The Latest Advances in Endometriosis Care with guest Dr. Mathew Leonardi

Sep 16, 2025

Dr. Mathew Leonardi, an advanced gynecological surgeon and researcher from McMaster University, dives into the complexities of endometriosis. He discusses the crucial role of ultrasound in diagnosis and management, and how the reproductive tract microbiome may affect both endometriosis and infertility. The conversation explores the limitations of common biomarkers like CA-125 and introduces new research avenues, including genetics. Dr. Leonardi also highlights complementary strategies for support, urging patients to advocate for better care and awareness.

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INSIGHT

Endometriosis Is A Complex, Life-Affecting Disease

Endometriosis is a common, chronic, and complex disease that can profoundly affect personal, professional, and fertility goals.
Mathew Leonardi defines expertise as deep curiosity and clinical, imaging, and surgical skill rather than formal credentialing.

ADVICE

Bring Ultrasound Into Gynecology Clinics

Integrate office ultrasound into gynecologic care so clinicians can scan, interpret, and give immediate feedback to patients.
Teach trainees gynecologic ultrasound to reduce imaging gaps between radiology and gynecology.

ADVICE

Avoid Surgical Surprises With Advanced Imaging

Use preoperative imaging (advanced ultrasound or MRI) to avoid intraoperative surprises and enable true informed consent.
Plan surgery durations and team needs from accurate imaging to reduce guesswork and anxiety.

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Welcome to The Egg Whisperer Show! Today's guest is Dr. Mathew Leonardi, an advanced gynecological surgeon, sonologist, and researcher at McMaster University Medical Center in Hamilton, Canada. He's also completing his PhD at the University of Sydney, focusing on the role of ultrasound in the diagnosis and surgical management of endometriosis. Dr. Leonardi is internationally recognized for his work in gynecological surgery and ultrasound, serves as a Junior Ambassador for the World Endometriosis Society, and contributes to clinical guidelines and editorial boards in reproductive medicine. In this episode, we're diving into the latest advances in endometriosis diagnosis, treatment, and whole-patient care, including research into the microbiome, biomarkers, and alternative management strategies. Here are some of the key questions and topics we cover in this conversation:

What it means to self-identify as an "endometriosis expert" and why early, accurate testing is so important
How the microbiome of the reproductive tract may influence both endometriosis and infertility
Why common biomarkers like CA-125 have limited usefulness, and what new research on VEGF and inflammatory markers may reveal
Whether genetic testing could one day help identify susceptibility to endometriosis
How complementary strategies like pelvic floor physiotherapy, dietary changes, acupuncture, cannabis, and psychotherapy can support fertility patients living with endometriosis
Why advocacy (both self-advocacy in the clinic and public advocacy through research and awareness) is key to advancing care for all patients

Resources: Read the full show notes on Dr. Aimee's website. Dr. Mathew Leonardi's website click here. Do you have questions about IVF?Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, October 20, 2025 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom. Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org. Other ways to connect with Dr. Aimee and The Egg Whisperer Show: Subscribe to my YouTube channel for more fertility tips!Subscribe to the newsletter to get updates