WEBVTT - Medical Matters: Infertility Affects Millions: Don’t Delay - Early Action Can Make All the Difference 0:00:00.840 --> 0:00:01.840 Medical Matters. 0:00:03.320 --> 0:00:06.320 All right, it's time now for our Medical Matters feature, 0:00:06.400 --> 0:00:09.040 and today we're speaking about something that's a you know, 0:00:09.119 --> 0:00:12.400 can be a really sensitive matter for many, especially people 0:00:12.440 --> 0:00:17.320 that are struggling with infertility. We speak about how infertility 0:00:17.360 --> 0:00:22.079 affects millions globally and how more of us may be 0:00:21.600 --> 0:00:26.480 at risk of being infertile or may be suffering from 0:00:26.520 --> 0:00:29.800 infertility without even knowing it. Our guest on the show 0:00:29.800 --> 0:00:33.920 this evening is doctor Lusanda Shiman gemss, a fertility specialist 0:00:33.920 --> 0:00:36.879 and director at med fem Fertility Clinic. 0:00:37.360 --> 0:00:39.680 Doctor Lusander, Good evening, and welcome to the show. 0:00:40.880 --> 0:00:43.080 Good evening, and thanks so much for having me. 0:00:43.240 --> 0:00:44.320 Yeah, fantastic. 0:00:44.680 --> 0:00:46.680 I mean, you know, I want to start with with 0:00:46.720 --> 0:00:52.560 our conversation just on I've been reading about how quite frankly, 0:00:53.560 --> 0:00:58.680 if you or the official definition of infertility is if 0:00:58.760 --> 0:01:02.320 you do not pregnant quote unquote, and please rectify me 0:01:03.320 --> 0:01:05.880 under trying for about twelve months. 0:01:06.080 --> 0:01:07.880 That's not a lot of time of trying, is it. 0:01:09.160 --> 0:01:11.800 No, it's not. And you know, the definition is actually 0:01:11.800 --> 0:01:16.640 really interesting and I personally don't particularly like it because 0:01:16.640 --> 0:01:19.360 I think it's very prescriptive and once you tell someone 0:01:19.400 --> 0:01:22.240 it's time to fall pregnant for a year, chances are 0:01:22.040 --> 0:01:25.039 they're going to be so stressed that they might just 0:01:25.120 --> 0:01:28.360 actually struggle to poll pregnant. So there is the textbook 0:01:28.440 --> 0:01:32.400 definition of below the age of thirty five years twelve 0:01:33.360 --> 0:01:36.960 of regular sexual intercourse, and then if you don't fall 0:01:37.000 --> 0:01:40.959 pregnant within those twelve months with regular sexual intercourse, then 0:01:41.040 --> 0:01:44.440 it's defined as infertility or above the age of thirty 0:01:44.480 --> 0:01:48.520 five six months of regular sexual intercourse. So the reason 0:01:48.600 --> 0:01:51.880 why I personally don't necessarily subscribe to it is that 0:01:52.360 --> 0:01:55.360 if you tell someone that Okay, fine, go and like 0:01:55.400 --> 0:01:57.720 I said, going for pregnant, you are above the age 0:01:57.720 --> 0:02:00.520 of thirty five, you've got six months to fall pregnant. 0:02:00.680 --> 0:02:03.720 That that's quite a stress and stresses is one of 0:02:03.760 --> 0:02:08.640 the contributors to infertility. But do not incorrect in saying 0:02:08.680 --> 0:02:11.160 that if you look it up, that's exactly what they'll 0:02:11.200 --> 0:02:11.480 give you. 0:02:13.200 --> 0:02:16.280 So I mean by that definition that would basically mean 0:02:16.400 --> 0:02:19.480 a lot more of us are struggling with infertility issues 0:02:19.520 --> 0:02:20.559 than we realize. 0:02:22.240 --> 0:02:27.160 Well, this is the whole thing. If you can categorically say, Okay, 0:02:27.240 --> 0:02:30.320 on this date, right on the seventh of July, I'm 0:02:30.360 --> 0:02:34.280 going to try and fall pregnant, and and I've got 0:02:34.320 --> 0:02:38.200 I'm giving myself till next year July on the seventh 0:02:38.320 --> 0:02:43.120 to fall pregnant. Then are you really infertile or is 0:02:43.160 --> 0:02:48.440 there something physiological that's preventing you from falling pregnant? So 0:02:49.160 --> 0:02:52.160 is it really infertility or are you struggling to fell 0:02:52.200 --> 0:02:54.760 pregnant and therefore you need some assistance. 0:02:56.360 --> 0:02:59.919 Okay, So I know that you don't like the textbook definition, Sophie, 0:03:00.080 --> 0:03:02.720 give us your definition of infertility. 0:03:03.040 --> 0:03:05.480 No, you know it's not even I mean, I'm not 0:03:05.520 --> 0:03:07.560 going to go against the grain and say, oh gosh, no, 0:03:07.840 --> 0:03:11.680 this is doctor she manuments also definition or something that 0:03:12.520 --> 0:03:15.600 once you are of reproductive age and you know that 0:03:15.680 --> 0:03:17.920 you want to conceive, and you know that you are 0:03:17.960 --> 0:03:22.320 really conceived, there's nothing wrong with going to get checked 0:03:22.360 --> 0:03:25.400 out to see that everything is in order, more than anything. 0:03:25.800 --> 0:03:28.800 And if you see that it's not happening sooner rather 0:03:28.840 --> 0:03:31.040 than later. And I'm just really saying this because we're 0:03:31.040 --> 0:03:34.200 seeing a lot of couples above the age of thirty five, 0:03:34.280 --> 0:03:36.920 above the age of forty who are coming to us 0:03:37.000 --> 0:03:39.680 and they want for pregnant. And you know, there's a 0:03:39.720 --> 0:03:42.040 concept of a variant agent, which really is a non 0:03:42.080 --> 0:03:45.920 modifiable factor. So it's not to say that look, okay, fine, 0:03:45.960 --> 0:03:49.200 put yourself within the definition. But I'm just saying, once 0:03:49.240 --> 0:03:54.200 you know that you want to be a parent, it's imperative. 0:03:54.440 --> 0:03:57.040 Or I'd highly suggest that you are in touch with 0:03:57.200 --> 0:04:02.200 some sort of health practitioner who can at least guide 0:04:02.200 --> 0:04:05.320 you in the right direction. Should you not feel pregnant, 0:04:05.840 --> 0:04:08.520 and do I think it needs a year? I don't 0:04:08.560 --> 0:04:11.200 think so. I think when you're ready, you're ready, And 0:04:11.240 --> 0:04:13.040 you don't think that a lot of us are walking 0:04:13.080 --> 0:04:15.240 around and we don't know if we've got something going 0:04:15.280 --> 0:04:18.440 on or not. And I'm saying, just get assessed sooner 0:04:18.560 --> 0:04:21.880 rather than later. A case example is they say someone 0:04:21.920 --> 0:04:26.680 with polycystic ovarian syndrome, which which is a hormonal imbalance 0:04:26.839 --> 0:04:29.920 that occurs a woman of reproductive age. If you don't 0:04:29.920 --> 0:04:32.200 know that, you've already got that and now you are 0:04:32.240 --> 0:04:34.000 going to go for a whole year to try and 0:04:34.040 --> 0:04:36.560 fell pregnant and all we have to do is sort 0:04:36.640 --> 0:04:39.240 that out. Wouldn't it be great if you find that 0:04:39.320 --> 0:04:42.400 out when you decide to conceive, so that it can 0:04:42.560 --> 0:04:46.040 actually happen and not take a whole year. Do you 0:04:46.040 --> 0:04:46.599 know what I mean. 0:04:48.240 --> 0:04:52.400 So, I mean, yeah, what are some of these factors 0:04:53.080 --> 0:04:57.479 you know that affects or call they cause infertility? As 0:04:57.480 --> 0:04:59.760 you've said it till I've heard it before. You know, 0:04:59.760 --> 0:05:02.680 you're as told. Overthinking is a big problem. 0:05:04.160 --> 0:05:08.360 So when we look at infertility and what really causes it, 0:05:08.560 --> 0:05:11.000 we have to first of all, I just want to 0:05:11.040 --> 0:05:13.800 say that it can be a female factor, and it 0:05:13.839 --> 0:05:16.840 can be a male factor, but I really want us 0:05:16.880 --> 0:05:19.640 to shift to the narrative of it's a couple issue 0:05:19.680 --> 0:05:23.239 and not necessarily one or the other. That is really 0:05:23.240 --> 0:05:27.320 important that we put that out there. And then going further, 0:05:27.480 --> 0:05:30.080 we need to see is their medical problem, is the 0:05:30.279 --> 0:05:34.800 genetic problem, is a lifestyle problem? Is it a hormonal problem? 0:05:35.279 --> 0:05:38.840 And then more so is it a structural problem? So 0:05:39.120 --> 0:05:43.400 just I'm expanding further on those different categories. So let's 0:05:43.400 --> 0:05:46.279 just say if it's a structural problem, you do get 0:05:46.320 --> 0:05:49.640 some women who are born without utresses, so they don't 0:05:49.680 --> 0:05:53.600 have a wound, and they may not know that. So 0:05:53.839 --> 0:05:56.839 that's important that we find that out sooner rather than later. 0:05:56.960 --> 0:05:58.880 And then you may ask, but how would you know that? 0:05:59.240 --> 0:06:01.839 So someone who's not going on the period has never 0:06:01.960 --> 0:06:06.120 had a period, and has never had a period, and 0:06:06.120 --> 0:06:08.840 therefore that person needs to be checked out because it's 0:06:08.839 --> 0:06:11.240 not normal for a woman of reproductive age to not 0:06:11.480 --> 0:06:14.240 have a period. And then if we go to things 0:06:14.320 --> 0:06:19.120 like medical disorders, does this person have a thyroid problem 0:06:19.680 --> 0:06:22.560 that we need to look at, and that is one 0:06:22.560 --> 0:06:26.000 of the big things that smith is their genetic issue 0:06:26.279 --> 0:06:29.240 or lifestyle. What type of lifestyle does this person need, 0:06:29.720 --> 0:06:32.560 you know, in terms of work, do they have work stresses, 0:06:32.600 --> 0:06:36.480 they don't exercise, they eat unhealthy, they are smokers, and 0:06:36.480 --> 0:06:39.520 so forth. And then hormonal problems. One of the big 0:06:39.560 --> 0:06:43.040 ones is the polycystic of wear in syndrome that I mentioned, 0:06:43.240 --> 0:06:46.000 So that is just really like the woman. And then 0:06:46.120 --> 0:06:48.080 it comes to the men, and the men we have 0:06:48.160 --> 0:06:50.640 to check. First of all, you need sperm to fell pregnant, 0:06:51.000 --> 0:06:53.480 So do they have a low sperm count? Do they 0:06:53.480 --> 0:06:56.960 have abnormal looking sperm, or do they have sperm that 0:06:57.080 --> 0:07:01.000 does not really move properly in other words, so that 0:07:01.120 --> 0:07:04.080 it can go through the wounds into the tubes and 0:07:04.160 --> 0:07:07.560 then fertilize their egg. Or is there a gland problems 0:07:07.600 --> 0:07:11.120 such as your thyroid. Is there a structural problem there 0:07:11.200 --> 0:07:15.800 is obstructions that does not allow the sperm to necessarily 0:07:15.880 --> 0:07:20.240 go into the women's reproductive tract or are they impotence 0:07:20.520 --> 0:07:23.520 Do these guys are they getting an erection, you know, 0:07:23.800 --> 0:07:26.240 or if they do get an erection and they ejaculate, 0:07:26.480 --> 0:07:29.960 are they actually producing sperm or not. So there are 0:07:30.040 --> 0:07:33.200 various factors, and that's why I come back to I 0:07:33.240 --> 0:07:35.800 think it's you know, when you've decided that you want 0:07:35.840 --> 0:07:38.920 to have a child, is go and visit your healthcare 0:07:39.000 --> 0:07:41.200 provider and just you know, you just made it, make 0:07:41.240 --> 0:07:43.200 it known that you want to have a child. There's 0:07:43.200 --> 0:07:45.400 a few simple blood tastes that need to be taken 0:07:45.880 --> 0:07:49.000 and an examination just to see if there is something 0:07:49.040 --> 0:07:50.480 that needs to be fixed or not. 0:07:52.560 --> 0:07:56.679 Lussander, I mean, at what point should a couple say, 0:07:57.120 --> 0:07:59.600 maybe we should get checked out? You know, having spoken 0:07:59.640 --> 0:08:04.680 to and family who suspects that they may be struggling 0:08:04.680 --> 0:08:09.280 with infertility issues, many of them will say, oh, just 0:08:09.800 --> 0:08:13.840 keep try and relax, don't overthink it, don't stress. 0:08:13.960 --> 0:08:14.640 It will come. 0:08:15.240 --> 0:08:18.240 But at what point should one go maybe or maybe 0:08:18.320 --> 0:08:21.040 the couple go, maybe we should get checked out. 0:08:22.240 --> 0:08:24.160 Well, look, one of the things that we need to 0:08:24.240 --> 0:08:27.440 look at is how old is the couple. So an 0:08:27.480 --> 0:08:32.280 older couple. Definitely sooner rather than later. We cannot be 0:08:33.240 --> 0:08:36.280 forty one forty two and we're just you know, trying 0:08:36.280 --> 0:08:39.400 to relax and see what happens in our lives and 0:08:39.440 --> 0:08:42.080 then if it doesn't happen, then we'll go. I want 0:08:42.120 --> 0:08:45.200 to see that couple as in yesterday, because then I 0:08:45.200 --> 0:08:48.160 can do investigations and I can have a frank conversation 0:08:48.320 --> 0:08:51.320 with them as to what's possible, what's possible, what we 0:08:51.360 --> 0:08:54.920 should look out for a younger couple. So let's just say, 0:08:55.000 --> 0:08:57.080 I don't know what age people get married these days. 0:08:57.120 --> 0:09:00.480 I've been married forever, so but let's just let's give 0:09:00.600 --> 0:09:03.600 or take people get married. I want to without touching 0:09:03.640 --> 0:09:07.520 any nerves at the age of twenty nine. Okay, So 0:09:07.640 --> 0:09:10.040 they get married at the age of twenty nine, and 0:09:10.080 --> 0:09:12.720 then they want to spend a year by themselves, and 0:09:12.760 --> 0:09:14.840 then the following year they're going to try and for pregnant. 0:09:15.080 --> 0:09:19.520 With that couple, we've got more time in order to 0:09:20.160 --> 0:09:22.760 try and for pregnant, So that definition of a year 0:09:23.120 --> 0:09:26.680 comes into play. But with that being said, when I 0:09:26.760 --> 0:09:29.640 think of when we talk about the women, this woman 0:09:29.760 --> 0:09:33.080 must be having regular mastrol cycles. You know, we can't 0:09:33.120 --> 0:09:37.040 have someone who's having irregular metroal cycles and then they 0:09:37.600 --> 0:09:41.120 are trying for a year. Once you have irregular metrol cycles, 0:09:41.320 --> 0:09:44.560 something is wrong and you need to get seen. So 0:09:44.720 --> 0:09:47.760 that couple, I would not give an extended period of time. 0:09:47.760 --> 0:09:50.720 I would want them to get seen sooner rather than later. 0:09:51.480 --> 0:09:54.080 Or if let's just say she was mestruating at some 0:09:54.240 --> 0:09:58.080 point and then stopped menstruating, that person, I'd like to 0:09:58.120 --> 0:10:01.320 see sooner rather than later. Or if they's now they're 0:10:01.320 --> 0:10:03.800 starting to go a beard which they never had, or 0:10:03.800 --> 0:10:06.560 they had been having a beard that they've been shaving off, 0:10:07.080 --> 0:10:10.160 that person, i'd want to see sooner rather than later. 0:10:11.080 --> 0:10:13.040 And then in terms of the guys, if they're having 0:10:13.120 --> 0:10:17.600 premature ejaculation, obviously they're having pre mature ejaculation. By the 0:10:17.600 --> 0:10:21.320 time there's penetration, you've already ejaculated, so you are going 0:10:21.400 --> 0:10:24.200 to find it a bit difficult to for pregnant. So 0:10:24.240 --> 0:10:27.360 I think where I would really come in is to say, 0:10:27.559 --> 0:10:29.880 if you feel something is wrong or you feel you 0:10:29.920 --> 0:10:33.520 need to consult, there's nothing wrong with having that first consultation, 0:10:33.760 --> 0:10:37.360 having investigations done, getting assessed, and then you know where 0:10:37.480 --> 0:10:41.400 your baseline is or where your standpoint is rather than no, 0:10:41.600 --> 0:10:43.960 let's just wait, let's just wait because a lot of 0:10:44.000 --> 0:10:47.679 couples actually put it off for it's longer they're necessary, 0:10:48.040 --> 0:10:50.320 and then by the time you know, by the time 0:10:50.360 --> 0:10:54.080 they come and see us, it's either now the old 0:10:54.400 --> 0:10:57.800 or the egg reserve is low, or the sperm count 0:10:57.920 --> 0:11:01.520 has been abnormal all this time and now we're only 0:11:01.600 --> 0:11:04.480 discovering it. So I think once you think about it, 0:11:04.520 --> 0:11:07.320 so if there are couples out there and they feel sure, 0:11:07.400 --> 0:11:10.120 we've been at this for I don't know, six months, 0:11:10.160 --> 0:11:13.760 they will take rather just go and see someone. Go 0:11:13.840 --> 0:11:15.959 and see your Guyanese so that you know, you can 0:11:16.200 --> 0:11:18.760 at least have the conversation, so you understand because I 0:11:18.800 --> 0:11:20.640 only say people, it's actually quite difficult. We see a 0:11:20.679 --> 0:11:22.679 lot of babies running around and so forth, but it's 0:11:22.720 --> 0:11:26.199 not it's actually hard to feel pregnant, and it's even 0:11:26.320 --> 0:11:30.439 harder when there is an issue. Sure. 0:11:31.280 --> 0:11:36.320 I mean, I've been wondering whether it is infertility becoming 0:11:36.360 --> 0:11:40.720 more prevalent, or is it the awareness and the speaking 0:11:40.760 --> 0:11:43.480 about it that's making it seem like more and more 0:11:43.520 --> 0:11:45.040 people are infertile. 0:11:46.120 --> 0:11:51.000 I think there's a subset of I actually call it 0:11:51.040 --> 0:11:53.760 a silence pandemic, and I think we're not vocal enough 0:11:53.800 --> 0:11:55.600 about it. I mean, it's at takes one in six 0:11:55.679 --> 0:12:00.040 couples globe. You know that that's quite that's quite a 0:12:00.080 --> 0:12:05.800 big number. But how many people actually openly speak about, 0:12:06.080 --> 0:12:09.120 you know, they're struggling to fall pregnant. Right now, there's 0:12:09.120 --> 0:12:12.840 a whole global movement which is break the taboo, and 0:12:12.880 --> 0:12:17.720 it's really break the taboo and speak about your infertility journey, 0:12:17.960 --> 0:12:20.720 regardless of what it is. And I think it's not 0:12:20.880 --> 0:12:23.839 necessarily that it's becoming you look that you can say 0:12:23.880 --> 0:12:27.640 it's becoming more prevalent because lifestyle has changed, you know, 0:12:28.200 --> 0:12:31.040 and and the job market has changed. Women are coming 0:12:31.120 --> 0:12:35.160 up corporate ladders. You know, they're putting all falling pregnant 0:12:35.320 --> 0:12:39.280 till they're much older. And that's where I'm like, okay, guys, now, 0:12:39.320 --> 0:12:42.079 let's start social freezing. Then freeze your age when you're 0:12:42.120 --> 0:12:45.280 younger so that you've got options later on in life. 0:12:45.520 --> 0:12:48.520 So in terms of prevalency is different factors. You know, 0:12:48.920 --> 0:12:51.440 now women are working in the minds and there's there's 0:12:51.480 --> 0:12:57.400 a concept called endocrime disruptors, so environmental factors that can 0:12:57.520 --> 0:13:01.720 affect your fertility so there is different reasons why women 0:13:01.840 --> 0:13:04.600 may becoming fertile. But I also think there is a 0:13:04.600 --> 0:13:07.160 subset of women who are actually happy to speak about it. 0:13:07.400 --> 0:13:09.480 I mean, when I think about our fertility clinic, it's 0:13:09.520 --> 0:13:13.040 been around for thirty years, you know, so it's been 0:13:13.080 --> 0:13:16.280 a long time since people have been struggling to fell pregnant. 0:13:18.320 --> 0:13:21.480 You know, you speak about freezing eggs, But how accessible 0:13:21.640 --> 0:13:26.439 is that doctor? Because I'm wondering, I can't even think 0:13:26.440 --> 0:13:29.920 where I would start if something to deb that conversation. 0:13:31.200 --> 0:13:33.600 And I'm so glad you're actually mentioning that. And that's 0:13:33.640 --> 0:13:36.800 where the problem is, is that are we actually having 0:13:36.840 --> 0:13:40.640 the conversation. Are we saying to someone who is twenty five, 0:13:40.760 --> 0:13:43.520 has just gotten into the job market. Are we talking 0:13:43.520 --> 0:13:46.160 about what are your aspirations in your job market? Are 0:13:46.200 --> 0:13:48.760 you considering being a parent at some point? At what 0:13:48.960 --> 0:13:51.760 point are you considering being a parent? And then you 0:13:51.800 --> 0:13:55.040 start having the conversation about, you know, the older you get, 0:13:55.040 --> 0:13:58.040 there's a concept of ovarian aging. This is a non 0:13:58.120 --> 0:14:01.800 modifiable factor. You're are forty five, or your eggs are 0:14:01.840 --> 0:14:05.360 thirty and so forth. So where would you start? And 0:14:05.400 --> 0:14:08.400 it starts with the first point of contact with any 0:14:08.480 --> 0:14:12.600 health care provider, and that's where we are really, that's 0:14:12.600 --> 0:14:15.040 where the gap is. So even if you like, I 0:14:15.040 --> 0:14:17.360 don't know, just random, you're going to see your dentist, 0:14:17.800 --> 0:14:19.640 you know, for your six month check up, but you 0:14:19.720 --> 0:14:21.960 don't see any other doctor. The only person you see 0:14:21.960 --> 0:14:25.480 is your dentists because you're so you know, intentional about 0:14:25.560 --> 0:14:30.320 having dental health and it's for that dentist to say, listen, 0:14:30.360 --> 0:14:32.640 actually i've been doing your teeth for quite a while. 0:14:33.040 --> 0:14:35.440 What is happening with you in terms of you know, 0:14:35.840 --> 0:14:38.120 fertility and so forth. Do you want to be a 0:14:38.200 --> 0:14:41.000 parent And you're like, yes, actually I do, but not 0:14:41.120 --> 0:14:42.800 right now. Maybe and I'm a bit older, and it's 0:14:42.800 --> 0:14:45.520 that well, you know, there is maybe you should go 0:14:45.600 --> 0:14:46.920 and see a guy, and you're going to see a 0:14:46.920 --> 0:14:51.160 fertility specialist in terms of guest seeing what your options 0:14:51.200 --> 0:14:53.960 are if you're going to put or falling pregnant, And 0:14:54.000 --> 0:14:58.080 that's where the conversation begins. And we're not having those conversations. 0:14:58.080 --> 0:15:00.560 We really just have them at dinner parties. If someone 0:15:00.960 --> 0:15:03.280 just happens to mention that they say they went to 0:15:03.360 --> 0:15:05.800 and made same fertility clinic, and they froze the eggs 0:15:06.040 --> 0:15:08.360 and then everyone gets excited like, oh my gosh, so 0:15:08.360 --> 0:15:10.560 what does it entail? What did you do? You know? 0:15:11.000 --> 0:15:14.320 And I want us to start having all those conversations 0:15:14.360 --> 0:15:17.320 because then I think it will sat out a lot. 0:15:17.400 --> 0:15:19.960 It just gives you options. So it's not to say 0:15:20.000 --> 0:15:22.720 when you're older you will struggle. You know, you won't 0:15:22.720 --> 0:15:26.480 feel pregnant. It just means that in the events that 0:15:26.560 --> 0:15:30.040 you do struggle, you've got these thirty year old eggs 0:15:30.040 --> 0:15:32.200 which are sitting there waiting to be used. 0:15:34.080 --> 0:15:36.480 You know. I'm actually thinking back to the first time 0:15:36.600 --> 0:15:40.120 I became aware. Maybe I was aware, but the first 0:15:40.160 --> 0:15:43.240 time I was actually confronted with the reality of freezing 0:15:43.240 --> 0:15:46.840 eggs was through a TV show called Being Mary Jane. 0:15:46.880 --> 0:15:48.000 I don't know if you remember that show. 0:15:48.040 --> 0:15:51.760 There was a show called and Mary Jane had decided 0:15:51.800 --> 0:15:53.720 to do that because she was having so many issues, 0:15:54.720 --> 0:15:57.240 you know, in terms of relationships and she wasn't finding 0:15:57.640 --> 0:16:01.200 the one right then out of thinking in the South 0:16:01.240 --> 0:16:04.640 African context, do people go to the guyany and what 0:16:04.720 --> 0:16:05.920 does that process. 0:16:05.520 --> 0:16:06.720 Even look like? Doctor? 0:16:07.960 --> 0:16:12.880 So basically, once that thought is in your head, is 0:16:12.920 --> 0:16:15.760 two on your Guyanese visits that you have or even 0:16:15.800 --> 0:16:17.920 if you if they say you're doing your pap smears 0:16:18.000 --> 0:16:21.680 at a GP, even that conversation can really begin there 0:16:21.720 --> 0:16:24.360 to say, look at the moment, I'm a single person, 0:16:24.760 --> 0:16:28.120 right and I'm working and so forth, and I don't 0:16:28.200 --> 0:16:31.000 know if I have a prospective partner or not, and 0:16:31.360 --> 0:16:34.800 what options do I have in terms of fertility preservation. 0:16:35.360 --> 0:16:38.000 It's a very easy answer. It would be like, look, 0:16:38.040 --> 0:16:41.520 consider freezing your eggs. Okay, so what does that entail. Well, 0:16:41.600 --> 0:16:45.440 you'll need to go to a fertility specialist and basically 0:16:45.480 --> 0:16:49.560 we do explain that to to to the patient. And 0:16:49.600 --> 0:16:51.360 mind you, it's not just about freezing eggs. You can 0:16:51.400 --> 0:16:55.760 free sperm as well, So the conversation really starts there. 0:16:55.920 --> 0:16:59.760 And then in terms of what it entails, basically is 0:17:00.440 --> 0:17:04.439 injections that we give which we basically we want to 0:17:04.520 --> 0:17:07.000 get as many eggs as possible, so we grow the 0:17:07.080 --> 0:17:10.800 follicles up to a certain size, and then after that, 0:17:11.080 --> 0:17:14.320 once we track them via ultrasound, and we'll give you 0:17:14.400 --> 0:17:17.600 other medication to stop you from augulating so that you 0:17:17.640 --> 0:17:20.560 don't lose the eggs. And when we ready, then we 0:17:20.680 --> 0:17:23.879 do what we call a trigger. So to always explain 0:17:23.880 --> 0:17:26.480 it to my patients where I'm like, think of an egg, 0:17:26.680 --> 0:17:28.879 like you know, a chicken egg that we make for breakfast. 0:17:29.480 --> 0:17:32.400 So we want that egg to grow, and then at 0:17:32.400 --> 0:17:35.240 a certain size, we give you an injection so that 0:17:35.280 --> 0:17:38.800 we can go and so that we can soften the 0:17:39.280 --> 0:17:42.840 egg shell so we can go and take out the 0:17:42.960 --> 0:17:46.520 egg white and hopefully that egg white will find an 0:17:46.520 --> 0:17:51.520 egg yolk and that's what we freeze. So it's quite 0:17:51.520 --> 0:17:55.720 a simple process which takes around to give or take 0:17:55.840 --> 0:18:00.000 two weeks. So it's something and a lot of women 0:18:00.119 --> 0:18:02.439 are doing it. A lot of women are actually waking 0:18:02.560 --> 0:18:05.560 up to the fact that, look, I'm not in a relationship. 0:18:05.600 --> 0:18:08.360 I don't know what my prospects are. But what I 0:18:08.440 --> 0:18:12.359 really love about social freezing of eggs is that it 0:18:12.400 --> 0:18:17.320 gives the woman reproductive freedom. It says, I'm not waiting 0:18:17.560 --> 0:18:20.760 for mister Wright to come, because what happens if mister 0:18:20.800 --> 0:18:22.000 Wright comes at forty five? 0:18:22.400 --> 0:18:22.680 Hey? 0:18:23.040 --> 0:18:23.240 You know? 0:18:23.800 --> 0:18:27.640 So it gives that woman that reproductive freedom to decide 0:18:27.680 --> 0:18:31.080 when she wants to parent and how she wants to parent. 0:18:31.800 --> 0:18:37.000 So we're talking in fertility with doctor Lucander Shimange Masource, 0:18:37.440 --> 0:18:40.879 who is a fertility specialist. This is our Medical Matters 0:18:40.920 --> 0:18:44.960 feature that we have on a Monday. Really interesting conversation here. 0:18:45.000 --> 0:18:48.280 I'm going to open up the lines and invite any 0:18:48.520 --> 0:18:52.040 of our callers who are interested or I have questions 0:18:52.040 --> 0:18:55.600 around fertility, whether they are personal questions, we want to 0:18:55.640 --> 0:18:57.640 hear from you. There A double one double a three 0:18:58.000 --> 0:19:03.040 seven two oh to one double four six five six seven. 0:19:03.720 --> 0:19:07.920 All right, So doctor, you spoke about lifestyle changes. How 0:19:08.200 --> 0:19:12.320 important is diet when one is trying to feel pregnant? 0:19:14.000 --> 0:19:18.359 That is important, and you know, and that's the one 0:19:19.640 --> 0:19:22.640 I suppose that's the one part that's really overlooked because 0:19:22.720 --> 0:19:24.919 we live in such a different world where you just 0:19:25.040 --> 0:19:27.240 order your food online, it gets delivered to your door. 0:19:27.280 --> 0:19:29.440 You don't know how it's cooked, you don't know who 0:19:29.480 --> 0:19:32.320 cooked it, and so forth. And I think that's why, 0:19:32.359 --> 0:19:35.399 you know, long time ago, women were really just having 0:19:35.560 --> 0:19:37.639 It was not abnormal to say, you know, we hear 0:19:37.760 --> 0:19:41.440 my grandmother had nine kids, you know, because they really 0:19:41.480 --> 0:19:45.159 actually had an organic diet, they ate what they planted. 0:19:45.680 --> 0:19:49.280 And now we are in a fast culture where it's 0:19:49.320 --> 0:19:51.639 just a matter of just putting something in the microwave 0:19:52.119 --> 0:19:54.399 and you know, and eating it, or in the a 0:19:54.560 --> 0:19:57.720 fryer and eating it and we're not cooking our food anymore. 0:19:57.800 --> 0:20:00.479 We don't know what's actually going into our food, so 0:20:00.520 --> 0:20:03.400 we have to look at you know, inflammation does play 0:20:03.440 --> 0:20:07.199 a big part, and what are those inflammatory foods? You know, 0:20:07.280 --> 0:20:11.000 so when you know your process, cover hydrates your process 0:20:11.359 --> 0:20:15.440 and your processed foods and so forth. So diet does 0:20:15.680 --> 0:20:18.520 play a big part. But it's not to say you 0:20:18.600 --> 0:20:21.359 have an unhealthy diet. You can't fall pregnant, because someone 0:20:21.640 --> 0:20:25.000 can easily phone now and say, look, I've been eating 0:20:25.080 --> 0:20:27.520 McDonald's all my life, or I've been eating fast food 0:20:27.520 --> 0:20:30.359 all my life and I've got four kids. That those 0:20:30.400 --> 0:20:34.000 people are outliers. But for someone who really is struggling 0:20:34.000 --> 0:20:37.080 to for pregnant, I will always gauge the diet aspect, 0:20:37.160 --> 0:20:39.920 like what do you actually eat, you know, and how 0:20:40.040 --> 0:20:42.960 is it affecting your body. But with that being said, 0:20:43.000 --> 0:20:45.360 I think in general we all need to check ourselves 0:20:45.440 --> 0:20:49.520 in terms of our lifestyles and what we're doing, because ultimately, 0:20:49.640 --> 0:20:53.960 let's just say you do for pregnant with this unhealthy lifestyle, 0:20:54.000 --> 0:20:55.920 you bring a child into the world, you really want 0:20:55.960 --> 0:20:58.159 to die young and leave this child without a parent. 0:20:59.359 --> 0:21:02.879 And that the part that we actually don't think about 0:21:03.480 --> 0:21:05.560 you know, we've all got bragging rights about how it 0:21:05.600 --> 0:21:08.400 felt pregnant, drinking every day and I've been smoking since 0:21:08.440 --> 0:21:12.480 our sixteen and eating false food. But then what does 0:21:12.520 --> 0:21:15.639 your lifespan look like and what happens to that child? 0:21:16.000 --> 0:21:19.280 So definitely, lifestyle diet definitely does play. 0:21:19.200 --> 0:21:21.879 Impact for both men and women. 0:21:23.800 --> 0:21:29.879 It definitely for both men and women. Definitely definitely, because ultimately, yes, 0:21:29.960 --> 0:21:32.720 a man will produce sperm, but what is the quality 0:21:32.800 --> 0:21:35.680 of that sperm. Does it have a potential to fertilize 0:21:35.680 --> 0:21:37.800 an egg because we look at we have to look 0:21:37.840 --> 0:21:39.959 at how you know, well, like I said to the number, 0:21:40.640 --> 0:21:45.920 how it moves, how it looks, does it have binding capacity? 0:21:46.520 --> 0:21:49.920 So it's definitely both men and women. And that's why, 0:21:50.400 --> 0:21:53.200 you know, what I always say is that this is 0:21:53.240 --> 0:21:57.200 a couple things. It's not either all. So if one 0:21:57.320 --> 0:22:00.840 is going to be on a healthy lifestyle chain, both 0:22:00.880 --> 0:22:02.960 of you must be on that train. 0:22:04.840 --> 0:22:07.920 And just you know, I think that there's an element 0:22:08.080 --> 0:22:14.240 also around shame when it comes to fertility, where couples 0:22:15.040 --> 0:22:19.199 come to you as a last resort, but oftentimes you know, 0:22:19.359 --> 0:22:22.560 or sometimes you know, one partner may may have a 0:22:22.600 --> 0:22:26.040 bit of shame, you know, around not being able to conceive. 0:22:26.200 --> 0:22:29.800