unknown location, the hCG discriminatory level, and how clinicians evaluate the possibility of an ectopic pregnancy. Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols. If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen. Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes. Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

  6. Jul 22

    Is God Punishing Me With Infertility? Faith, Guilt, and What the Bible Says

    Send us Fan Mail Infertility can lead to a painful question that many people are afraid to say aloud: Is God punishing me? In this deeply personal episode of Taco Bout Fertility Tuesday, Dr. Mark Amols explores why infertility can feel like spiritual rejection. When children are described as blessings, pregnancy comes easily to others, and treatment repeatedly fails, it can be tempting to believe that God is angry—or that something from your past made you undeserving of becoming a parent. But does the Bible actually support that conclusion? Drawing from the stories of Hannah, Zechariah and Elizabeth, the teachings of Jesus, and several key passages of Scripture, Dr. Amols examines the difference between feeling punished and having evidence that punishment is occurring. He also discusses how religious comments, self-blame, and the need to find an explanation can add spiritual shame to an already painful medical diagnosis. Infertility is not a spiritual report card. A failed treatment is not proof that you prayed incorrectly, lacked faith, or were found unworthy. Your empty arms are not proof of God’s anger, and your unanswered prayers are not proof that He has forgotten you. Thanks for listening to another episode of Taco Bout Fertility Tuesday with Dr. Mark Amols. If you found this episode helpful, please share it with someone who might benefit—and don't forget to follow the show and leave us a review on Apple Podcasts, Spotify, or wherever you listen. Want to explore more fertility topics? Visit TacoBoutFertility.com, where you can search our entire episode library, find episodes about the questions that matter to you, try our interactive fertility tools, and submit questions or topic requests for future episodes. Join us next Tuesday for another episode of Taco Bout Fertility Tuesday, where we make fertility medicine easier to understand—one topic at a time.

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About

This podcast presents an in-depth exploration of fertility concerns and inquiries straight from those undergoing fertility treatment. Standing apart from the usual information found online, we dive headfirst into the real science and comprehensive research behind these challenges. Amidst all this, we never forget to honor our cherished tradition - celebrating the simple joys of Taco Tuesday!

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