A New Approach in Fertility: BEA Fertility's Innovative Solution

[00:00:00] If you enjoyed podcasts like this, you should check out our other shows on Health Podcasts Network. For example, Women Physicians Lead, hosted by Dr. Lisa Herbert, helps women physicians move from surviving to thriving in their personal and professional lives.

[00:00:17] Dr. Lisa shares leadership tips, burnout support, stress management strategies, and inspiration from women physicians who have made remarkable transitions into leadership roles.

[00:00:28] There is a fantastic episode that you should check out called Taking Care of Yourself during the journey about how women physicians can care for themselves while on their leadership journeys. Check out Women Physicians Lead on your favorite podcast platform or visit healthpodcastnetwork.com

[00:00:47] Welcome to Beyond The Paper Gown, where we explore the cutting edge developments as well as oppressing issues in women's health and wellness. I'm your host, Dr. Mitzi Krockover.

[00:01:12] In the United States, approximately 13.4% of women ages 15 through 49 have trouble getting pregnant, and this is based on data from between 2015 and 2019. In about a third of the cases, the issue lies with the male sperm, but in about a third there's no clear cause.

[00:01:31] We do know that due to aging of the eggs, older women have a harder time getting pregnant or carrying a pregnancy to term.

[00:01:39] Some couples will choose to go through IVF or in vitro fertilization, which entails hormone injections, retrieving and fertilizing eggs, and re-implanting those embryos into the uterus. But many women, especially when they start out to conceive, want to try less invasive and less expensive ways to get pregnant.

[00:02:00] And then there are some same-sex couples, mostly women, who want to have a way to conceive that is more effective than older methods of insemination. In today's episode we have a special guest, Tess Cossaud, the CEO and co-founder of Baye Fertility.

[00:02:17] She has a passion for equity and fairness, especially when it comes to the fertility industry. She's going to share how she reimagined an age-old fertility method to make it more accessible and effective for individuals and couples on their fertility journeys.

[00:02:33] Just a reminder that this podcast is for informational and educational purposes only, and it's not meant to be taken as medical advice. We encourage you to share this episode with your healthcare provider so that you can discuss your specific healthcare needs.

[00:02:49] It's my pleasure today to welcome our guest, Tess Cossaud, who is the CEO of Baye, and she's also the co-founder at Baye Fertility. Tess, welcome. Thanks, Mitzi. It's so nice to be here.

[00:03:12] It is terrific to have you. And tell us a little bit about yourself before we start talking about your company. I'm always a bit embarrassed to admit this, but I'm not actually a scientist or a physician.

[00:03:24] I'm at my core, a marketer, a storyteller, a commercial person with a personal vendetta against things that aren't fair and a true desire to create things that are just a little bit more equitable.

[00:03:40] And for me, fertility made so much sense mostly because the more you look at the fertility industry, the more you realize for so many reasons I know we'll get into quite how unfair it is for everyone who's trying to start their family.

[00:03:54] And so it sort of made so much sense for me to go in and start to shine a light on it, tell some stories, and try to work towards it a better way.

[00:04:05] Talk a little bit about what the company is and what it does and what that solution is that you came up with. Yeah, so really it's sort of a very modern take on an old technology. What we've done is take intra-servical insemination ICI, and we've brought that back.

[00:04:24] ICI at its core is super simple. This is usually where I've reached for my model uterus and sort of show what actually happens in the body with the product, but of course on audio you're just going to have to rely on my ropey description skills.

[00:04:38] And we'll put the link in the podcast notes so that people can link and take a look. Perfect, we'll do that. But essentially we take what's called a cervical cap.

[00:04:50] And at Bayer we've created an applicator. Now the applicator, think of it sort of like a slightly bigger tampon applicator. And what you do is you collect a semen sample from a partner or donor into a container and you pour it through a funnel into that cervical cap.

[00:05:08] And you use the applicator essentially to insert the applicator into the vaginal canal where you turn a handle at the bottom of the applicator which releases the cervical cap onto the cervix.

[00:05:20] You then remove the applicator, which kind of pulls a string out. So if you think about a tampon and a tampon applicator, sort of the same action except for that the applicator is depositing a cup, a little silicon cervical cup onto the cervix.

[00:05:36] And what we do is create a treatment kit where there are two of those devices. So you inseminate on consecutive ovulation days. We've found in our first cohort of users, kind of excitingly actually, a pregnancy rate of 39.28%.

[00:05:58] Now, small group of people and we're going to continue to sort of update the data. But our first baby is coming on the 4th of April and we're all getting really excited about it. Sure. Congratulations to you and the parents to be.

[00:06:17] Are the folks that are using this folks that just want to kind of hedge their bets or people that are having problems or had problems conceiving and wanted to start with this process?

[00:06:33] It's such a good question. So honestly, we're getting sort of a whole spectrum of people in the cohort that I talked about where it was a 39.28% pregnancy rate. I can share a little bit more about that group of people. And so it was small group 56 people in total.

[00:06:57] They used three treatment cycles of Bayer. And what we found in that cohort was just over 40% of the female population had a gynecological issue.

[00:07:08] So PCOS, endometriosis, 30% of the males in that cohort had a semen abnormality and 60% of them had been trying to conceive through intercourse at home for 12 or more months. And the average age of the female carrying the child was 37.5.

[00:07:31] So I think if you've kind of extrapolate that out and that's pretty consistent with who we see using Bayer, which is people who are sort of in their mid to late 30s, they've been trying a home for a little while.

[00:07:43] They're getting really frustrated. Maybe they're not ready for IVF. You know, maybe they can't afford IVF.

[00:07:48] Maybe they don't feel like they want to make that last treatment option their next step. That's when they come and find us, when they're ready for something, but they're not ready for IVF.

[00:07:59] Okay, thank you. A couple of just random questions. First of all, is it painful when you take it out? I would assume it's not painful when you put it in, but when you have to remove it?

[00:08:14] Good question. Not at all. No. So I mean, I've got, I have every story under the sun to do with this, but there are, you know, I think we 3D printed 90 different iterations of this product before we landed on this one.

[00:08:27] And we actually even took it back into R&D and redesigned it after the first iteration and every single one of those has gone in my body.

[00:08:34] So if it's on the market, it's because I've tested it and it's, you know, it's felt fine. No, it's not painful. So it's actually a really soft cervical cap.

[00:08:44] I'm sort of holding one up here, but it's really soft silicone softer than a menstrual cup. And there's a little removal string.

[00:08:51] And the removal string is threaded through the cap in a way that it breaks the seal when you pull the string out from outside the body to remove the cap.

[00:09:01] So it's really easy. Okay. Not at all. Not at all. The first iteration we did go through, we did that dance though. We learned hardware.

[00:09:11] Well, thank you for your service and trying it out. Also, you talk about intra-cervical insemination, ICI. I've always heard it as IUI, which is intrauterine insemination. Is there any difference? Good question. Yes, there is. So intra-cervical insemination happens at the cervix.

[00:09:36] So semen is taken as it leaves the male body and it is placed onto the cervix where it's left to interact with the cervical mucus and sperm move through the cervical os and into the uterus.

[00:09:49] Now, that's ICI. IUI, intrauterine insemination. The key is kind of in the name of the treatment, uterine. So insemination happens in the uterus, which means that we need to process our semen sample because you can't inject sort of unprocessed meat semen directly into the uterus for many medical reasons.

[00:10:10] But essentially, intrauterine insemination takes the process semen sample and passes through the cervix and directs, puts that into the uterus using a catheter usually. So it's a slightly different, I mean, it's actually a very different fertility treatment.

[00:10:33] And that has to be done in the office. Absolutely. And in many cases under sedation, right? Because it's a little bit like when you have a coil put in, right? Like it's quite painful having something pass through your cervical canal.

[00:10:46] Great. Thank you for that definition. You know, the other group that I would think might find this really interesting are same-sex couples. Yes. So I'm sort of smiling because our first baby who's coming on the 4th of May is due to two fathers and their surrogate. Oh, wow.

[00:11:09] So we have two who are looking for a long time for a way to start their family that they could afford. And it's quite a regulated path and an uncommonly trodden path for sort of starting your family, which often means that it comes with a really high price tag.

[00:11:25] We know some people mostly in the US who spend upwards of half a million dollars to fathers to get their twin babies. And this baby is coming and I think this baby costs these fathers 250 pounds.

[00:11:43] So less than $300. And she's going to be the first actually. So you're absolutely right. Same-sex couples, less common first same-sex male couples with a surrogate,

[00:11:53] more common first same-sex female couples because the design of the device is such that you don't need to have intercourse. And which is fantastic for same-sex female couples with a known donor, for example. I'm going to ask a really crass question. Go for it.

[00:12:13] Do you know what it is? I'm not going to guess, but I'm excited for it. Do you know if you are more successful than a turkey baster? My question.

[00:12:31] And I say that, you know, and it sounds funny, but I have had friends who have same-sex couples, women who have gone that route and have had their children that way. Totally. Totally.

[00:12:44] Totally. It's, you know, I think so turkey basters are, we actually, when I first started working on this, I called it Turkey Baster 2.0. So you can tell like that. That's not so far off. Despite coming from a marketing background, I'm bound from ever naming this product.

[00:13:03] So turkey basters are actually, I mean, very hard to get the data for a turkey baster because people are obviously not reporting to the manufacturer. But turkey basters are very similar to syringes.

[00:13:19] So not to introduce another acronym, but it's called IVI, intravaginal insemination, which is essentially where you deposit semen in the vaginal canal. Now intercourse, deposit semen in the vaginal canal, syringes, deposit semen in the vaginal canal and turkey basters also deposit semen in the vaginal canal.

[00:13:38] The difference with the Bayer treatment with ICI is we are putting semen into a cap, which means we're protecting it from the vaginal environment, which contains sort of acidic fluids, lactobacillus bacteria that isn't very good for sperm.

[00:13:55] And we're placing that cap containing semen directly onto the cervix where it sits for an hour. Now, sort of cervical mucus, not that it's the world's most wonderful word, but that it actually really is the sort of perfect chemical partner for sperm.

[00:14:15] It has this beautiful membrane, it's this sort of beautiful structure that allows, you know, most days of the month, it's actually the only fluid barrier in the human body that is made of fluid, that's sterile.

[00:14:30] Right? Nothing's supposed to go in there, right? Nothing is supposed to go into the uterus. And on broad strokes, cervical mucus does a fantastic job of preventing anything from entering the uterus, except for when you're ovulating.

[00:14:42] When it literally changes structure to allow morphologically normal sperm to enter the uterus. It is... Totally magic. It becomes less gooey and thinner, right? Exactly right. So, do you have any companion piece that helps women know when they're ovulating?

[00:15:08] That's a really good question. When we first launched, we really thought we would need to include ovulation tests.

[00:15:15] And we were very firm that you need midstream urine ovulation tests because apps temperature, sort of the clinical data sort of lands on the side of tracking urine for the first time. And we thought, right, we're going to include ovulation tests and pregnancy tests and everything.

[00:15:35] What we actually found is by the time people come to us, they already have their system for tracking ovulation and what doesn't help them is us throwing a new one their way.

[00:15:45] And so honestly, we don't include ovulation tests not because we didn't want to but because our users told us that that wouldn't serve them in this process. And do you suggest that they start this process one to two days before ovulation as the hormone levels start going up?

[00:16:06] What's the timing that you suggest? So we usually suggest using your first device on peak ovulation and your second device 24 hours after that. Okay. That makes sense because you're really only using it for an hour then.

[00:16:24] Yeah, so the cervical cap sits in the body for one hour. The reason actually we include two devices is kind of a sperm optimization strategy.

[00:16:36] So there's an abstinence period before you use your first device which means we're counting on the first semen sample if it's from a partner and not a donor, the bank. We're counting on your first semen sample being pretty high count but not super fresh.

[00:16:52] So by forcing you to do it again 24 hours later, A, you're a lot more confident with your second device because it's not a new experience and B, we're counting on your semen sample being maybe sort of lower count but a lot fresher in terms of sperm.

[00:17:10] So that's a little bit of a call it a sperm strategy having two devices in the kit. Sure. Now you're based in London in the UK. Is this device available there now? It is. Yes, it's on the market in the UK.

[00:17:28] Terrific. But it's not quite yet here in the United States. So what is the process and what's your timeline?

[00:17:35] Yeah, so it's a regulated device. It's a 510K pathway with the FDA but it's also class 2 medical device which is completely right. I think it's going inside a body that's absolutely right that it's regulated in this way. Explain for our listeners what that is.

[00:17:56] So the two main pathways for the FDA are DeNovo and 510K. DeNovo means new. There's nothing like it that exists and so you need to prove that it works.

[00:18:06] 510K means that there's something like it's similar on the market already so you can kind of piggyback on that clearance and so it's a slightly more streamlined approval process with the FDA.

[00:18:17] Class 2 is just the classification of device. It means that there's a slightly more rigorous testing standard than for example a class 1 device. Terrific, thank you. That was a beautiful definition. I'm going to use that.

[00:18:30] Very clear. So when we were talking before briefly, you still need to do clinical studies? We do and we're in the middle of it now which means we're all on Thunderhooks. Terrific. Is that in the UK or the United States?

[00:18:48] In the US and Atlanta. So I was just there this weekend dropping off medical devices for that study. So you're not recruiting anymore? We are fully recruited for that study and we're actually expecting to wrap it up at the end of next week.

[00:19:06] Okay, terrific. And so then there's obviously a lag time between that and your actual approval. What's your best guess as to when you think it might go on market here?

[00:19:18] Yeah, so we're on track to submit to the FDA in June which means that we're tentatively hoping to be cleared by October. And do you anticipate that it's going to be covered by insurance?

[00:19:32] So the product is FSA and HSA eligible in terms of being covered by insurance to begin with no. I'll tell you what they were going to fight real hard to turn that into a yes.

[00:19:46] Terrific. What has been the reception in the UK since it's already out and about from the medical community? Yeah, it's been really interesting actually. So when we speak to gynecologists and reproductive urologists and they see the technology and they understand it.

[00:20:08] It's broadly been an incredibly positive reception. What we've heard from gynecologists is this intuitively feels like a really good first step on the treatment pathway.

[00:20:20] Something in between intercourse and turkey basters IVF and the clinical treatment for fertility or infertility is really out of reach for a whole group of people. You know, maybe they can't afford it but also they just want something that they can control.

[00:20:38] And that's why what we hear from the medical community, what we hear from gynecologists is finally something that is rooted in clinical credibility and science that we can offer to our patients that is a first step for them.

[00:20:58] We may have talked about this earlier. How is this more successful than natural intercourse? Yeah, so the statistics on the pregnancy rate for natural intercourse are actually really hard to pin a number on because they're not consistently collected.

[00:21:18] You know, if you have intercourse get pregnant, who do you report that to? So we don't consistently collect that data anyway, right? But in terms of how it is more efficacious than intercourse, it's really hard to draw a comparison.

[00:21:31] What we know is that there are some data sets that indicate the efficacy of intercourse and there are some data sets that indicate the efficacy of ICI.

[00:21:39] ICI consistently comes out as a more efficacious way to conceive but it's kind of like comparing apples and oranges with the data sets because they're not the same age, they're not the same amount of time, etc.

[00:21:51] Again, this is the pseudo-scientist in me. I'm wondering also is because folks that are using ICI are more likely to be tracking their ovulation, more likely to be doing everything that they can to increase their chance of conception.

[00:22:11] You're exactly right. By the time you start using ICI, you're no longer in the phase of conception where you're thinking, oh well, let's come off the pill and see. You know, you're actually in a slightly more structured, hey something's not working, what can I do to optimize this?

[00:22:31] And so yes people and we absolutely tell people to use this device around ovulation. You mentioned the fact and I've heard this also from other fertility companies that they're seeing a skew towards older women.

[00:22:47] And again, I think in general women are delaying childbirth but my guess is that it's even more market in those that are seeking fertility help. And so my question is do you use and at that point not to be over dramatic but every month counts.

[00:23:09] And so do you suggest any kind of time limitation in terms of using your product before they seek another modality? Yeah, it's a really important point that you raise there.

[00:23:23] What we tend to say is try it for six months because there's a pretty solid amount of data to suggest that a delay of six months in seeking IVF doesn't actually impact the outcome of IVF. It doesn't have a negative impact on the potential success rate for you.

[00:23:41] And so we've used that data and folded it into our own to say, look, we suggest that you try this for six months if at the end of six months it hasn't worked. We're not going to keep selling you stuff that we don't think is going to work.

[00:23:55] You know, we're going to absolutely refer you on. Would you say the same thing to say a 40 year old? No, we'd probably start to say give it a try for three months.

[00:24:09] And I think this is something that we've struggled with a lot actually Mitzi Abaya is to what extent do we gatekeep based on whether we think this will work for you or not, right?

[00:24:19] Because in that cohort of 56 people where the efficacy rate was 39%, one of the pregnancies is a woman who's 46 years old. You know, another one is 43 and her partner has a 1% semen morphology and she's been trying for a really long time.

[00:24:39] If someone else got pregnant, she's been trying with multiple partners for 13 years. So who are we to look at you and say, you know, imagine if that 46 year old woman had come to bed and said I'd love to try your treatment.

[00:24:54] And we said, oh no, no, we don't think that's going to work for you actually go straight to IVF.

[00:24:57] And so we really struggle with this is what where's the balance of being really moral and being being sort of clinically accurate and in how and who we offer care to but also not gatekeeping and controlling this journey.

[00:25:15] Well, let me turn it around then so say that you're the customer or you're advising a customer or a potential customer, not you, the co-founder of Bayer but just in general. How would you counsel a woman that's looking at all these options and maybe decides to do this?

[00:25:36] What questions should she be asking so that she can make those decisions for herself?

[00:25:41] Yeah, that's an awesome question. So if I were talking to a friend and if I'm speaking to a friend that for me really is the highest bar of really loving and them and wanting them to succeed.

[00:25:55] So for me what I would say is look, first of all how old is my friend? If my friend is sort of in her 40s, what I will say is look be very realistic about the chances that this gives you.

[00:26:10] You go into this knowing and you know with your expectations in the right place and go into it. You try it and if after sort of two or three cycles it hasn't worked pause and think through what your next steps are move on.

[00:26:28] You know, and plan for that and really what we say so we've got an online consultation that you go through it.

[00:26:36] You answer a bunch of medical questions. Now if the treatment based on what you tell us isn't going to work for you, we're very clear that it's not going to work for you and we tell you why.

[00:26:48] If you have two blocked fallopian tubes this will not work for you do not buy it. And so right away we try very hard to tell it be upfront about who it will and will not work for.

[00:26:59] If it might work for you, we tell you, you know this could be a good option for you based on what you've told us. We don't know everything but here's the efficacy data in that age group for this treatment go into it with your eyes wide open.

[00:27:16] And so we try as much as we can to be very transparent about the chances that this will give you. That's really helpful. Thank you. You are speaking obviously very knowledgeably and probably have more of a grasp of certain gynecologic issues and maybe, you know, some providers.

[00:27:40] So my guess is that you've obviously learned a lot and researched a lot and also who advises you from the company standpoint. What's your team look like?

[00:27:53] So we have an incredible clinical advisory board at Bayer with people who have been with us, you know, some of them since day one. And then we also have a sort of pretty incredible just general advisory board of people who understand the journey,

[00:28:11] who understand the path, who've maybe walked this path before, who did IVF themselves, who were able to talk about the journey and help us understand it. And then to be honest, you ask who's advising us Mitzi? For us it's actually our users.

[00:28:25] We have hundreds of hours of interview transcript because we try to talk to every single one of our users. You know, when we were going through our product launch in the UK, we actually created WhatsApp conversations with all of our early users.

[00:28:41] And we were talking to them all the time. We were getting photographs of their cervical mucus and commentary on, you know, do I have sex today or not? And we're going back saying, hmm, well, and kind of talking to them like they're our friends, right?

[00:28:57] So we really try to just hear the user and understand what they're going through because if you really understand what they're going through and you really, really listen, you really take the time. You know what you need to do after that.

[00:29:13] You and I were talking earlier and you said you had some talking about the journey, some interesting stories. Any that you'd like to share with us? I'm trying to rifle through a sort of rock my brain for one that feels appropriate. Oh please do the inappropriate ones.

[00:29:33] Those are always more interesting. So we were chatting to the FDA and the FDA were saying when you do this study, you need to create, you need to use semen. And we were thinking, well, it's a usability study, right? So we're not testing whether people get pregnant.

[00:29:54] We're testing whether they know how to use the device. And if we introduce semen into the equation, suddenly you're recruiting two people, not one. You're recruiting a female participant and her male partner to come in and produce a sample.

[00:30:08] And it sort of started to create what felt like an incredibly complex study. So of course we sort of think outside the box, ironically, given that we've created something that goes in a box, but we kind of laugh sometimes about that.

[00:30:20] But we were like, oh well, what if we created fake semen? And off we go on what ended up becoming sort of Beo folklore. But essentially we were like, right, what would fake semen look like? What's safe to put in a vagina?

[00:30:34] And then you start to think about all the things that go in a vagina and as it turns out actually the list is quite long. So we decided we sort of settled on vaginal moisturizer gel because that can sit in the vaginal canal for 72 hours. How long? Great.

[00:30:49] So we call up a pharmacy here in the UK and I'm looking online for a vaginal moisturizer gel that's also cleared by the FDA so we can use it instead. And there's one.

[00:30:59] And I call up a pharmacy because it says that they have it in stock at their store but they don't have it in stock anywhere else. And I call up the store manager and I'm like, hey, I hear that you have product in stock.

[00:31:09] And the store manager goes, wow, this store is closing down. We actually don't have any much of anything in stock. I was like, oh no, no, no. The website says you have this one product and he goes, okay, well, what's the product?

[00:31:20] And I was like, vaginal moisturizer gel. And he just skips a beat and this poor man on the other end of the phone, I could just hear him trying to think, think, think, think. And he's like, oh, oh that stuff. Oh, we have loads of that stuff.

[00:31:33] How much do you want? I'm like all of it. I want every single bottle so we get like a liter of vaginal moisturizer gel that we pick up from this store.

[00:31:40] And then we start testing and we add a little bit of blue dye that's used in gynecological surgery to create our fake blue semen, which of course, you know, sort of common theme.

[00:31:53] I test everything before anyone else is able to go near it just to make sure it's safe, which anyway ends up meaning that I sort of accidentally die. Well, we didn't quite get our dilution right died this far too blue, which meant that I ended up.

[00:32:08] I dyed myself blue, like very, very blue. And my my opi-gine friend when I called him, it's like Ben, Ben, I've used this dye. I've tested a cap, you know, inside vaginal canal with this dye. How long is it going to last?

[00:32:25] And then just sat back, he laughed, he laughed, he laughed. He said test that blue dye is going to last until the epithelium sheds. You got about four to six weeks to go girl. Oh my goodness. Oh, we laughed so much.

[00:32:42] Anyway, that's probably one of the most recent stories you'll be pleased to know that the fake blue semen we finally did get the dilution right. And it is being used with no problems, but it took a little bit of time and a lot of pride to get there.

[00:32:56] I can tell you that much. And you're no longer a Smurf, I assume. No, but Smurf memes live on forever in my friendship circles. Unfortunately, I'll never let it down. That's great. So looking ahead, are you going to be adding on any products or devices in the future?

[00:33:18] Eventually, yes. And to be honest, that'll be completely steered by our users and what they want. You know, is it, is it ovulation testing? Do they want us to include that in the box? Maybe is it medication, you know, ovulation induction, et cetera.

[00:33:33] Do they do do they want that? I don't know.

[00:33:37] Our sort of guardrails, I guess, where we operate is our mission is to create a pre IVF care pathway that gets as many people pregnant as possible without needing to go through the invasive, sort of painful, expensive process that is IVF.

[00:33:57] What message do you want to share with people considering fertility treatments and certainly your option as well as a kind of final thought in terms of what they should be thinking about?

[00:34:13] So I think when you're trying to conceive, a lot of the time what we hear is sort of people come into it with a plan and they're like, okay, I'm going to get pregnant by this point, which means I'm going to have a baby by September.

[00:34:26] So they'll be great at school because they'll be all and so when we say make a plan, those are kind of the plans that people make when they're starting their family.

[00:34:35] And the mental model is the one that you get when you're a teenager in school and you're kind of taught that sneezing on a boy will get you pregnant.

[00:34:41] Right. So what I would say is, is when you are actually going on this journey, when I say make a plan, I don't mean plan your due date.

[00:34:52] I mean, just have a little bit of a think about what your steps might be along this path if you need to take them.

[00:35:01] You know, when might the right time be for you to move from intercourse to something else and then from that something else to something else?

[00:35:09] Like when would you feel most comfortable maybe having a conversation with your gynecologist or urologist or doing a semen sample or just have a little bit of a think as you embark on this journey is as to not the due date. And the school start date plan.

[00:35:25] But what are my steps on this journey if it doesn't go according to, you know, what I thought maybe it might be because, you know, as with the best of plans they always sort of never really come to fruition.

[00:35:40] But thinking through them is almost, it's almost the sort of thinking through of the plan that is what matters most and hey ask questions.

[00:35:49] You know, always ask questions. Give me the evidence. Send me some case studies. What's your success rate for this procedure? What's your success rate for this medication? Get curious about it and get the data. Terrific advice. Tess Cossad, thank you so much for being with us today.

[00:36:07] Oh, such a pleasure, Mincy. Thank you for having me. Thank you to our guest, Tess Cossad for walking us through Bay of Fertility's innovative cervical cap insemination system and for sharing her journey of bringing this new fertility option to the market.

[00:36:28] The cap is available in the UK and it's anticipated to be approved for the US market later this year. If you're considering fertility treatments, here are a few takeaways from our talk. Thoroughly research and understand the data and success rates for any procedure or technique.

[00:36:46] Then make a general plan for the different steps you may need to take and the timeline, but do stay flexible. Track your ovulation closely and don't be afraid to ask questions.

[00:36:59] Thank you for listening. I invite you to visit our website at BeyondThePaperGown.com and to subscribe to our newsletter so you can keep up with the latest episodes and articles as well as be informed about women's health issues, activities, events and initiatives.

[00:37:16] You can also follow us on Instagram, TikTok, Facebook and LinkedIn. Do leave us a comment we love hearing from you. Until next time, take good care. This episode was produced by Patrick Shambayati and me and our associate producer is Kyla McMillian.