From academia to laboratory, how your true calling can guide career decisions

Dr Diana Vaamonde has done extensive research on the effects of exercise, nutrition and complementary therapies on fertility. Here, she talks about her work and the difficult decision to leave her professorial position at the University of Cordoba, Spain, to return to the lab.

With almost two decades of research and clinical experience, Prof Diana Vaamonde opens in new tab/window is a renowned expert in female reproductive pathology.

Initially attending medical school in Spain, her desire to live in America led her to pursue a bachelor’s degree in Biology at Washington and Lee University opens in new tab/window followed by a master’s degree with an emphasis on human reproduction. This was the beginning of a lifelong professional interest in human fertility and reproductive medicine.

She explains the appeal succinctly:

Helping to make life is a miracle. That's really what has taken me down this path.

That professional interest has taken her through a very successful academic career and a rewarding clinical path.

After earning a PhD in Sports Sciences at the Faculty of Medicine and Nursing of the University of Cordoba opens in new tab/window, an opening for tenure track as a professor arose at the university.

It led her to a critical junction in her career:

I realized I wasn’t going to be able to keep doing clinical work as well as being a professor. The research work required alongside lecturing was going to take time. I stepped off the path of clinical embryology and became a professor of human anatomy and embryology. 

Over the course of nearly two decades of professorship, Diana did extensive research on the interaction between exercise and human reproduction. This included numerous published research articles and book chapters, speaking invitations at international symposia and presenting work at the annual conference of the European Society for Human Reproduction and Embryology opens in new tab/window, the European College of Sports Science opens in new tab/window and the American Society for Reproductive Medicine (ASRM) opens in new tab/window.

Her most recent publication melds her experience and work in academia with the work she has done as clinician.

“People probably thought I was crazy …”

Diana increasingly realized that she missed having a clinical role. In 2015, she took an 8-month sabbatical from the university to work as a clinical embryologist — an experience that would play into one of the most difficult choices she would ever make.

In October 2021, Diana left the university to work as a clinical embryologist and lab supervisor in the US:

It was a very hard decision, but I missed helping people have their kids.

Weighing up the reasons that led her back to a clinical role, she has advice for anyone considering a similar move:

You need to think about what your purpose and desires are beyond any expectations that are put on you. People probably thought I was crazy, leaving when I was so close to becoming a full professor. But I had to be true to myself. I do miss teaching and research and the interaction with students. But I have listened to what really drives me and what I feel I am called for.

A changing clinical landscape

Diana is well placed to observe how the profession has changed in the years since her last clinical position. Modern clinicians all over the world are facing a raft of challenging and emerging themes, from aging populations to the role of digital technology, as revealed by Elsevier’s Clinician of the Future Report 2022.

Interestingly, while physicians in the field of human reproduction may have to grapple with many of these changes, the lab experience remains comparatively similar. Diana explains:

If you take digital technology — well, when you work as an embryologist in a lab setting, there's really no way to make that digital other than, for example, keeping electronic records or providing the patient with a picture of the embryo on their phone.

It’s different for the physician. They now incorporate a mix of telehealth and in-person visits and have to account for the sensitivities around that. 

One aspect that has filtered through is the rise of the informed patient. Some 86% of clinicians surveyed by Elsevier felt the rise of informed patients is driving healthcare change. Diana’s experience corroborates while highlighting the risks:

Patients have often read a lot online and via medical forums. Forums are great, but like anything on the internet, you have to weed out so much. What works for one person might not work for the other. I believe in tailored medicine and procedures, analyzing what's wrong with the specific couple and what we are going to do. We do not establish one protocol that we apply to absolutely everybody.

The idea that the traditional patient relationship is becoming more of a partnership is something Diana would also agree with. This loops neatly back to her body of research. She devotes a chapter in her book to the ethics of managing infertility and pregnancy:

A woman should have the right to direct how she wants to proceed with her pregnancy. Yes, physicians have the knowledge of healthy embryo and fetal development. But the patient should be able to have their say without being stigmatized or dismissed.

A holistic view of fertility

Her book is the culmination of research experience, but also has a personal influence behind it.

My path has always been related to human reproduction. Linked to that is my growth as a person, as a woman. I have opened my soul in that book.

Initially, the focus of the book was how nutrition and exercise contribute to human fertility. The topics covered soon expanded to encompass a more holistic look at wellbeing.

At first, the book was an answer to the question, ‘How can I help make my body healthy so I can have babies?’ It came from a physical perspective. But completely interlinked with exercise to achieve that is nutrition — we know that's the basis. The old proverb ‘you are what you eat’ is so true.

Exercise has been shown to have a positive impact on many conditions, including metabolic syndrome and cardiovascular disease. Through the addition of nutritional intervention, Diana believes this can be taken much further.

Unfortunately, access to good food is not a simple issue, and it highlights global inequality. The presence of alluring fast-food options and the prohibitive expense of high-quality food are barriers to good nutrition. Coupled with this are questions about the legitimate quality of what is on your plate:

Is organic really that good? That could vary country to country. You could have a piece of land in which you are planting everything organic, but the land next to it uses pesticides. One big step is to be aware at least. I'm the type of person that likes to have answers. Ultimately, if you have poor nutrition, exercise can compensate a little bit, but it's not going to override it.

Diana notes there is much more we are learning more about when it comes to health — and particularly reproductive health — such as endocrine disruptor chemicals:

We have those everywhere. In softeners when we do laundry, every lotion, every shampoo. Everything we are putting on our bodies and faces can have negative endocrine effects. I think being aware of the potential risks, that is a big step. Science knows so much about things that people didn't consider a few decades ago.

Emotions and ethics

Alongside nutrition and exercise, emotional wellness is included within the book. Traditionally, Western medicine has tended to treat the symptom and not necessarily get to the root cause. This is particularly true when the root cause is emotionally grounded. In the case of fertility issues, Diana explains that patients often have significant emotional factors:

People with fertility issues can experience a lot of distress and anxiety. They may have been really stigmatized by everyone asking when they will have kids. Or they may start questioning what’s wrong with them when their friends start having families. There can be pressure because of this idea that the role of the woman is to have babies.

This is why the book is called Fertility, Pregnancy and Wellness. We need to look at the whole  picture.

With such an all-round view of human reproductive pathology, from academia to laboratory, it is clear that Diana is perfectly placed to highlight patient wellness in its entirety.