1 00:00:05,240 --> 00:00:09,720 Speaker 1: Doctor Jenny Cook is a highly skilled gynecologist, fertility specialist 2 00:00:09,800 --> 00:00:14,560 Speaker 1: and advanced laparoscopic surgeon with over twenty years experience in 3 00:00:14,640 --> 00:00:20,200 Speaker 1: gynecology and fertility. Jenny' special interests are fertility treatment and demetriosis, fibroids, 4 00:00:20,200 --> 00:00:24,800 Speaker 1: and histeroscopic surgery. She has published widely in the area 5 00:00:24,880 --> 00:00:29,800 Speaker 1: of gynecologic laparoscopy and has also presented at many national 6 00:00:29,840 --> 00:00:33,400 Speaker 1: and international meetings. She has trained at overseas units and 7 00:00:33,440 --> 00:00:38,360 Speaker 1: has attained the highest level of advanced laparoscopic surgery. Jenny 8 00:00:38,479 --> 00:00:41,360 Speaker 1: wholly understands the stresses which single women face and is 9 00:00:41,400 --> 00:00:43,680 Speaker 1: well regarded to discuss the role for egg freezing and 10 00:00:43,760 --> 00:00:46,480 Speaker 1: donus ferm, which allows same sex couples and single women 11 00:00:46,479 --> 00:00:49,640 Speaker 1: to fulfill their dreams of creating a family. A highly 12 00:00:49,800 --> 00:00:53,479 Speaker 1: regarded expert in her field, Jenny consults from nash IVF 13 00:00:53,520 --> 00:01:01,040 Speaker 1: Bonde Junction, where she has recently been appointed the clinical director. Jenny, 14 00:01:01,200 --> 00:01:03,480 Speaker 1: Welcome to the Female Athlete Project. 15 00:01:03,840 --> 00:01:05,840 Speaker 2: Thank you so much for having me here, Chloe. It's 16 00:01:05,840 --> 00:01:06,840 Speaker 2: a pleasure to be here. 17 00:01:07,200 --> 00:01:10,199 Speaker 1: I'm really looking forward to having a chat and i 18 00:01:10,240 --> 00:01:14,559 Speaker 1: am a mon ash ivf ambassador myself, and I'm really 19 00:01:14,720 --> 00:01:20,360 Speaker 1: passionate about empowering women through education, and as we mentioned 20 00:01:20,400 --> 00:01:23,280 Speaker 1: in the introduction, you've got a very extensive career in 21 00:01:23,319 --> 00:01:25,760 Speaker 1: this area. So I'm really looking forward to having a 22 00:01:25,840 --> 00:01:30,200 Speaker 1: chat to you about fertility, women's health, how that intersects 23 00:01:30,200 --> 00:01:32,800 Speaker 1: with sport. And we've also had a number of people 24 00:01:32,840 --> 00:01:37,400 Speaker 1: submit some questions anonymously too. To kick us off, can 25 00:01:37,440 --> 00:01:42,760 Speaker 1: we start talking about periods and what is normal for 26 00:01:42,800 --> 00:01:47,520 Speaker 1: a woman to experience, what's painful that should be accepted 27 00:01:47,520 --> 00:01:49,520 Speaker 1: and painful where you should start to seek some more 28 00:01:49,560 --> 00:01:50,360 Speaker 1: medical advice. 29 00:01:51,680 --> 00:01:52,880 Speaker 3: That's a very good question. 30 00:01:53,240 --> 00:01:57,840 Speaker 2: So the normal range for a period is twenty eight 31 00:01:57,880 --> 00:02:00,720 Speaker 2: to thirty five days. I suppose most have a monthly 32 00:02:00,800 --> 00:02:03,400 Speaker 2: cycle to So to start off with, if there is 33 00:02:03,480 --> 00:02:07,279 Speaker 2: any degree of irregularity, that's not normal and that's something 34 00:02:07,280 --> 00:02:10,000 Speaker 2: that can be investigated. 35 00:02:09,360 --> 00:02:11,800 Speaker 3: And treated if necessary. 36 00:02:13,840 --> 00:02:18,399 Speaker 2: Pain if the pain feels wrong and there's too much 37 00:02:18,440 --> 00:02:21,480 Speaker 2: pain that it needs to be investigated. I see too 38 00:02:21,520 --> 00:02:24,480 Speaker 2: many women who say I just thought this was normal. 39 00:02:24,520 --> 00:02:27,400 Speaker 2: You know, all women experience pain, and you're not in 40 00:02:28,520 --> 00:02:32,839 Speaker 2: an understanding way. Any degree of pain which doesn't feel 41 00:02:32,919 --> 00:02:36,920 Speaker 2: right is not right and needs to be investigated. And 42 00:02:36,960 --> 00:02:41,239 Speaker 2: of course the primary cause would be endometriosis, and there's 43 00:02:41,280 --> 00:02:43,240 Speaker 2: something that we can do about it. I always say 44 00:02:43,240 --> 00:02:45,120 Speaker 2: to women, you don't need to suffer with it, there's 45 00:02:45,120 --> 00:02:46,600 Speaker 2: something that we can do about it. 46 00:02:47,040 --> 00:02:52,119 Speaker 1: Yeah, it's a really big topic, endometriosis and something that 47 00:02:52,639 --> 00:02:56,760 Speaker 1: a lot of female athletes may have been diagnosed, may 48 00:02:57,480 --> 00:02:59,679 Speaker 1: suspect that there's something else going on with the level 49 00:02:59,680 --> 00:03:01,960 Speaker 1: of pain they're experiencing with their periods. What are some 50 00:03:02,000 --> 00:03:06,040 Speaker 1: of the common management strategies used for painful periods and 51 00:03:06,080 --> 00:03:08,079 Speaker 1: potentially endometriosis. 52 00:03:09,600 --> 00:03:13,640 Speaker 2: So the gold standard for the treatment of endometriosis is 53 00:03:14,280 --> 00:03:18,560 Speaker 2: to do what's called a laparoscopy and to remove all 54 00:03:18,680 --> 00:03:22,960 Speaker 2: visible disease and then to do something to stop to 55 00:03:23,000 --> 00:03:26,600 Speaker 2: minimize the risk that endometriosis will reproliferate. And the most 56 00:03:26,720 --> 00:03:30,840 Speaker 2: common modality there would be something called the marina. It's 57 00:03:31,200 --> 00:03:35,160 Speaker 2: a device you can put inside the uterus which releases progesterone. 58 00:03:35,600 --> 00:03:40,000 Speaker 2: Another alternative would be the oral contraceptive pill. But I 59 00:03:40,120 --> 00:03:45,040 Speaker 2: fully recognize that female elite athletes are tied down to 60 00:03:46,520 --> 00:03:50,440 Speaker 2: a competing schedule and a type training schedule, and they 61 00:03:50,440 --> 00:03:55,880 Speaker 2: can't always take time out to have a laparoscopy. So 62 00:03:56,600 --> 00:03:59,640 Speaker 2: short of that and this is not the gold standard, 63 00:03:59,640 --> 00:04:02,040 Speaker 2: but I think think in the interests of managing the 64 00:04:02,080 --> 00:04:08,800 Speaker 2: symptoms in the meantime, the oral contraceptive pill would be 65 00:04:08,920 --> 00:04:12,840 Speaker 2: an ideal way to result in a regular cycle and 66 00:04:12,880 --> 00:04:16,400 Speaker 2: to make periods lighter and less painful, and possibly to 67 00:04:16,480 --> 00:04:22,120 Speaker 2: minimize the risk that endometriosis will continue to proliferate. The 68 00:04:22,200 --> 00:04:24,760 Speaker 2: other modality would be to just put in what as 69 00:04:24,760 --> 00:04:27,880 Speaker 2: I referred to before the Marina. But I would stress 70 00:04:28,040 --> 00:04:32,200 Speaker 2: that it's a temporary procedure if you have significant endometriosis 71 00:04:32,560 --> 00:04:34,960 Speaker 2: that may help with the pain, but it's certainly not 72 00:04:35,120 --> 00:04:39,359 Speaker 2: a cure or a treatment that I would advocate in 73 00:04:39,360 --> 00:04:40,200 Speaker 2: the long term. 74 00:04:40,560 --> 00:04:43,320 Speaker 1: Yeah, and even in my personal experience, I've been on 75 00:04:43,360 --> 00:04:46,080 Speaker 1: the contraceptive pill to help try and manage some of 76 00:04:46,120 --> 00:04:48,000 Speaker 1: that pain, and then I've had periods of time coming 77 00:04:48,080 --> 00:04:51,120 Speaker 1: off the pill and it's almost sometimes working out is 78 00:04:51,160 --> 00:04:53,960 Speaker 1: this something that I want to do if it's not 79 00:04:54,080 --> 00:04:58,200 Speaker 1: the best option in a way. 80 00:04:58,839 --> 00:05:01,760 Speaker 2: And clearly you have a come into the category of 81 00:05:01,800 --> 00:05:05,039 Speaker 2: having a very tight schedule and just can't drop everything 82 00:05:05,320 --> 00:05:09,279 Speaker 2: to commit to a laparoscopy and the recovery time involved. 83 00:05:10,600 --> 00:05:13,039 Speaker 2: This is a conversation that I often have with women, 84 00:05:13,400 --> 00:05:17,520 Speaker 2: and sometimes there's no perfect solution. It's sometimes a matter 85 00:05:17,560 --> 00:05:20,599 Speaker 2: of looking at how do you feel on the pill, 86 00:05:21,160 --> 00:05:23,880 Speaker 2: and how do you feel off the pill? What side 87 00:05:23,920 --> 00:05:26,800 Speaker 2: effects are you experiencing on the pill? How well is 88 00:05:26,839 --> 00:05:29,839 Speaker 2: it controlling your pain? And it may be necessary to 89 00:05:29,880 --> 00:05:33,599 Speaker 2: take additional analgesia such as panidol or some form of 90 00:05:33,600 --> 00:05:37,880 Speaker 2: a nonsteroidal sorry, when you're off the pill, how do 91 00:05:37,920 --> 00:05:42,560 Speaker 2: you feel off the pill and how how is the 92 00:05:42,560 --> 00:05:48,080 Speaker 2: pain going? The pill is a very safe and effective modality, 93 00:05:48,360 --> 00:05:50,600 Speaker 2: and I would say to you, if it's making your 94 00:05:50,600 --> 00:05:53,359 Speaker 2: life easier, you go with the pill. 95 00:05:54,760 --> 00:05:57,479 Speaker 1: Putting the pill to the side for a second. Is 96 00:05:57,520 --> 00:06:03,520 Speaker 1: it normal for female athletes to miss the period. 97 00:06:02,360 --> 00:06:05,560 Speaker 2: So we're now talking about women who aren't on the pill. Yes, 98 00:06:05,600 --> 00:06:09,880 Speaker 2: it is very common. So the medical term for that, 99 00:06:10,800 --> 00:06:13,839 Speaker 2: it's a long word. It's called hypothalamic amen area. But 100 00:06:13,880 --> 00:06:17,000 Speaker 2: in simple terms, what that means is whenever you put 101 00:06:17,000 --> 00:06:21,960 Speaker 2: your body under stress, physical or emotional stress, your ovaries 102 00:06:22,000 --> 00:06:25,800 Speaker 2: can shut down so they don't release an egg every month. 103 00:06:26,400 --> 00:06:30,200 Speaker 2: And that's more likely to happen to elite athletes who 104 00:06:30,800 --> 00:06:33,720 Speaker 2: have doing a lot of high intensity exercise and who 105 00:06:33,760 --> 00:06:38,440 Speaker 2: probably have a lower body mass index. One figure that 106 00:06:38,480 --> 00:06:43,320 Speaker 2: I've come across is that in sixty five its ovulatory 107 00:06:43,720 --> 00:06:46,120 Speaker 2: disorders are seen in up to sixty five percent of 108 00:06:46,120 --> 00:06:51,160 Speaker 2: long distance runners, compared to about five percent of the population. 109 00:06:52,160 --> 00:06:56,840 Speaker 1: It's quite a significant number. Yeah, And is it something 110 00:06:56,880 --> 00:07:00,479 Speaker 1: do you think that you probably can't come on behalf 111 00:07:00,520 --> 00:07:02,520 Speaker 1: of athletes, But is it something do you think sometimes 112 00:07:02,520 --> 00:07:05,120 Speaker 1: that athletes might normalize it. I'm just having a really 113 00:07:05,200 --> 00:07:06,720 Speaker 1: heavy training bloss Sure. 114 00:07:06,680 --> 00:07:12,000 Speaker 2: I'm sure that's the case. We became aware of a 115 00:07:12,080 --> 00:07:20,640 Speaker 2: swimmer who contacted our inquiry line after the alliance the 116 00:07:20,680 --> 00:07:25,200 Speaker 2: partnership was announced with monash IVF who basically indicated, now 117 00:07:25,280 --> 00:07:27,640 Speaker 2: she understands why she wasn't getting periods, and it was 118 00:07:27,840 --> 00:07:32,160 Speaker 2: the high level of intense exercise. She normalized it, and 119 00:07:32,200 --> 00:07:36,240 Speaker 2: there absolutely was a reason for it. Look, the thing 120 00:07:36,280 --> 00:07:38,000 Speaker 2: that I might go on to say is if you're 121 00:07:38,000 --> 00:07:41,240 Speaker 2: not getting periods, clearly that's going to have a knock 122 00:07:41,280 --> 00:07:42,640 Speaker 2: on effect for fertility. 123 00:07:43,000 --> 00:07:44,120 Speaker 3: But the second thing. 124 00:07:44,160 --> 00:07:48,200 Speaker 2: Will be if you've got low estrogen, that's going to 125 00:07:48,280 --> 00:07:50,640 Speaker 2: have a knock on effect for bone density in the 126 00:07:50,640 --> 00:07:55,200 Speaker 2: long term and the risk of osteopenia thinning of the 127 00:07:55,240 --> 00:07:58,760 Speaker 2: bones leading onto osteoporosis is something you need to think about. 128 00:07:59,160 --> 00:08:02,200 Speaker 2: That would be another reason to have some form of 129 00:08:02,400 --> 00:08:06,120 Speaker 2: estrogen replacement, just low those in the term the form 130 00:08:06,120 --> 00:08:08,640 Speaker 2: of the oral contraceptive pill and vitamin D. 131 00:08:10,040 --> 00:08:14,400 Speaker 1: Looking at fertility and athletes, we're starting to see a 132 00:08:14,480 --> 00:08:18,600 Speaker 1: number of athletes progress further into their career with different 133 00:08:18,640 --> 00:08:23,080 Speaker 1: advancements in science and technology and probably challenging stereotypes in 134 00:08:23,080 --> 00:08:26,000 Speaker 1: a way around how long women can be playing professional sport. 135 00:08:26,040 --> 00:08:29,000 Speaker 1: We're seeing the emergence of a number of professional leagues 136 00:08:29,040 --> 00:08:34,120 Speaker 1: domestically and expansion of global leagues. How do you see 137 00:08:34,160 --> 00:08:37,680 Speaker 1: it looking for women playing sport for longer having to 138 00:08:37,720 --> 00:08:40,000 Speaker 1: factor in the fertility conversation. 139 00:08:41,240 --> 00:08:44,440 Speaker 2: Look, the fertility conversation needs to be a conversation that 140 00:08:44,720 --> 00:08:46,840 Speaker 2: is had that That's really all I can say there. 141 00:08:47,440 --> 00:08:52,480 Speaker 2: It's absolutely wonderful that women are now in a position 142 00:08:53,160 --> 00:08:58,720 Speaker 2: to play their sport longer, their chosen career if you like, 143 00:09:00,160 --> 00:09:04,400 Speaker 2: because of you know, recognition of pay and everything. 144 00:09:05,200 --> 00:09:07,360 Speaker 3: But there needs to be support around that. 145 00:09:10,240 --> 00:09:13,400 Speaker 2: I feel this alliance with Monash is a step in 146 00:09:13,400 --> 00:09:16,839 Speaker 2: the right direction, but the sporting codes need to step 147 00:09:16,920 --> 00:09:22,240 Speaker 2: up as well. There needs to be discussion around the 148 00:09:22,280 --> 00:09:25,240 Speaker 2: recognition that some women are again to have problems falling pregnant, 149 00:09:25,280 --> 00:09:29,120 Speaker 2: particularly athletes who may be away from home at a 150 00:09:29,160 --> 00:09:31,640 Speaker 2: time that they're ovulating, who may be overseas for long 151 00:09:31,679 --> 00:09:37,160 Speaker 2: periods of time, who may have physical consequences of their 152 00:09:37,160 --> 00:09:40,559 Speaker 2: sport leading to ovulatory problems where they're going to have 153 00:09:40,600 --> 00:09:47,280 Speaker 2: difficulty conceiving. Quite apart from the other factors that women experience, 154 00:09:47,320 --> 00:09:51,559 Speaker 2: such as endometriosis, athletes will experience all of that as well. 155 00:09:52,520 --> 00:09:55,439 Speaker 2: There just needs to be more recognition around that. 156 00:09:56,520 --> 00:09:59,440 Speaker 1: When we post content on our social channels on the 157 00:09:59,440 --> 00:10:03,400 Speaker 1: Female Applet Project around female athletes and fertility, there's often 158 00:10:03,400 --> 00:10:05,480 Speaker 1: a couple of people in the comment sections who are 159 00:10:05,520 --> 00:10:07,560 Speaker 1: just like, well, you can just freeze your eggs, almost 160 00:10:07,600 --> 00:10:10,400 Speaker 1: as if it's this real guarantee that the second you've 161 00:10:10,440 --> 00:10:13,280 Speaker 1: retire from sport, you can just get pregnant using your 162 00:10:13,280 --> 00:10:14,120 Speaker 1: frozen eggs. 163 00:10:14,160 --> 00:10:16,280 Speaker 3: Can you touch on absolutely. 164 00:10:16,840 --> 00:10:21,440 Speaker 2: I'm a big advocate of egg freezing, a really big 165 00:10:21,480 --> 00:10:27,000 Speaker 2: advocate of egg freezing. The technology of surrounding egg freezing 166 00:10:27,000 --> 00:10:30,920 Speaker 2: has improved dramatically in the last ten years, and it 167 00:10:31,040 --> 00:10:35,600 Speaker 2: really is a vible option for young women to preserve fertility. 168 00:10:35,760 --> 00:10:39,680 Speaker 2: But I have to say it's a good insurance policy, 169 00:10:39,720 --> 00:10:44,400 Speaker 2: but it's not a guarantee of pregnancy. And for a 170 00:10:44,440 --> 00:10:48,760 Speaker 2: woman in her thirties, if I did one egg collection, 171 00:10:48,960 --> 00:10:51,880 Speaker 2: roughly the statistics would be about a thirty percent chance 172 00:10:51,920 --> 00:10:55,319 Speaker 2: of a pregnancy afterwards, and that's without me knowing anything 173 00:10:55,360 --> 00:10:58,600 Speaker 2: about her blood results and her are Verian reserve. So 174 00:10:58,640 --> 00:11:00,880 Speaker 2: I'd normally say, have it in your mind that you'll 175 00:11:00,880 --> 00:11:05,440 Speaker 2: have to egg collections? And do you think there's certain 176 00:11:05,520 --> 00:11:09,040 Speaker 2: conversations that can be had. You've touched on a couple 177 00:11:09,080 --> 00:11:11,559 Speaker 2: of times that partnership between mon Ash IVF and the 178 00:11:11,600 --> 00:11:14,280 Speaker 2: Australian Athletes Alliance, which I think is so important for 179 00:11:14,320 --> 00:11:17,319 Speaker 2: the education piece. That egg freezing piece is obviously a 180 00:11:17,320 --> 00:11:21,520 Speaker 2: big part of that as well. Right, No, definitely, because look, 181 00:11:22,040 --> 00:11:26,480 Speaker 2: egg freezing and embryo freezing. If women are in a 182 00:11:26,520 --> 00:11:31,760 Speaker 2: situation to do that, that's really what we've got. If 183 00:11:31,880 --> 00:11:35,040 Speaker 2: they make if a woman makes the decision to put 184 00:11:35,040 --> 00:11:39,280 Speaker 2: off fertility, have some sort of an insurance policy, and 185 00:11:39,600 --> 00:11:41,120 Speaker 2: that's the best one that we've got. 186 00:11:41,640 --> 00:11:44,360 Speaker 1: I'd love to jump into some of the anonymous questions 187 00:11:44,360 --> 00:11:48,480 Speaker 1: that I've been submitted. I love you've got some notes 188 00:11:48,520 --> 00:11:52,920 Speaker 1: prepared I'm looking forward to these. So how can female 189 00:11:52,960 --> 00:11:56,520 Speaker 1: athletes use knowledge of their cycle to improve their performance? 190 00:11:57,880 --> 00:12:00,240 Speaker 3: So there really is there. 191 00:12:00,720 --> 00:12:04,800 Speaker 2: There's such a lack of research regarding female elite athletes 192 00:12:05,480 --> 00:12:11,760 Speaker 2: and fertility, their cycle, pregnancy and the postpartum period. But 193 00:12:11,840 --> 00:12:16,360 Speaker 2: to focus on their cycle, there was some work done 194 00:12:16,559 --> 00:12:21,600 Speaker 2: by the doctor of the Women's Cricket Association getting women 195 00:12:21,760 --> 00:12:24,080 Speaker 2: to chart their cycle, and I now believe that other 196 00:12:24,200 --> 00:12:28,119 Speaker 2: sporting codes are doing that and in terms of measuring 197 00:12:28,440 --> 00:12:33,120 Speaker 2: their performance, but I haven't seen any results. So I 198 00:12:33,160 --> 00:12:37,240 Speaker 2: can't answer this question in using scientific knowledge. 199 00:12:37,520 --> 00:12:39,600 Speaker 3: But if I looked at it logically. 200 00:12:40,480 --> 00:12:43,360 Speaker 2: My answer would be what are the negative factors of 201 00:12:43,400 --> 00:12:47,119 Speaker 2: a cycle and and how that may detract from performance 202 00:12:47,200 --> 00:12:49,360 Speaker 2: and how can we overcome that? And the first one 203 00:12:49,400 --> 00:12:53,960 Speaker 2: that comes to mind is PMS pre menstrual symptoms, which 204 00:12:54,040 --> 00:13:00,959 Speaker 2: are unfortunately very common. Women can experience bloating, breast tenderness, depression, 205 00:13:01,160 --> 00:13:05,000 Speaker 2: lack of drive in the days before their menstrual cycle starts. 206 00:13:05,840 --> 00:13:09,680 Speaker 2: I believe that PMS is poorly understood and poorly treated, 207 00:13:10,600 --> 00:13:16,839 Speaker 2: but various modalities to address it would be Now I'm 208 00:13:16,840 --> 00:13:18,760 Speaker 2: going to say this is to look at your diet 209 00:13:18,800 --> 00:13:22,439 Speaker 2: to avoid caffeine and chocolate because that's known to exacerbate it. 210 00:13:22,559 --> 00:13:24,880 Speaker 2: Maybe this is something that the female lead athletes are 211 00:13:24,920 --> 00:13:28,280 Speaker 2: already avoiding to try and plan their day to avoid 212 00:13:28,320 --> 00:13:31,440 Speaker 2: stressful decisions. Well, that's going to be difficult because they're 213 00:13:31,480 --> 00:13:39,000 Speaker 2: already committed to a tight schedule. Probably the oral contraceptive 214 00:13:39,080 --> 00:13:42,880 Speaker 2: pill again, and the mechanism of action is just thought 215 00:13:42,920 --> 00:13:45,160 Speaker 2: to be it dampens down to all their hormones and 216 00:13:45,200 --> 00:13:47,480 Speaker 2: they're not exposed to the ups and downs of the 217 00:13:47,480 --> 00:13:48,800 Speaker 2: hormones so much. 218 00:13:50,960 --> 00:13:53,120 Speaker 3: The second negative. 219 00:13:52,640 --> 00:13:55,640 Speaker 2: Impact of a menstrual cycle on performance is going to 220 00:13:55,640 --> 00:13:59,520 Speaker 2: be if you've got severe period pain, if it's endometriosis, 221 00:13:59,679 --> 00:14:04,120 Speaker 2: have it assist, you know, a detailed but biogynecologist who 222 00:14:04,200 --> 00:14:09,439 Speaker 2: knows about it, a detailed history, a detailed imaging if necessary, 223 00:14:09,679 --> 00:14:16,720 Speaker 2: discussion on a laparoscopy, and I think and with you know, 224 00:14:16,840 --> 00:14:20,320 Speaker 2: hormonal manipulation afterwards to minimize the risk of it coming back, 225 00:14:20,360 --> 00:14:23,920 Speaker 2: so a marina or the oral contraceptive pill. And I 226 00:14:23,960 --> 00:14:27,640 Speaker 2: think that the very sad thing here is that it 227 00:14:28,080 --> 00:14:32,560 Speaker 2: is acceptable to say I've got an ACL injury or 228 00:14:32,920 --> 00:14:37,920 Speaker 2: I've I've got some other physical injury I can't perform, 229 00:14:37,960 --> 00:14:40,800 Speaker 2: but if you say I've got severe period pain and 230 00:14:40,840 --> 00:14:44,600 Speaker 2: that's going to affect my performance, there would be a 231 00:14:44,600 --> 00:14:47,160 Speaker 2: lot of concern about how the response to. 232 00:14:47,160 --> 00:14:47,720 Speaker 3: That would be. 233 00:14:47,960 --> 00:14:51,880 Speaker 2: And it shouldn't be like that. Female elite athletes are 234 00:14:51,920 --> 00:14:53,520 Speaker 2: going to have that problem and should be in a 235 00:14:53,520 --> 00:14:57,440 Speaker 2: position where they can talk to someone about it in 236 00:14:57,560 --> 00:14:59,680 Speaker 2: an open forum and feel comfortable. 237 00:15:00,120 --> 00:15:03,840 Speaker 1: Yeah, And unfortunately that's something I've experienced personally myself, that 238 00:15:03,880 --> 00:15:07,120 Speaker 1: feeling of not feeling like I would be validated and 239 00:15:07,160 --> 00:15:09,320 Speaker 1: heard and understood. And a lot of the time in 240 00:15:09,360 --> 00:15:13,760 Speaker 1: a sporting environment, because there's not great pathways yet around 241 00:15:13,760 --> 00:15:15,840 Speaker 1: coaching and strength and conditioning, a lot of the time 242 00:15:15,920 --> 00:15:18,840 Speaker 1: that conversation is being had with a male staff member. Yeah, 243 00:15:19,480 --> 00:15:23,120 Speaker 1: that can put further barriers in place for a female 244 00:15:23,120 --> 00:15:26,280 Speaker 1: athlete to feel comfortable to have those conversations. And something 245 00:15:26,520 --> 00:15:29,160 Speaker 1: I've touched on in the past is my club at 246 00:15:29,160 --> 00:15:32,720 Speaker 1: GWS and now making sure that all the male staff 247 00:15:32,800 --> 00:15:36,400 Speaker 1: participate in our education sessions around women's health and fertility. 248 00:15:36,640 --> 00:15:38,560 Speaker 3: Double thumbs up, double thumbs up. 249 00:15:39,920 --> 00:15:44,680 Speaker 1: Love that. I love that onto. The next question is 250 00:15:44,720 --> 00:15:46,960 Speaker 1: an interesting one. Not to sound like this question is 251 00:15:47,000 --> 00:15:49,800 Speaker 1: from the eighteen hundreds, but is there any heightened risk 252 00:15:49,960 --> 00:15:53,440 Speaker 1: to our reproductive organs when playing contact sports which involve 253 00:15:53,520 --> 00:15:55,200 Speaker 1: tackles or kicks to the stomach. 254 00:15:56,040 --> 00:16:00,520 Speaker 2: So, firstly, every question is valid, and this is not 255 00:16:00,560 --> 00:16:04,160 Speaker 2: from the eighteen hundreds. Clearly, I understand if you were 256 00:16:04,160 --> 00:16:06,800 Speaker 2: playing a contact sport, it'd be something you would worry about. 257 00:16:06,840 --> 00:16:10,920 Speaker 2: Am I doing damage? I cannot think of any conceivable 258 00:16:10,960 --> 00:16:15,040 Speaker 2: way that you could damage the uterus tubes or ovaries 259 00:16:17,000 --> 00:16:20,440 Speaker 2: by repeated tackles or kicks to the stomach. I mean 260 00:16:20,480 --> 00:16:22,720 Speaker 2: you could damage other organs which are very close to 261 00:16:22,760 --> 00:16:25,920 Speaker 2: the surface, but not the uterus tubes and ovaries. 262 00:16:26,240 --> 00:16:29,760 Speaker 1: As someone with endometriosis, is there anything I can do 263 00:16:29,920 --> 00:16:32,920 Speaker 1: to minimize the effects of ENDO on my exercise or 264 00:16:32,960 --> 00:16:34,200 Speaker 1: sport experiences. 265 00:16:35,720 --> 00:16:38,160 Speaker 2: Yeah, my answer to that is going to be to 266 00:16:39,840 --> 00:16:43,680 Speaker 2: address the pain. And I may be repeating an answer 267 00:16:43,720 --> 00:16:48,200 Speaker 2: that I've given earlier. There are non invasive modalities to 268 00:16:48,280 --> 00:16:51,160 Speaker 2: address the pain, and that would be taking the r 269 00:16:51,280 --> 00:16:56,720 Speaker 2: contraceptive pill on a continuous basis, or the Marina intriuterine 270 00:16:56,720 --> 00:17:00,400 Speaker 2: device which releases progesterone. But I have to stress the 271 00:17:00,560 --> 00:17:05,680 Speaker 2: gold standard for managing and demetriosis is to do a 272 00:17:05,760 --> 00:17:11,520 Speaker 2: laparoscopy and definitively remove all visible disease, and then a 273 00:17:11,600 --> 00:17:14,359 Speaker 2: second modality to minimize the risk of it coming back. 274 00:17:14,440 --> 00:17:17,440 Speaker 2: Either the marina or the oral contraceptive PILM. 275 00:17:17,520 --> 00:17:21,040 Speaker 1: Are steps being taken to address medical misogyny. 276 00:17:22,240 --> 00:17:25,040 Speaker 2: I'm uncertain about what medical misogyny means, and I can 277 00:17:25,080 --> 00:17:30,159 Speaker 2: only imagine it was older gynecologists in years gone by saying, 278 00:17:30,520 --> 00:17:34,080 Speaker 2: there you go, lovey, dearie, period pains normal. You just 279 00:17:34,119 --> 00:17:36,600 Speaker 2: put up with it, have a baby, and it'll go away. 280 00:17:37,040 --> 00:17:41,800 Speaker 2: And that is not our current thinking, not at all. 281 00:17:41,840 --> 00:17:44,960 Speaker 2: We have definitely grown in our understanding of what causes 282 00:17:45,000 --> 00:17:48,600 Speaker 2: period pain. There is so much research going into it, 283 00:17:49,320 --> 00:17:53,919 Speaker 2: and I can say personally, I've done laparoscopy now for 284 00:17:53,960 --> 00:17:57,439 Speaker 2: twenty five years, and I have learned over that time 285 00:17:58,119 --> 00:18:02,159 Speaker 2: that we need to become even more aggressive in our 286 00:18:02,200 --> 00:18:06,760 Speaker 2: management of endometriosis. There would be too many times where 287 00:18:06,760 --> 00:18:09,359 Speaker 2: a woman says, I've got pain on the left side, 288 00:18:09,400 --> 00:18:12,200 Speaker 2: and when you look leproscopically, it looks normal. But you 289 00:18:12,320 --> 00:18:15,400 Speaker 2: remove the area, it treats her pain and it comes 290 00:18:15,400 --> 00:18:19,840 Speaker 2: back as endometriosis. And you know, when I was doing 291 00:18:19,880 --> 00:18:21,840 Speaker 2: my training, I would have been taught to leave that 292 00:18:23,200 --> 00:18:27,919 Speaker 2: but that's how my approach to endometriosis has has changed 293 00:18:27,960 --> 00:18:31,360 Speaker 2: over twenty five years. And I would say as a 294 00:18:31,640 --> 00:18:35,400 Speaker 2: as a group of gynecologists, we are growing in our 295 00:18:35,520 --> 00:18:40,960 Speaker 2: understanding of endometriosis and how it's treated, and even so 296 00:18:41,080 --> 00:18:44,640 Speaker 2: much research going into it, looking at other medical modalities 297 00:18:44,720 --> 00:18:49,200 Speaker 2: to treat it, something called estrogen receptor modulators, which opens 298 00:18:49,280 --> 00:18:53,480 Speaker 2: up a whole new area. But the future, the future 299 00:18:53,640 --> 00:18:56,600 Speaker 2: is looking bright. We haven't got there yet. We've still 300 00:18:56,600 --> 00:18:57,520 Speaker 2: got a long way to go. 301 00:18:58,160 --> 00:19:00,439 Speaker 1: It's really interesting just hearing your touch on that idea 302 00:19:00,920 --> 00:19:04,000 Speaker 1: around how you've developed over that time, and even for 303 00:19:04,080 --> 00:19:07,440 Speaker 1: me going through this process. I haven't been diagnosed with endometriosis, 304 00:19:07,480 --> 00:19:11,359 Speaker 1: but I experience significant pain and I've had internal ultrasounds 305 00:19:11,400 --> 00:19:13,720 Speaker 1: done and it's a horrible feeling to walk away and 306 00:19:13,760 --> 00:19:15,520 Speaker 1: someone saying we can't see anything. 307 00:19:16,400 --> 00:19:19,240 Speaker 2: So this is a story I hear every day of 308 00:19:19,280 --> 00:19:22,680 Speaker 2: my life. Yeah, the vast majority of women I see 309 00:19:22,720 --> 00:19:27,440 Speaker 2: with endometriosis have a completely normal ultrasound, And that doesn't 310 00:19:27,520 --> 00:19:30,040 Speaker 2: mean that they haven't got it. That just means that 311 00:19:30,160 --> 00:19:34,120 Speaker 2: the non invasive imaging techniques that we've got, which are limited, 312 00:19:34,320 --> 00:19:38,280 Speaker 2: won't pick it up. Look, we've never we know that 313 00:19:39,320 --> 00:19:44,320 Speaker 2: a laparoscopy with definitive treatment of endometriosis and a hysteroscopy 314 00:19:44,320 --> 00:19:47,400 Speaker 2: which means looking inside the uterus, will have a positive 315 00:19:47,440 --> 00:19:51,520 Speaker 2: impact on natural fertility. We've never shown that it improves 316 00:19:51,520 --> 00:19:55,679 Speaker 2: the successive IVF. That doesn't mean that it doesn't, but 317 00:19:55,760 --> 00:19:58,560 Speaker 2: we've never shown that it does as a And there's 318 00:19:58,600 --> 00:20:04,520 Speaker 2: also no international accepted indications for doing a laparoscopy before 319 00:20:04,560 --> 00:20:09,119 Speaker 2: you do fertility treatment. But my own personal feeling would be, 320 00:20:09,720 --> 00:20:13,120 Speaker 2: if you've got assist on your ovaries dud to endometriosis, 321 00:20:14,080 --> 00:20:16,600 Speaker 2: I would do a laparoscopy and fix that up. And 322 00:20:16,680 --> 00:20:21,040 Speaker 2: I stress paying particular attention to preserving normal ovarian tissue 323 00:20:22,040 --> 00:20:26,000 Speaker 2: because that is critical for fertility. Clearly, that will improve 324 00:20:26,040 --> 00:20:29,120 Speaker 2: my ability to stimulate the ovaries and minimize the risk 325 00:20:29,200 --> 00:20:33,800 Speaker 2: of infection. Two, if a woman has significant pain, there 326 00:20:33,880 --> 00:20:36,960 Speaker 2: is the risk that IVF will exacerbate that and make 327 00:20:37,040 --> 00:20:39,480 Speaker 2: it worse, So that would be a discussion that I 328 00:20:39,480 --> 00:20:44,320 Speaker 2: would have before. Three would be a woman who doesn't 329 00:20:44,320 --> 00:20:47,680 Speaker 2: want to take hormones and is in a situation where 330 00:20:47,720 --> 00:20:50,119 Speaker 2: she could conceive naturally, so we would talk about the 331 00:20:50,200 --> 00:20:56,439 Speaker 2: role for a laparoscopy and four would be if whatever 332 00:20:56,480 --> 00:20:58,280 Speaker 2: you do doesn't work, you have to come back to 333 00:20:58,320 --> 00:21:00,600 Speaker 2: what I call the drawing board and perhaps consider a 334 00:21:00,640 --> 00:21:03,399 Speaker 2: new direction. If you've done two cycles of IVF and 335 00:21:03,440 --> 00:21:07,000 Speaker 2: it hasn't worked, you need to talk about a laparoscopy. 336 00:21:07,320 --> 00:21:10,080 Speaker 2: You don't have endless cycles before you think what else 337 00:21:10,119 --> 00:21:11,000 Speaker 2: could I have done? 338 00:21:11,600 --> 00:21:15,160 Speaker 1: And I think you've actually answered a question that had 339 00:21:15,160 --> 00:21:20,120 Speaker 1: been submitted. I think it was this one. And I've 340 00:21:20,160 --> 00:21:24,160 Speaker 1: recently been diagnosed with deeply invasive endometriosis DIE. We're wanting 341 00:21:24,200 --> 00:21:26,439 Speaker 1: to start a family as the same sex couple with 342 00:21:26,480 --> 00:21:28,840 Speaker 1: me going through the IVF process. My doctor has said 343 00:21:28,880 --> 00:21:31,480 Speaker 1: we should try IVF prior to surgery, but also said 344 00:21:31,480 --> 00:21:33,200 Speaker 1: we could look at surgery to try and remove the 345 00:21:33,320 --> 00:21:35,960 Speaker 1: end doough Is there any evidence of going straight to 346 00:21:36,000 --> 00:21:38,880 Speaker 1: IVF over surgery for ENDO? Or is the surgery likely 347 00:21:38,880 --> 00:21:41,880 Speaker 1: to help the IVF process? But surgery pre IVF also 348 00:21:41,920 --> 00:21:44,280 Speaker 1: means a longer wait to start the IVF process. So 349 00:21:44,320 --> 00:21:46,800 Speaker 1: you've kind of already answered that one, haven't you. There. 350 00:21:47,160 --> 00:21:51,840 Speaker 2: Yeah, No, there's no scientific evidence. That may be a 351 00:21:51,880 --> 00:21:55,680 Speaker 2: limitation of the research that's being done. It doesn't mean 352 00:21:55,680 --> 00:21:57,919 Speaker 2: that it doesn't improve the success, but we don't have 353 00:21:58,000 --> 00:21:59,280 Speaker 2: that scientific evidence. 354 00:21:59,760 --> 00:22:03,320 Speaker 1: This person has asked, how can we promote fertility education 355 00:22:03,480 --> 00:22:06,560 Speaker 1: to women earlier? As an educator, I see my students 356 00:22:06,600 --> 00:22:09,960 Speaker 1: exposed to safe sex practices to avoid pregnancy, but no 357 00:22:10,040 --> 00:22:13,520 Speaker 1: current opportunity to empower young women with knowledge that may 358 00:22:13,600 --> 00:22:17,560 Speaker 1: support proactive decisions in regard to having or planning to 359 00:22:17,600 --> 00:22:19,600 Speaker 1: have children. 360 00:22:19,320 --> 00:22:23,480 Speaker 2: And clearly, teenagers and women in their twenties we talk 361 00:22:23,520 --> 00:22:27,000 Speaker 2: about contraception and suddenly they get into their thirties and 362 00:22:27,080 --> 00:22:28,640 Speaker 2: we say, you've got to get pregnant now. 363 00:22:28,680 --> 00:22:30,119 Speaker 3: Did we not tell you that before? 364 00:22:31,480 --> 00:22:36,560 Speaker 2: It can only be with programs in schools, and there 365 00:22:36,640 --> 00:22:39,480 Speaker 2: are with all this research that's being done, there's a 366 00:22:39,480 --> 00:22:42,960 Speaker 2: lot of research that's being done in period problems in 367 00:22:43,040 --> 00:22:45,960 Speaker 2: teenagers and that is going out into the schools. And 368 00:22:46,000 --> 00:22:49,639 Speaker 2: I can tell you with my personal involvement with the 369 00:22:49,680 --> 00:22:52,359 Speaker 2: school nearby, they are learning about endometriosis. 370 00:22:52,600 --> 00:22:55,800 Speaker 3: And you know that is one thing that. 371 00:22:57,440 --> 00:22:59,879 Speaker 2: I thought, well, I could contribute to that conversation for 372 00:23:00,400 --> 00:23:05,480 Speaker 2: it's education in schools and bringing up the discussion on 373 00:23:05,560 --> 00:23:10,360 Speaker 2: fertility that it doesn't last forever. I think the second 374 00:23:10,520 --> 00:23:16,360 Speaker 2: way is really what we're achieving through the Australian Athletes 375 00:23:16,400 --> 00:23:20,560 Speaker 2: Alliance and monosh ivf to educate and empower women to 376 00:23:20,640 --> 00:23:24,000 Speaker 2: help them better understand their reproductive health, why they might 377 00:23:24,040 --> 00:23:30,040 Speaker 2: be experiencing menstrual irregularities or period pain and what can 378 00:23:30,080 --> 00:23:33,000 Speaker 2: be done about it, and empowering them to make decisions 379 00:23:34,200 --> 00:23:36,560 Speaker 2: to help them achieve a baby now or in the 380 00:23:36,600 --> 00:23:39,760 Speaker 2: future if they want to really to in align with 381 00:23:39,840 --> 00:23:41,120 Speaker 2: what their plans might be. 382 00:23:42,040 --> 00:23:46,840 Speaker 1: This person has asked, I'm thirty three and made the 383 00:23:46,840 --> 00:23:49,760 Speaker 1: decision to freeze my eggs two years ago after receiving 384 00:23:49,800 --> 00:23:53,879 Speaker 1: a low AMH of twelve. If women want children, how 385 00:23:53,960 --> 00:23:56,879 Speaker 1: much should we respond to our AMH scores. I know 386 00:23:56,960 --> 00:24:00,000 Speaker 1: people who have actively started trying to have children because 387 00:24:00,080 --> 00:24:02,280 Speaker 1: they had a low score, and we're told they would 388 00:24:02,280 --> 00:24:04,960 Speaker 1: struggle to get pregnant. Then many of them have had 389 00:24:05,000 --> 00:24:07,679 Speaker 1: little trouble getting pregnant. While I acknowledge that there are 390 00:24:07,680 --> 00:24:11,520 Speaker 1: individual factors that impact conception, I've seen this score put 391 00:24:11,560 --> 00:24:13,639 Speaker 1: a lot of pressure and stress on my friends. It 392 00:24:13,680 --> 00:24:16,000 Speaker 1: doesn't seem to be the most reliable measure to help 393 00:24:16,080 --> 00:24:17,440 Speaker 1: us plan for our future. 394 00:24:18,359 --> 00:24:22,760 Speaker 2: So firstly, you can plot AMH anti malarian hormone out 395 00:24:23,040 --> 00:24:26,600 Speaker 2: against age and twelve at the age of thirty three 396 00:24:26,600 --> 00:24:29,720 Speaker 2: would actually come within the normal range. I even think 397 00:24:30,040 --> 00:24:31,760 Speaker 2: off the top of my head it might even be 398 00:24:31,800 --> 00:24:36,879 Speaker 2: around the fiftieth percentile. AMH is not the new black 399 00:24:36,960 --> 00:24:41,639 Speaker 2: of fertility investigations. It's not a standalone investigation. It's important. 400 00:24:42,280 --> 00:24:46,120 Speaker 2: It tells me how you're overian reserve or the number 401 00:24:46,119 --> 00:24:49,000 Speaker 2: of eggs you have left plots out against a group 402 00:24:49,000 --> 00:24:51,880 Speaker 2: of women who are a similar age. So it tells 403 00:24:51,960 --> 00:24:55,240 Speaker 2: me if you've got expected ovarian reserve or low. 404 00:24:56,160 --> 00:24:58,440 Speaker 3: But it's just part of the story. 405 00:24:59,040 --> 00:25:01,400 Speaker 2: It is part of the picture that we paint when 406 00:25:01,400 --> 00:25:04,040 Speaker 2: we do all the investigations to work out a women's 407 00:25:04,400 --> 00:25:10,480 Speaker 2: woman's individual fertility. Another important measure of overian reserve would 408 00:25:10,520 --> 00:25:13,760 Speaker 2: be an ultrasound to look at the ovaries, to look 409 00:25:13,960 --> 00:25:16,200 Speaker 2: at the number of what we call follicles. The egg 410 00:25:16,280 --> 00:25:20,879 Speaker 2: sit inside follicles, and the antial follical count is also 411 00:25:21,000 --> 00:25:25,640 Speaker 2: a critical measure of overian reserve. But having said all 412 00:25:25,680 --> 00:25:29,639 Speaker 2: of that, a woman's fertility is linked most closely to 413 00:25:29,720 --> 00:25:33,240 Speaker 2: her age, which means a woman in her twenties may 414 00:25:33,280 --> 00:25:36,600 Speaker 2: have lower veriin reserve, she may have a lower AMH 415 00:25:37,119 --> 00:25:40,120 Speaker 2: or angel follicle count, but she will still get pregnant 416 00:25:40,240 --> 00:25:43,639 Speaker 2: because she's young and she has good iverian reserve. A 417 00:25:43,680 --> 00:25:47,080 Speaker 2: woman in her late thirties or early forties will have 418 00:25:47,560 --> 00:25:53,080 Speaker 2: lower equality, and the additional impact of lower veriin reserve 419 00:25:53,280 --> 00:25:55,240 Speaker 2: is going to create is going to create a problem, 420 00:25:55,240 --> 00:25:57,320 Speaker 2: and she will struggle to get pregnant. 421 00:25:57,720 --> 00:26:01,080 Speaker 1: As a single queer female in her late twenties who's 422 00:26:01,119 --> 00:26:03,600 Speaker 1: been researching about having a baby on her own, I've 423 00:26:03,640 --> 00:26:06,400 Speaker 1: seen so much about what types of procedures there are, 424 00:26:06,440 --> 00:26:09,320 Speaker 1: but never enough about how to start the whole process, 425 00:26:09,680 --> 00:26:11,480 Speaker 1: even down to what I should be looking for in 426 00:26:11,520 --> 00:26:14,280 Speaker 1: clinics or red flags. Is there's some advice you could 427 00:26:14,320 --> 00:26:16,399 Speaker 1: offer on this. The internet is still just full of 428 00:26:16,520 --> 00:26:19,359 Speaker 1: articles of couples, with only a small part for single 429 00:26:19,400 --> 00:26:23,280 Speaker 1: women or anyone who doesn't fit a standard nuclear family ideal. 430 00:26:24,040 --> 00:26:25,879 Speaker 3: So that is a wonderful question. 431 00:26:27,200 --> 00:26:29,320 Speaker 2: I would say the first thing that you need to 432 00:26:29,359 --> 00:26:34,000 Speaker 2: consider is the specialist you gain to see. You need 433 00:26:34,040 --> 00:26:36,879 Speaker 2: to know that you can have a rapport with that person, 434 00:26:36,920 --> 00:26:39,640 Speaker 2: because it might be a short journey or it might 435 00:26:39,720 --> 00:26:42,440 Speaker 2: go on for a long time. You need to know 436 00:26:42,520 --> 00:26:45,840 Speaker 2: that you've got trust and understanding there. 437 00:26:46,600 --> 00:26:48,520 Speaker 1: I think we've covered all of the questions that have 438 00:26:48,560 --> 00:26:49,240 Speaker 1: been submitted. 439 00:26:50,080 --> 00:26:53,920 Speaker 2: I'm just interested. It seems to me that the next 440 00:26:53,960 --> 00:26:59,639 Speaker 2: step forward for women is to have the sporting codes 441 00:26:59,680 --> 00:27:04,760 Speaker 2: on would and I from my reading, the Cricket Australia 442 00:27:05,280 --> 00:27:09,080 Speaker 2: is leading the way there. But I'm just wondering about 443 00:27:09,160 --> 00:27:12,119 Speaker 2: the other sporting codes and where they are with that, 444 00:27:12,160 --> 00:27:14,240 Speaker 2: because it really does seem to be the next step. 445 00:27:14,280 --> 00:27:16,960 Speaker 2: Women are going to be playing sport at the elite 446 00:27:17,080 --> 00:27:20,280 Speaker 2: level for longer and we need to support them with 447 00:27:20,359 --> 00:27:26,760 Speaker 2: that both during a pregnancy, maternity agreements, breastfeeding afterwards, taking 448 00:27:26,960 --> 00:27:29,640 Speaker 2: the young child, support to take the young child when 449 00:27:29,800 --> 00:27:34,800 Speaker 2: they're touring and competing away from their home. I'm now 450 00:27:34,840 --> 00:27:37,520 Speaker 2: asking you a question that just seem to be the 451 00:27:37,560 --> 00:27:39,439 Speaker 2: next obvious step. 452 00:27:40,040 --> 00:27:43,480 Speaker 1: Yeah, it's been a really interesting progression seeing the way 453 00:27:43,560 --> 00:27:47,359 Speaker 1: that the collective bargaining agreements between players, associations and the 454 00:27:47,400 --> 00:27:50,080 Speaker 1: sporting bodies have developed over time, and as you touched on, 455 00:27:50,119 --> 00:27:52,399 Speaker 1: Cricket Australia has really led the way in that space 456 00:27:52,760 --> 00:27:56,679 Speaker 1: with their pregnancy and parental policies, and sporting bodies like 457 00:27:56,720 --> 00:27:59,840 Speaker 1: the AFL with the AFLW have now started to follow. 458 00:27:59,840 --> 00:28:02,600 Speaker 1: So we recently signed off on a new collective bargaining 459 00:28:02,640 --> 00:28:06,119 Speaker 1: agreement and part of our pregnancy policy allows players to 460 00:28:06,200 --> 00:28:10,040 Speaker 1: have security over their playing contract if they needed if 461 00:28:10,080 --> 00:28:12,720 Speaker 1: they were to full pregnant, which is such an important step. 462 00:28:12,760 --> 00:28:16,600 Speaker 1: And there's also other provisions which the cricketers have as well, 463 00:28:16,640 --> 00:28:19,080 Speaker 1: around having a care that can travel with you to 464 00:28:19,200 --> 00:28:21,439 Speaker 1: games up to a certain age. I think each of 465 00:28:21,440 --> 00:28:25,560 Speaker 1: the sporting bodies have different agreements in place, but really 466 00:28:25,680 --> 00:28:28,120 Speaker 1: practical things that haven't been in place for a very 467 00:28:28,119 --> 00:28:31,760 Speaker 1: long time, and I think they've started to really get 468 00:28:31,840 --> 00:28:35,760 Speaker 1: the ball rolling. I think as you've touched on these 469 00:28:35,800 --> 00:28:40,600 Speaker 1: conversations around fertility at age, egg freezing, women's health, there's 470 00:28:40,640 --> 00:28:42,960 Speaker 1: so much more that can be addressed, and I think 471 00:28:42,960 --> 00:28:46,040 Speaker 1: that's why this partnership between Monash IVF and the Triple 472 00:28:46,080 --> 00:28:47,400 Speaker 1: A is such an important one. 473 00:28:48,360 --> 00:28:49,040 Speaker 3: Fantastic. 474 00:28:49,320 --> 00:28:52,080 Speaker 2: It's just wonderful to know that good work is being 475 00:28:52,160 --> 00:28:54,280 Speaker 2: done and we're working towards the same goal. 476 00:28:54,600 --> 00:28:55,840 Speaker 3: Absolutely there, we. 477 00:28:55,880 --> 00:28:57,480 Speaker 1: Will get there. Thank you so. 478 00:28:57,480 --> 00:29:00,000 Speaker 3: Much, time, pleasure, It's been wonderful. Thank you. 479 00:29:00,040 --> 00:29:03,480 Speaker 1: I loved having you on. Thanks Jenny, thanks so much 480 00:29:03,480 --> 00:29:06,000 Speaker 1: for listening. If you got something out of this episode, 481 00:29:06,080 --> 00:29:08,240 Speaker 1: I would absolutely love it if you could send it 482 00:29:08,280 --> 00:29:12,560 Speaker 1: on to one person who you think might enjoy it. Otherwise, subscribe, 483 00:29:12,720 --> 00:29:14,680 Speaker 1: give us a review, and make sure you follow us 484 00:29:14,720 --> 00:29:17,520 Speaker 1: on Instagram at the Female Athlete Project to stay up 485 00:29:17,560 --> 00:29:20,760 Speaker 1: to date with podcast episodes, merch drops, and of course, 486 00:29:21,200 --> 00:29:23,880 Speaker 1: news and stories about epic female athletes.