Speaker 1: I feel so privileged to be a fertility expert in
Speaker 1: a time where success rates are at an all time high.
Speaker 2: Speaking as someone who is yet to go on this journey,
Speaker 2: when do you feel like is the right time for
Speaker 2: women to really start thinking about fatility?
Speaker 1: I think it's never too early.
Speaker 2: Doctor Lucky Second is a reproductive androcrinologist who's helping women
Speaker 2: understand their fertility clearly, calmly, and proactively. She cuts through myths, pressure,
Speaker 2: and online noise and focuses on what really matters. Do
Speaker 2: you have any advice for women who are trying to
Speaker 2: you know, we build trust with their own body after
Speaker 2: they feel like their bodies failed them.
Speaker 1: It's not because of something you did or didn't do,
Speaker 1: and you're definitely not alone. One in six couples have infertility.
Speaker 2: What if this time will be the time.
Speaker 1: There is some serendipity, there is some luck, and you
Speaker 1: just need one egg to make it past all those hurdles.
Speaker 2: Welcome to a Really Good Cry podcast. A Really Good
Speaker 2: Cry is here to help you understand your body, feel
Speaker 2: confident in your skin, manage your emotions, and take back
Speaker 2: control of your health. Because growth doesn't always start with answers,
Speaker 2: Sometimes it starts with a really good cry Lucky thank
Speaker 2: you so much for being here. I really really appreciate it.
Speaker 2: I know you've flown in from New York and I'm
Speaker 2: so grateful to have you on the podcast.
Speaker 1: Thank you for having me.
Speaker 2: We're gonna dive into your book, The Lucky Egg, Understanding
Speaker 2: your Fertility and how to get Pregnant. Now, let me
Speaker 2: tell you, this is one juicy book. There's so much
Speaker 2: information in here. And what I loved about it was
Speaker 2: you don't make it feel too scary.
Speaker 1: Yeah, that's really the goal.
Speaker 2: Yes, and I think that, you know, speaking as someone
Speaker 2: who is yet to go on this journey, I definitely
Speaker 2: feel overwhelmed by this whole space and it's a little
Speaker 2: bit scary. Me and my friends talk about it and
Speaker 2: we're like, I don't know, I'm avoiding it. I'm avoiding
Speaker 2: thinking about it until I'm really ready to think about it.
Speaker 2: And when we are, it feels really intense, especially when
Speaker 2: you're over the age of thirty.
Speaker 1: Yes, it feels overwhelming. There's so much noise and advice
Speaker 1: coming out you.
Speaker 2: A mile a minute, there is, And so I know
Speaker 2: you've been doing this for nearly a decade. I would
Speaker 2: have to start off with some beautiful success stories that
Speaker 2: you've experienced.
Speaker 1: I mean so many, you know, I feel so privileged
Speaker 1: to be a fertility expert in a time where success
Speaker 1: rates are at an all time highly Yes. Yeah, if
Speaker 1: you think about when IVF was first invented, and I'm
Speaker 1: talking about IVF, but there are so many different ways
Speaker 1: to help people get pregnant, but that's the one that
Speaker 1: everyone associates with my job, right, But it is the
Speaker 1: most striking change that in the nineteen seventies, when it
Speaker 1: first came about and this technology became a thing, it
Speaker 1: was like single digit success rates. And now every week,
Speaker 1: you know, at least two thirds of my patients who
Speaker 1: had an embryo transfer the week before, I'm calling them
Speaker 1: to say, hey, you're pregnant. Oh my god. No. So
Speaker 1: it's really something that I never take for granted because
Speaker 1: I have predecessors, you know, mentors of mine that always
Speaker 1: remind me of how lucky I am. When they were
Speaker 1: coming up in their careers, They're like, it was really hard,
Speaker 1: you know, to tell patients let's keep going in the
Speaker 1: face of really low success rates compared to what we
Speaker 1: can offer now.
Speaker 2: Yeah, when do you feel like is the right time
Speaker 2: for women to really still think about the to like
Speaker 2: your ideal puss. And if you're talking to them from
Speaker 2: a young age, when would you say this is the
Speaker 2: time we need to stop thinking about it. So.
Speaker 1: I know it might sound crazi or extreme, but I
Speaker 1: think it's never too early. I mean, I have a
Speaker 1: five year old and an eight year old daughter. Both
Speaker 1: of them know how to correctly identify their body parts.
Speaker 1: They know about the menstrual cycle. I think we need
Speaker 1: to normalize this and make it so that people aren't
Speaker 1: growing up afraid of their bodies or feeling that their
Speaker 1: bodies are a mystery. I think it should be a
Speaker 1: topic of conversation, maybe not with the lens of trying
Speaker 1: to get pregnant necessarily, but just understanding your menstrual cycle,
Speaker 1: understanding red flags and identifying things early instead of saying, Okay,
Speaker 1: I'm only going to react after the fact once I'm
Speaker 1: in a moment of crisis when it comes to my fertility.
Speaker 1: I would love for everyone in their twenties to have
Speaker 1: like a secondary formalized education, because high school health class
Speaker 1: or junior high health class isn't enough. The goals are
Speaker 1: very different, and then that's the last of our formative education,
Speaker 1: and we go off into our twenties and our thirties
Speaker 1: and we're expected to, you know, kind of strive towards
Speaker 1: having it all and achieving our professional goals while navigating
Speaker 1: our personal goals, and then magically trying to figure out
Speaker 1: our biological clock, hoping to stumble upon the right obgyn
Speaker 1: and the right Google search or the right group of
Speaker 1: friends that are happening to share the good information. And
Speaker 1: it seems a little bit too left up to chance.
Speaker 1: And so that's really why I wrote this book. This
Speaker 1: isn't for people who are only struggling in the trenches
Speaker 1: of infertility, but it's really for people as they enter
Speaker 1: their twenties and thirties to say, Hey, what should I
Speaker 1: be thinking about? How should I be viewing, you know,
Speaker 1: wellness and my overall habits day to day, and what
Speaker 1: should I be thinking about as I embark on this
Speaker 1: journey of trying to get pregnant so that I can
Speaker 1: be as efficient and as effective as possible.
Speaker 2: I know you said that IVF. Obviously you're seeing so
Speaker 2: many great success stories yeah happen and IVF, which is
Speaker 2: so beautiful. What about when it comes to natural pregnancies.
Speaker 2: Have you seen a trend in what's happening there? Is
Speaker 2: it still the same? Well? Does it feel like it's
Speaker 2: getting hot?
Speaker 1: I think that it's largely the same. I don't think
Speaker 1: there's anything about our biology that has really changed, Right.
Speaker 1: It takes a long time for evolution to actually take place,
Speaker 1: but our behaviors are changing, and we're waiting longer to
Speaker 1: have children, you know, And I shouldn't say it like
Speaker 1: that because it makes it sound like it's an active choice.
Speaker 1: I think it's a confluence of factors of how we're
Speaker 1: living differently. It's taking longer to become financially independent and
Speaker 1: feeling like you're in the right place in your life,
Speaker 1: feeling like you have the right partner. I mean, there's
Speaker 1: good things about that. Right. We now live in a
Speaker 1: society where we're saying, let's not settle and let's not
Speaker 1: stay in toxic relationships just for the sake of Hey,
Speaker 1: I want to have children. And there's technologies to try
Speaker 1: to work around that as well. Right, Like women can
Speaker 1: freeze their eggs and say, I feel less pressured to
Speaker 1: stick with something that's not right for me. I'm going
Speaker 1: to listen to that voice inside my head and say
Speaker 1: let me start fresh, and that would have been really
Speaker 1: hard to do as someone in their mid thirties or
Speaker 1: early forties, maybe twenty years ago, where certain things weren't options, right,
Speaker 1: like egg freezing. But I think you know, the average
Speaker 1: age of when we're starting to build our families has
Speaker 1: definitely increased. Just think about our mother's generation, our grandmother's generation,
Speaker 1: and there's good things about that, right, But our biology
Speaker 1: hasn't kept pace, and we're not really giving women the tools,
Speaker 1: the support, and the education or even the access to
Speaker 1: certain techniques or strategies to try to work around that,
Speaker 1: or even just policies that help us to create space
Speaker 1: in our life so that we can achieve our dreams
Speaker 1: professionally and personally alongside each other.
Speaker 2: You mentioned lifestyle quite a bit throughout this and the
Speaker 2: things that we should be doing in our twenties and thirties.
Speaker 2: Would you say that fertility from your experience is many genetics?
Speaker 2: Is it mainly lifestyle? Is it? You know, what are
Speaker 2: the main factors that are influencing fertility along our journey?
Speaker 1: So timing is really important on two different levels. One
Speaker 1: is the effective age.
Speaker 2: Right.
Speaker 1: Age impacts our ability to ovulate a healthy egg and
Speaker 1: it's not all doom and gloom. It's not like, oh,
Speaker 1: over thirty five, all of your eggs go bad. That's
Speaker 1: what society likes to tell people. But in fact, even
Speaker 1: in our late thirties and early forties, you still have
Speaker 1: normal eggs that you can ovulate, but the ability to
Speaker 1: do that starts to shift where it takes many more
Speaker 1: cycles for that egg that you need to ovulate to
Speaker 1: be the one that's selected randomly, because it's a random
Speaker 1: selection process that you cannot control, and it can take
Speaker 1: longer to get pregnant, and there can be a higher
Speaker 1: risks of things like miscarriage. So age is definitely a
Speaker 1: big factor, but also timing with regards to knowing when
Speaker 1: you're ovulating right, and so for people who aren't getting
Speaker 1: regular periods and they never know when their next ovulation
Speaker 1: is happening, or they don't ovulate regularly, that can make
Speaker 1: it more challenging. And there are shifts in health in society.
Speaker 1: The rise in obesity has led to more and more
Speaker 1: people having a harder time ovulating regularly, so that indirectly
Speaker 1: impacts fertility as well. Genetics is huge. A lot of
Speaker 1: people aren't aware that if they have a first degree
Speaker 1: relative with premature MENOPAUSEIDS, polycystic ovary syndrome which can lead
Speaker 1: to regular cycles, problems like endometriosis. These are all major
Speaker 1: gynecologic disorders that can relate to fertility issues, and there
Speaker 1: can be a several fold increased risk of you yourself
Speaker 1: having those issues if your mom or your sister first
Speaker 1: degree relative also did so. Genetics can play a huge
Speaker 1: role in fertility.
Speaker 2: And not the specific tests that you recommend women do
Speaker 2: to you know, let's say find out from a younger
Speaker 2: age if these things are an issue for them, like
Speaker 2: what would you recommend some of the symptoms out that
Speaker 2: they should look out for, all tests that they should
Speaker 2: be doing.
Speaker 1: So, starting with your period, if your periods are regular,
Speaker 1: that's the first red flag that tells you that you're
Speaker 1: not ovulating regularly. And if you're not ovulating, you're not
Speaker 1: in the game, right. That means releasing an egg, so
Speaker 1: there's a chance for that egg to get fertilized. And
Speaker 1: so I've had women sometimes come to me and say,
Speaker 1: I've been trying for a year, but I've only gotten
Speaker 1: two periods in the last year, And I tell them, well,
Speaker 1: then you really haven't been trying for the full year, right,
Speaker 1: You've only had two attempts that entire time, and so
Speaker 1: we need to do something to give you that opportunity.
Speaker 1: I think the other major thing is it's never normal
Speaker 1: to have debilitating periods, periods that are so painful that
Speaker 1: you miss school or work. And it takes an average
Speaker 1: of eight to ten years for someone to be diagnosed
Speaker 1: with endometriosis because a lot of times women's pain has
Speaker 1: been dismissed, overlooked, or normalized. It's just kind of told
Speaker 1: to them, maybe by well meaning family members, that this
Speaker 1: is just a burden that women have to bear, and
Speaker 1: it's kind of a normal thing in our family. Heavy
Speaker 1: periods that can be a sign that you have problems
Speaker 1: like fibroids. So I think really tracking your cycle and
Speaker 1: being intentional is important. You want to be in tune
Speaker 1: with your body, right. And then besides that, I would
Speaker 1: say other things to look out for. We know maintaining
Speaker 1: a healthy body weight is really important for metabolic balance.
Speaker 1: There is this concept of insulin resistance, which you may
Speaker 1: have heard of. This is a major buzzword in the
Speaker 1: wellness world, but it's actually a real issue that I
Speaker 1: see play a role in many cases of infertility and
Speaker 1: pregnancy loss. Insulin is basically a hormone that your body produces.
Speaker 1: It's like a key that unlocks cells, that helps the
Speaker 1: blood sugar get stored effectively in your cells. And a
Speaker 1: lot of people's cells might not be listening to the
Speaker 1: signal of insulin. There's like resistance to it and sometimes
Speaker 1: weight gain, especially around the mid section, or having a
Speaker 1: strong family history of type two diabetes. These are dead
Speaker 1: ringers where you're like, okay, pcos someone having polycystic ovary syndrome.
Speaker 1: There's a strong relationship. The reason why it matters is
Speaker 1: that insulin gets produced at a higher level if your
Speaker 1: cells aren't listening to that signal, and that can actually
Speaker 1: cause your ovaries to overproduce testosterone and it can lead
Speaker 1: to unhealthy balance imbalances where the eggs are being matured,
Speaker 1: so it can affect our egg quality, the ability to
Speaker 1: ovulate a healthy egg. It can also make it easier
Speaker 1: to have problems like miscarriage. Most miscarriages are not within
Speaker 1: our control. I want to make that clear. Most of
Speaker 1: the time, this is just you ovulated an egg that
Speaker 1: had a type BO or error. But those typos or
Speaker 1: errors in the genetic code of those eggs are more
Speaker 1: likely to happen if the environment around the egg when
Speaker 1: it's maturing is affected by things like insulin resistance or imbalances.
Speaker 1: So it's really important to think intentionally about how do
Speaker 1: we make someone more responsive to the effects of insulin. Right,
Speaker 1: if someone is overweight and they lose weight, that alone
Speaker 1: can help, But building muscle can make you more sensitive
Speaker 1: to insulin. The way we eat, the pattern that we
Speaker 1: have in our diet in terms of fiber and protein,
Speaker 1: and trying to avoid glucose spikes and really stabilizing your
Speaker 1: blood sugar. All of this matters. And this is not
Speaker 1: a moral feeling. There are a lot of people who
Speaker 1: this is just genetically how they're wired, and it's not
Speaker 1: always going to be possible to fix it with diet
Speaker 1: and exercise. Sometimes you do need the help of certain medications,
Speaker 1: whether that be metformin or GLP one agonists.
Speaker 2: Yeah, I was going to ask about GLP one's day
Speaker 2: TIPA you mentioned them now, So why is that helping?
Speaker 2: I've had a sage like people get being able to
Speaker 2: get pregnant after they've been on GLP. Is that to
Speaker 2: do with the weight loss or is there something else
Speaker 2: that happens when people are on these peptides.
Speaker 1: It's both weight loss because weight is basically like that
Speaker 1: fat can be like another organ that actually helps you
Speaker 1: overproduce too much estrogen. So in our fat cells we
Speaker 1: convert excess testosterone to estrogen, and so it's all related. Right,
Speaker 1: Your ovaries will overproduce or have a tendency to overproduce testosterone,
Speaker 1: maybe because insulin is causing that to happen, and then
Speaker 1: that extra testosterone is getting converted in your fat cells
Speaker 1: to estrogen. Estrogen is confusing your brain, which is listening
Speaker 1: for the estrogen signal to see what your ovary is doing,
Speaker 1: and then it's not sending the signals to the ovary
Speaker 1: to tell it to ovulate effectively. And it's this vicious cycle.
Speaker 1: And so a lot of people are having what they're
Speaker 1: calling ozembic babies because yes, they've had this lifelong history
Speaker 1: of irregularity in their ovulation. It's linked to insulin resistance.
Speaker 1: Maybe they've struggled with their weight. Now they're correcting that
Speaker 1: underlying disturbance, and all of a sudden, the signals from
Speaker 1: their brain are getting through to the over and low
Speaker 1: and behold, they're ovulating and that was the thing that
Speaker 1: was making it harder for them to get pregnant. So
Speaker 1: it's helping a lot of people because it's a very
Speaker 1: potent way to help with weight loss and to make
Speaker 1: someone more sensitive to insulin, especially certain formulations of GLP
Speaker 1: one agonists.
Speaker 2: Does that have any benefit for people have endometriosis or
Speaker 2: is that issue completely separate to this.
Speaker 1: I think we're still in the research phases of this.
Speaker 1: You know, endometriosis is a different entity, but it is
Speaker 1: related to inflammation and having too much insulin, and that
Speaker 1: insulin resistance I'm talking about is also a pro inflammatory effect.
Speaker 1: Enomeytriosis is a really important one because it's such a
Speaker 1: quality of life issue and there's so many different ways
Speaker 1: it can impact fertility, and no two cases of endometriosis
Speaker 1: are going to be exactly alike. It's very unique per individual.
Speaker 1: But it's basically a condition where the cells that act
Speaker 1: like the innerlining of the uterus that are supposed to
Speaker 1: build up and be hormonally responsive and then shed every
Speaker 1: month when you get your period, are found in other
Speaker 1: parts of the body that they shouldn't be, most often
Speaker 1: the pelvic cavity, and we still don't really truly understand
Speaker 1: the mechanism of why this happens to some people and
Speaker 1: not to others. We know that we all sometimes menstrate
Speaker 1: a little bit backwards. It's called retrograde menstruation through the
Speaker 1: fallopian tubes. And our immune system is like a janitor
Speaker 1: that goes around and kind of recognizes, oh, these cells
Speaker 1: are foreign, let's clean them up. But some people's cells
Speaker 1: may evade detection by their immune system, and it can
Speaker 1: set up shop. And the lining of your uterus is
Speaker 1: meant to be a little bit sticky and invasive. It's
Speaker 1: meant to receive an embryo and allow it to kind
Speaker 1: of burrow its way in, and it can really be
Speaker 1: effective at creating new blood vessels. And so what can
Speaker 1: happen is is if it's in the pelvic cavity, it
Speaker 1: can start setting up shop and becoming hormonally responsive, and
Speaker 1: every time you're getting a period, it's stimulating those implants.
Speaker 1: And what's really mysterious is that it can be found
Speaker 1: in remote locations, like it's been documented in the brain,
Speaker 1: in the lung cavity, but most often it's like location,
Speaker 1: location location, it's in the pelvic cavity causes really painful periods.
Speaker 1: It can cause blockages in the fallopian tubes. It can
Speaker 1: make it harder for an embryo to implant, It can
Speaker 1: affect egg quality, it can cause your eggs to get
Speaker 1: depleted faster. But there are many women that have endometriosis
Speaker 1: that go on to have healthy pregnancies without any issue.
Speaker 1: But there are some women with mouth cases that end
Speaker 1: up having major problems with fertility. So there's a lot
Speaker 1: we still don't understand about it. But we know that
Speaker 1: a huge mechanism of how it affects fertility is through
Speaker 1: inflammatory pathways, and we know there's a lot of information
Speaker 1: now coming out about how GLP ones may help with
Speaker 1: inflammatory issues in our body in general. So you may
Speaker 1: have heard of people saying, you know, my eximo got
Speaker 1: better while I was on a GLP one pagonist. They're talking,
Speaker 1: you know, about so many different potential off target health effects,
Speaker 1: and I wouldn't be surprised if we find out that
Speaker 1: there could be a benefit for women with enomytriosis.
Speaker 2: Hearing people or friends coming out with telling me that
Speaker 2: they've got endometriosis more than I've heard, you know, in
Speaker 2: the past. Maybe just because they're more open about talking
Speaker 2: about it. But what are some of the tools, techniques,
Speaker 2: the medications, or the holistic treatments that people can do
Speaker 2: that you've seen have really helped them.
Speaker 1: Yeah, I think you know, the key is really trying
Speaker 1: to lead an anti inflammatory lifestyle. And I know that
Speaker 1: sounds kind of woo woo, but it is a real thing.
Speaker 1: I've had many patients with endometriosis, and I do think
Speaker 1: it's amazing that we're having this conversation. And that's why
Speaker 1: you're hearing about it more because more and where women
Speaker 1: are going to their doctors and saying, you know what,
Speaker 1: I am going to keep probing and asking questions because
Speaker 1: it just doesn't feel right that it's so painful. And
Speaker 1: I think a huge red flag or hallmark sign that
Speaker 1: you could have endometriosis is a history of really painful
Speaker 1: periods and then you went on the birth control pill,
Speaker 1: you shut down ovulation, you shut down that stimulation, and
Speaker 1: all of a sudden that pain went away. That is
Speaker 1: really endometriosis until proven other wise. So I have had
Speaker 1: many patients who've tried different ways of eating, trying to
Speaker 1: adopt a more pro antioxidant type diet like a Mediterranean
Speaker 1: style diet. There are some supplements that have been touted
Speaker 1: as having anti inflammatory effects and maybe being helpful, and
Speaker 1: a lot of this has been studied, but the reality
Speaker 1: is is that a lot of the data on supplements
Speaker 1: is not from well designed studies, and you're looking at
Speaker 1: different types of patient populations, and you don't always know
Speaker 1: what you're getting in each bottle of supplements. So I
Speaker 1: think it's harder to really put a finger on exactly
Speaker 1: what supplements are better for endometriosis. I think when it
Speaker 1: comes to medical management, that's usually the mainstay is, well,
Speaker 1: let's stop what's driving this, right, And so if someone
Speaker 1: says I have debilitating cramps, I've been diagnosed with endometriosis.
Speaker 1: And by the way, the diagnosis, the gold standard way
Speaker 1: is kind of invasive. You have to have a surgery
Speaker 1: where they go through the belly button with a camera
Speaker 1: and actually visualize and take a sample of the tissue
Speaker 1: that they think looks like endometriosis and send it off
Speaker 1: for analysis. That's not very practical to send everyone to
Speaker 1: the operating room just to get a diagnosis. And I
Speaker 1: think that you can make the diagnosis clinically and say, listen,
Speaker 1: it's probably endometriosis. Sometimes you can see it on ultrasound,
Speaker 1: But even if you have a clean looking ultrasound with
Speaker 1: no signs of it, it doesn't mean it's not there.
Speaker 1: It can be insidious in the pelvic side wall. But
Speaker 1: a lot of times if someone's not trying to get pregnant,
Speaker 1: stopping their ovulation. And I know that's not a popular answer,
Speaker 1: and I think a lot of women are very angry
Speaker 1: and bitter, and rightly so about maybe ten years prior
Speaker 1: twenty years prior, being in their teens and it not
Speaker 1: being explained to them clearly. You know, we think you
Speaker 1: of endometriosis. This is why we're advising going on the pill.
Speaker 1: So I've had a lot of patients who are like,
Speaker 1: I went on the pill in my teens. I don't
Speaker 1: know why. I've never explained, and now I'm coming off
Speaker 1: of it and I'm having trouble with my ability to
Speaker 1: get pregnant, and I'm the one diagnosing them with endometriosis,
Speaker 1: when in reality, whoever put them on the pill likely
Speaker 1: suspected that that was what was going on. So I
Speaker 1: think it's about education and trusting women, even at a
Speaker 1: young age. To understand complicated things about their body and
Speaker 1: making sure people are as informed as they possibly can be.
Speaker 1: Sometimes medications isn't going to cut it, and that's where
Speaker 1: surgery could have a role to say, Okay, let's have
Speaker 1: you go see an endometriosis expert. This is what they
Speaker 1: do all day, every day, and they can do it
Speaker 1: via a minimally invasive approach and remove those metriosis lesions
Speaker 1: and it may help to improve your pain and even
Speaker 1: help to improve your fertility.
Speaker 2: Wow, And I know you mentioned regular periods being such
Speaker 2: a good sign of you know, good fertility. So is
Speaker 2: regular periods? Say? Would you say that if you have
Speaker 2: a regular period, you have regular ovulation?
Speaker 1: Pretty much? Yes, But sometimes it can be tricky because
Speaker 1: some women will have problems like polyps in their uterus
Speaker 1: where they're getting cyclical bleeding or regular bleeding and maybe
Speaker 1: mistaking that to be their period. So I think it's
Speaker 1: really about having that regular, characteristic period, like you know,
Speaker 1: three to five days of bleeding. It's different for different people,
Speaker 1: but I think it's not always clear to every patient,
Speaker 1: and so I think keeping a menstrual diary and really
Speaker 1: writing everything down so you can go to your doctor
Speaker 1: with objective data. In general, though, what goes up must
Speaker 1: come down. And I always say when you ovulate, your
Speaker 1: progesterrial levels rise, and then when they drop, your lining
Speaker 1: breaks down. So that's usually why you're bleeding, is because
Speaker 1: you ovulated in the preceding cycle. But bleeding can happen
Speaker 1: for a variety of reasons. So if anything feels off
Speaker 1: or it feels like it's not a normal period, it's
Speaker 1: possible that it isn't. And I'd say the first step
Speaker 1: is getting a pelvic culture sound to investigate, well.
Speaker 2: The kind of test you think that women should be
Speaker 2: doing regularly. Should they be getting the homeless checked regularly,
Speaker 2: and if so, what kind of homeland level should they
Speaker 2: be asking to get checked.
Speaker 1: I'm not a big believer in you need to go
Speaker 1: in every year and check your egg count, but I
Speaker 1: think everyone one could benefit from getting it checked at least,
Speaker 1: you know, once or twice in their twenties or early thirties.
Speaker 1: I am a big believer in getting at least one
Speaker 1: pelvic ultrasound, And this is not a guideline based recommendation.
Speaker 1: This is just my observation as a fertility doctor who
Speaker 1: has seen so many women of varying ages where I'm
Speaker 1: often the first one diagnosing problems like fibroids or that
Speaker 1: they were born with a uterus that has a different
Speaker 1: shape than the average person. And I think that all
Speaker 1: too often this is only coming up because they're coming
Speaker 1: to me with a fertility issue, and then I'm investigating.
Speaker 1: And you see a lot of variation across the board.
Speaker 1: You see some women who are going to their OBGN
Speaker 1: and every once in a while they get a public
Speaker 1: ultrasound because sometimes you have problems going on that you're
Speaker 1: only going to see if you do imaging and they
Speaker 1: haven't manifested as physical symptoms yet. And then there are
Speaker 1: some women that up until they're forties, you know, they've
Speaker 1: never had one and I'm the first one doing it.
Speaker 1: So it's just not standard across the board. And sure,
Speaker 1: maybe it's not practical for everyone to get one ultrasound
Speaker 1: per year, but I think at least once in your
Speaker 1: twenties or thirties just to say that you've taken a
Speaker 1: look at the uterus, at the ovaries and there aren't
Speaker 1: any major red flags.
Speaker 2: Yeah, because if you, let's say you're a woman who
Speaker 2: has decided to freeze her eggs, and the eggs are
Speaker 2: good and good quality, they've said they're fine, But what
Speaker 2: other I guess there's so many other aspects of you
Speaker 2: may have the egg, but the size, the shape or
Speaker 2: size of the vehin of your muterus and all of
Speaker 2: that must also impact. And then does it also change
Speaker 2: as you get older? Because obviously frozen the eggs, so
Speaker 2: that's great, that's there. But does the women's body shift
Speaker 2: and change that makes it harder to get pregnant as
Speaker 2: we get older?
Speaker 1: To for sure? I mean, every time you ovulate, you
Speaker 1: have a cyclical exposure to higher estrogen, and then the
Speaker 1: cycle begins again when you go through your next ovulation.
Speaker 1: And the more ovulations you have in your lifetime, the
Speaker 1: more opportunity for fibroids to grow, for endometriosis to grow.
Speaker 1: So it is definitely something that can change over time.
Speaker 1: And there is this concept of secondary infertility, which we
Speaker 1: don't talk about enough. A lot of women think, Okay,
Speaker 1: I didn't have any issues getting pregnant with baby number one?
Speaker 1: Why is it so difficult now?
Speaker 2: Right?
Speaker 1: And just because it was easy once doesn't mean it
Speaker 1: will always be easy because things can change and evolve
Speaker 1: with your body. We know there's the biological clock right
Speaker 1: as we get older, it becomes harder and more challenging
Speaker 1: to ovulate that healthy egg, and that in and of
Speaker 1: itself might be the reason why it's just taking longer.
Speaker 1: But of course things can change with your uterus, even
Speaker 1: your fallopian tubes. You can develop inflammation where they become
Speaker 1: blocked over time even though they previously weren't blocked. So
Speaker 1: it's always really important to never take anything for granted
Speaker 1: and always reevaluate. If more than a year has passed,
Speaker 1: it's time to get a reevaluation if there's a problem,
Speaker 1: if you're trying to get pregnant and it's.
Speaker 2: Not happening, and with regass of testing. Obviously this is
Speaker 2: a smaller type of test. But do these ovulation kits?
Speaker 2: Are they quite accurate for people to use if they
Speaker 2: are on the pregnancy journey.
Speaker 1: Yes, they can be. I mean, I think they work
Speaker 1: really well for people that have regular periods. What they
Speaker 1: are detecting is basically when you ovulate. What's happening is
Speaker 1: you have a stockpile of eggs that you're born with
Speaker 1: like one to two million, and at any given time point,
Speaker 1: a very small subset of them get recruited to the
Speaker 1: surface of the ovaries in a process I can't control,
Speaker 1: and neither can you. Then your brain, like a lottery,
Speaker 1: sends a signal and randomly chooses one of those eggs
Speaker 1: to mature and ovulate, and that's your one shot at
Speaker 1: getting pregnant. That egg lasts for twelve to twenty four hours,
Speaker 1: and if it's not fertilized in that timeframe, it basically
Speaker 1: disintegrates and goes away and you have to wait till
Speaker 1: the next cycle.
Speaker 2: Right.
Speaker 1: So, when you PI on a stick an ovulation predictor kit,
Speaker 1: what you're looking for when it lights up or whatever
Speaker 1: the indicator is, is that you're about to ovulate. It's
Speaker 1: actually detecting a signal from your brain, your putuitary gland
Speaker 1: called LH. So that signal initially will cause you to
Speaker 1: mature an egg. It's called follicle stimulating hormone. And then
Speaker 1: a second signal goes out called lutinizing hormone or LH,
Speaker 1: and that gets into your urine very quickly, and so
Speaker 1: that's why we have EP these ovulation predictor kits. Day,
Speaker 1: ok And if you see that signal light up, you're like, Okay,
Speaker 1: this gives me a twenty four to thirty six hour window,
Speaker 1: and it's very beneficial to know about ahead of time
Speaker 1: because sperm will wait in the reproductive tract for three
Speaker 1: to five days, and so you really want to be
Speaker 1: having sex in that three to five day window before
Speaker 1: you actually ovulate any attempts after the egg is already
Speaker 1: released or lower yield. So it's basically giving yourself a
Speaker 1: warning or heads up pay ovulation is about to happen. Now.
Speaker 1: The tricky thing is especially for women with polycystic ovary
Speaker 1: syndrome PCOS. That's a condition where your ovaries, just like
Speaker 1: the insulin resistance we were talking about, there's this overall
Speaker 1: theme of resistance where your ovaries are a bit stubborn
Speaker 1: and resistant to those signals from the brain, and so
Speaker 1: your brain ends up kind of shouting at the ovaries saying, hey,
Speaker 1: I need you to work, and that high LH can
Speaker 1: become this constant force, and so you might get positive
Speaker 1: ovulation predictor kits throughout your cycle and come to me
Speaker 1: and say, I don't understand what's going on. Says I'm
Speaker 1: ovulating all the time, but I'm not getting my period.
Speaker 1: So it might not be the best idea for someone
Speaker 1: who knows they have PCOS, who has irregular or confusing
Speaker 1: cycles to try diy ovulation predictor kids or ovulation monitoring,
Speaker 1: because it could end up being inaccurate and really frustrating.
Speaker 2: Let's get into peacos a little bit, because again, something
Speaker 2: that I hear constantly that people around me end up
Speaker 2: finding out that they've got. I would love to start
Speaker 2: off with what have you found has helped people in
Speaker 2: that situation, because the people like I've got family members
Speaker 2: and friends with it, and they're on their pregnancy journey
Speaker 2: and they're really struggling, and it's a very defeating process. It's,
Speaker 2: you know, lose weight, lose weight. They go to the doctor's,
Speaker 2: everyone's like, just lose weight, just lose weight, and being
Speaker 2: told that even if they try, sometimes it's really difficult
Speaker 2: to use the way. And so I would love to
Speaker 2: hear from your experience, what has helped people that you've
Speaker 2: seen with pea COSS and one of the main changes
Speaker 2: that people should be making.
Speaker 1: Yes, So, there are so many different types of polycystic
Speaker 1: over e syndrome. There are some women who have just
Speaker 1: a smidge of it, but their brain is able to
Speaker 1: get through to the over eventually, and they still kind
Speaker 1: of ovulate regularly. I will say for most women with pcos,
Speaker 1: if they're able to ovulate regularly, then it probably isn't
Speaker 1: going to be a huge hindrance to their fertility, right.
Speaker 1: But it's for the people that hardly get a period
Speaker 1: or they never know when their next period's coming. It
Speaker 1: could be every forty five days, could be up to
Speaker 1: every seventy days. That's when it becomes really unfair and
Speaker 1: unpredictable because you're not getting as many shots on goal
Speaker 1: as the person with the twenty eight day ovulation, right,
Speaker 1: And so you never know when it's going to happen.
Speaker 1: And even if you're someone who could have sex every day, right,
Speaker 1: I don't know who those people are, but apparently they exist,
Speaker 1: it's still not fair because you're not getting as many tries.
Speaker 2: Right.
Speaker 1: So that's probably the biggest mechanism when we think about
Speaker 1: the link between pcos and infertility. But then you also
Speaker 1: have this association with ovulation at sorry insulin resistance and
Speaker 1: how that may affect in subtle ways and sometimes more
Speaker 1: drastic ways, egg quality and the environment being more inflammatory
Speaker 1: making it harder for an embryo to implant and stay implanted.
Speaker 1: So there's multiple ways that this can affect fertility. But
Speaker 1: for the person with really irregular cycles, often, yes, we'll
Speaker 1: talk about lifestyle changes, but if you're overweight, you're not
Speaker 1: at your healthy set point. Yes, losing weight might make
Speaker 1: you more sensitive to insulin, and that might reduce the
Speaker 1: interference of the signals to the ovary and help you
Speaker 1: to ovulate more readily, but it's often not enough, and
Speaker 1: sometimes you do need medication, and there's a medication called letrosol.
Speaker 1: It's a pill that basically fools your brain into thinking
Speaker 1: there's no estrogen and it cranks out an even stronger
Speaker 1: signal and we force the ovary to listen. But it's
Speaker 1: frustrating for people, even though I tell them, hey, PCOS
Speaker 1: is one of the easiest problems that I treat, because
Speaker 1: it's not that you don't have the eggs. It's that
Speaker 1: your body doesn't know how to access the eggs, and
Speaker 1: we do have ways to force it to access the eggs.
Speaker 1: But it seems really unfair that you have to take
Speaker 1: a pill for five days, come in for an all ultrasound,
Speaker 1: maybe some blood work to kind of gauge what's actually
Speaker 1: happening with your body and your ovulation, and it's like,
Speaker 1: you know, work to do something that a lot of
Speaker 1: people take for granted, being able to on their own
Speaker 1: track their ovulation do this without intervention. So something I'm
Speaker 1: constantly saying to my patients with PCOS because they get
Speaker 1: very worn down very quickly, where they're like, I just
Speaker 1: started my journey, and I've been on this journey now
Speaker 1: for five months, and you've made me ovulate five months
Speaker 1: in a row. That's great, but nothing's happening. What's wrong.
Speaker 1: I'm starting to panic. And I always explain to them
Speaker 1: human reproduction is so inefficient. When you ovulate one egg,
Speaker 1: it's a long shot. We all need to think about
Speaker 1: it that way, even in our twenties, not every egg
Speaker 1: is going to fertilize, turn into an embryo, and actually implant.
Speaker 1: So if I'm just giving you the opportunity to release
Speaker 1: that egg, I'm giving you, let's say, a twenty percent
Speaker 1: chance of pregnancy each month. I'm just presenting the option.
Speaker 1: But whether it actually all happens after the fact after
Speaker 1: you ovulate, is largely out of our control. So it's
Speaker 1: going to take persistence in time, and eventually if someone
Speaker 1: gets really tired by it. We can always say, let's
Speaker 1: bypass ovulation. You know, we can do things like IBF,
Speaker 1: or we have to take some shots. We extract eggs,
Speaker 1: we put the eggs and sperm together outside the body,
Speaker 1: We put one embryo in at a time, and we
Speaker 1: just say, forget about the ovulation piece, let's just get
Speaker 1: you pregnant. But there's a step wise approach, and I
Speaker 1: think it's really about educating my patients and arming them
Speaker 1: with all of the tools to be resilient because a
Speaker 1: lot of this is just like persistence paying off, but
Speaker 1: you have to stay in it to win it.
Speaker 2: Yeah, I think it's so difficult for women when you're
Speaker 2: really trying and you just don't know when do I stop.
Speaker 2: You always, you know with some of my friends that
Speaker 2: you just think, well, what if this time will be
Speaker 2: at the time totally and it's so hard for them
Speaker 2: to know, Okay, well maybe this is the time I
Speaker 2: should give up, like five years, ten years, however long
Speaker 2: you're trying for. It's so hard to put a stop
Speaker 2: to it because you're always live in that hope, because
Speaker 2: you also want to believe that your body's capable of.
Speaker 1: That, right and I've seen such miraculous things happen. You know,
Speaker 1: when you were asking me earlier, what are some of
Speaker 1: your favorite fertility stories. I mean, I was talking to
Speaker 1: one of my dear friends today. She's publicly shared her journey,
Speaker 1: and I told her I was going to give her
Speaker 1: a shout out. But Jordana Abram, she has her own
Speaker 1: podcast about, you know, infertility, in her journey with infertility,
Speaker 1: and she just had twin girls after a really harrowing
Speaker 1: journey with infertility and pregnancy loss. And you know, she
Speaker 1: actually kind of gave up on the idea of trying
Speaker 1: to carry on her own and pivoted to surrogacy, and
Speaker 1: the surrogate got pregnant, and then she wasn't even really trying,
Speaker 1: wasn't in the midst of IVF for her own journey,
Speaker 1: and miraculously got pregnant. So she just had two babies,
Speaker 1: like within the span of weeks, two baby girls, and
Speaker 1: they call I guess they're called like twibblings because they're
Speaker 1: kind of like twins. But she carried one and the
Speaker 1: surrogate carried the other, and it was just so fertuitous.
Speaker 1: And it's actually why I called my books Lucky egg
Speaker 1: is stories like this that even when the stats are
Speaker 1: stacked against you, the odds are stacked against you, You've
Speaker 1: tried everything. Sometimes you know, science can get you very far,
Speaker 1: but at the end of the day, there is some serendipity,
Speaker 1: there is some luck, and you just need one egg
Speaker 1: to make it past all those hurdles. And despite all
Speaker 1: of the science and the predictions, at the end of
Speaker 1: the day, it worked for her. And I think that
Speaker 1: those stories give a lot of hope.
Speaker 2: They really do. I think people need to hear those
Speaker 2: because there are so many of the other stories and
Speaker 2: you need those little glimpses of hope that kind of
Speaker 2: get you through the next You know, if you're doing IVF,
Speaker 2: the next cycle and the next cycle, there's.
Speaker 1: More than one way to get there. Yeah, And I think,
Speaker 1: you know, while you don't always have a clear defined
Speaker 1: path and I don't have a crystal ball, trust me,
Speaker 1: it would make my job so much easier if I did.
Speaker 1: I think that the key thing that I can do
Speaker 1: is really coach and guide my patients and give them
Speaker 1: my honest, professional opinion about when it's time to pivot,
Speaker 1: but also leave the door open for you know, there
Speaker 1: is no finality in all of this, Like, you can't
Speaker 1: always pret what's going to happen. All we can do
Speaker 1: is make the next best take the next best step
Speaker 1: based on the information we have at hand.
Speaker 2: Yes, I'd love to get into natural fertility for a
Speaker 2: bit and then move on to IVF. But what would
Speaker 2: you say, because obviously there's so many things that out
Speaker 2: there if you should try this for fertility, and you
Speaker 2: should be eating this and doing this. But as some
Speaker 2: of the lifestyle changes you think that matter the most,
Speaker 2: if there's any that you haven't already mentioned, and which
Speaker 2: ones do you think are overrated and don't really make
Speaker 2: much of a difference.
Speaker 1: Yeah, I think lifestyle plays a huge role in our
Speaker 1: general health and in our fertility. And I think the
Speaker 1: best way to think about it is in simple terms,
Speaker 1: whatever is better for heart health tends to be better
Speaker 1: for your fertility. Right, So when you think about exposures
Speaker 1: to avoid, that's the easy place to start. Smoking is
Speaker 1: never good for fertility, right, And it's not good for
Speaker 1: your health in general. We know that it depletes your
Speaker 1: eggs at a faster rate, It is associated with going
Speaker 1: into early menopause, and if you're in menopause, it means
Speaker 1: you run below a critical threshold of eggs, you're not
Speaker 1: able to ovulate. And if you're not ovulating, you're not
Speaker 1: in the game. And if it's because of a quantity issue,
Speaker 1: there isn't very much that I can do to work
Speaker 1: around that. I need eggs to work with, right.
Speaker 2: And you're just born with the amount of eggs that
Speaker 2: you keep the whole life.
Speaker 1: Right, correct, and things like genetics age. We know as
Speaker 1: we get older we lose eggs at a faster rate,
Speaker 1: but also toxic exposures including smoking, can accelerate that process. Drinking, right, alcohol,
Speaker 1: especially the threshold that has been kind of looked at,
Speaker 1: and the overall pattern that has been establ established is
Speaker 1: that less than four drinks in a given week is
Speaker 1: kind of associated with better outcomes versus more than four
Speaker 1: drinks moderate to heavy drinking. When it comes to diet,
Speaker 1: the best diet for fertility is usually the boring one.
Speaker 2: Right.
Speaker 1: There are all these bad diets out there about, you know,
Speaker 1: keto or carnivore diet. Anything that's extremely restrictive or very
Speaker 1: one sided and doesn't involve a lot of variety is
Speaker 1: not something that I would ever recommend to my patients.
Speaker 1: And it's shocking how much that is pushed and recommended. Yeah,
Speaker 1: you look online, a Mediterranean style diet is always going
Speaker 1: to serve your health better, whether it be your heart
Speaker 1: health or your fertility. So that means, you know, lean proteins,
Speaker 1: healthy sources of fats like nuts, seeds, avocado, eating the
Speaker 1: rainbow like this is such common sense stuff, but it's
Speaker 1: actually been proven in the data that this seems to
Speaker 1: be associated with better pregnancy rates, whether trying on your
Speaker 1: own or looking at women who are undergoing treatment. Exercise
Speaker 1: is so important, you know, movement is medicine and one
Speaker 1: hundred and fifty minutes of cardiovascular exercise per week, but
Speaker 1: also resistance training and doing kind of a mix of everything.
Speaker 1: But I think building muscle because again that makes you
Speaker 1: more resistant to the effects of insulin, which is really
Speaker 1: important for your overall health and fertility. Sleep we know
Speaker 1: that if you're consistently getting less than seven hours, that
Speaker 1: can lead to menstrual disturbances, so it's really important to
Speaker 1: be consistent with your sleep routine. And then stress is
Speaker 1: a big one, right I'm here to actually tell you
Speaker 1: that the day today's stress, you know, the boardroom meeting,
Speaker 1: that big deadline. Those aren't affecting your fertility in a
Speaker 1: negative way, and we need to stop blaming ourselves.
Speaker 2: Right.
Speaker 1: So many women who go through miscarriages or failed cycles
Speaker 1: or they're not getting pregnant trying on their own, they'll
Speaker 1: often say, you know, I really need to clean up
Speaker 1: my lifestyle. I need to like clear my life of stress.
Speaker 1: And I just think that that is a losing battle.
Speaker 1: You know, living a stress free life is not really
Speaker 1: the goal. I think it's about setting up coping mechanisms
Speaker 1: and being able to build resilience so that you can
Speaker 1: handle stress effectively and that you don't have unhealthy coping mechanisms.
Speaker 1: That's really the key.
Speaker 2: I think, even though you said, oh, you know, it's
Speaker 2: all the basic things that we already know. Even if
Speaker 2: it is basic, it's so needed to be reminded of
Speaker 2: every single day, because yes, of course we're told eating vegetables,
Speaker 2: but all we eat all vegetables, And yeah, we're told
Speaker 2: to exercise for this many hours, but are we actually
Speaker 2: doing it right? A lot of the time, it's the
Speaker 2: simple stuff that people struggle with the most. Right is
Speaker 2: getting a takeaway and eating something deep fried might be
Speaker 2: a lot more convenient but all we thinking on a
Speaker 2: daily basis about our hot health, are we thinking about
Speaker 2: all fertility and so yes, it sounds really simple, but
Speaker 2: if we actually affect on it. Sometimes I think we
Speaker 2: hear things over and over again, but oh we've heard that,
Speaker 2: but all we actually doing it?
Speaker 1: No, and there's opposite advice out there. R exactly the
Speaker 1: number of times I've sat across my desk from a
Speaker 1: couple and you know, either partner will be like, well,
Speaker 1: he or she exercises five days a week, and I'm like, bravo,
Speaker 1: Oh that's a good thing. But there is this narrative still,
Speaker 1: and I feel like this was a really really prevalent
Speaker 1: narrative like ten twenty years ago, that when women are
Speaker 1: trying to get pregnant they should be treating their bodies
Speaker 1: so delicately, and especially when you are pregnant, oh god
Speaker 1: forbid you exercise. I think we're moving away from that,
Speaker 1: and now it's understood that, you know, our bodies are amazing,
Speaker 1: and when you are pregnant, it's actually advised that you
Speaker 1: should exercise regularly. But there's still this idea of like, well,
Speaker 1: you don't want to toast you too much exercise and
Speaker 1: that's actually bad advice. You know, being sedentary is actually
Speaker 1: so bad for our health, and it's not great for
Speaker 1: our fertility either. So movement is good. Movement is medicine,
Speaker 1: and we shouldn't be afraid of it. I mean there
Speaker 1: are extremes. You know, if someone's training for the Olympics
Speaker 1: and in combination, you know, eating very little and there's
Speaker 1: a major imbalance in the amount of energy they're taking
Speaker 1: in and what they're expending. That can affect your fertility
Speaker 1: because it can shut down ovulation. It's almost like your
Speaker 1: brain is saying, we're too stressed out, we don't have
Speaker 1: enough resources to just keep you alive, Like we're not
Speaker 1: going to shunt energy towards ovulation because we don't want
Speaker 1: to support a baby right now. That's a very extreme example.
Speaker 1: But for someone who's exercising three to five days a week,
Speaker 1: that's a good thing and we shouldn't be afraid of that.
Speaker 2: And should women be avoiding high intensity exercises during the
Speaker 2: prices of trying to get pregnant.
Speaker 1: I don't think so. I think exercise is better than
Speaker 1: no exercise. Maybe, you know, in early pregnancy, it's not
Speaker 1: lies to be like, now's a great time to take
Speaker 1: up CrossFit. You know, I've never worked out before, but
Speaker 1: now I'm gonna enjoin the CrossFit cults. Like I don't
Speaker 1: necessarily think that's a good idea, but that's because physiologically,
Speaker 1: in the early steps of pregnancy, especially in the first trimester,
Speaker 1: your body is adjusting and you have a lot of
Speaker 1: progesterone and that can cause your ligaments to be more
Speaker 1: relaxed and you're more prone to injuries. So I always
Speaker 1: tell patients to be careful when they're doing new things
Speaker 1: or easing back into an exercise routine. But the earlier
Speaker 1: you get back into it, the easier it is. I
Speaker 1: think the longer you go without exercise, it's easier to
Speaker 1: become deconditioned, and it's much harder to kind of pick
Speaker 1: up in the second and third trimester.
Speaker 2: Because I always hear about how for women, you know,
Speaker 2: especially recently Expects saying avoid any woman should be avoiding
Speaker 2: high intensity training because it really throws off your hormones
Speaker 2: and your courts all. And I guess I was wondering,
Speaker 2: what is too intense exactly? Is it breaking a sweat
Speaker 2: like she's breaking a sweat? Should we not be out
Speaker 2: of breath when we're walking out by now it's really
Speaker 2: hard because then as soon as you're told that, yeah,
Speaker 2: you think, oh so I should stick to pelosis, Yeah,
Speaker 2: stick to going on wolves.
Speaker 1: No, you need to work your heart out right. And
Speaker 1: I don't think when people are I think when people
Speaker 1: are saying that, what they're really referring to is like
Speaker 1: Olympic level training, like where you're really doing something repetitive
Speaker 1: and it's not in balance. But I think for someone
Speaker 1: who's just like I want to go for a run
Speaker 1: for half an hour to an hour a day, not
Speaker 1: only is that so good for your physical health and
Speaker 1: your fertility, but it's also great for your mental health too.
Speaker 1: So this narrative of women, you know they're going through
Speaker 1: fertility treatments or they're trying on their own, and now
Speaker 1: maybe they're in early pregnancy, and telling them to be
Speaker 1: so careful and that they are these delicate beings and
Speaker 1: they shouldn't be exercising, it's doing a major disservice to
Speaker 1: them because it's not actually rooted in scientific evidence. We
Speaker 1: know the scientific evidence actually is saying it's better to
Speaker 1: be someone that exercises regularly. But I think it's a
Speaker 1: huge problem when it comes to taking away a tool
Speaker 1: that so many use for their mental health.
Speaker 2: Yes, and if you think about it tribally, like even
Speaker 2: if you go back culturally, back in the day, women
Speaker 2: were grinding, like, they were really out there. They were
Speaker 2: picking the they were picking the fruits, they were going out,
Speaker 2: they were foraging.
Speaker 1: They were doing so much, not working desk jobs.
Speaker 2: Yeah, exactly, they were sitting around for that long. So
Speaker 2: I imagine moving your body. All you're really doing is
Speaker 2: a one hour to maybe two hours.
Speaker 1: Work, counteracting all of the sedentary other hours of the day.
Speaker 1: It's really important. I'm here to say that that's not
Speaker 1: a thing.
Speaker 2: Okay, good to know. Are there any foods that you
Speaker 2: recommend when someone is starting to try and get pregnant.
Speaker 2: Are there any foods that you're like, you know what,
Speaker 2: this has actually been found to really help on this
Speaker 2: journey or is it generally just the Mediterranean diet.
Speaker 1: It's more the pattern of eating there isn't. I think
Speaker 1: one of the biggest fertility myths is that there's this
Speaker 1: set formula, whether it be a superfood or you know,
Speaker 1: a particular set of supplements that are guaranteed to reverse
Speaker 1: the biological clock or a guarantee that you're going to
Speaker 1: get pregnant faster than the next person that's not doing
Speaker 1: those things. That's not true, right, There isn't a single
Speaker 1: thing that falls within that bucket. I think it's more
Speaker 1: of a dietary pattern. I think variety is always good,
Speaker 1: you know, when you think about the major top nutrients,
Speaker 1: like folate is really important from leafy green vegetables. We
Speaker 1: also say to take folic acid as part of your
Speaker 1: prenatal vitamin because it's actually very important for preventing a
Speaker 1: certain type of birth defect that affects the spinal canal.
Speaker 1: And that's why a lot of the American diet is
Speaker 1: actually fortified with fullic acid. But taking you know, folate
Speaker 1: through diet as well as a follic acid in your
Speaker 1: supplement Omega threes. These are fatty acids, healthy sources of
Speaker 1: fats that you don't produce naturally in your body, and
Speaker 1: you can get them from nuts, seeds, salmon. It's anti
Speaker 1: inflammatory and it is known to be better for fertility
Speaker 1: and for pregnancy health.
Speaker 2: Anify greens for the pholin and healthy fats exactly.
Speaker 1: And then iron, I would say iron and protein are
Speaker 1: really important as well. There are many people that are
Speaker 1: undiagnosed with iron deficiency and there can be an association
Speaker 1: with it making it harder to get pregnant. So it's
Speaker 1: something that I screen all my patients.
Speaker 2: Especially in all culture iron and I just had got
Speaker 2: some of my block tests back and I was like, oh,
Speaker 2: my iron has gotten so low. Iron invismin dy Yeah,
Speaker 2: like every time I stopped taking it.
Speaker 1: It just do you live in LA I don't want
Speaker 1: to know what my vidy swinter.
Speaker 2: I really need to get back to it. So I
Speaker 2: took my IES supplement this morning for you. I wanted
Speaker 2: to ask about supplements because you just mentioned them prenatals.
Speaker 2: Do you have anyones that you recommend and what's your
Speaker 2: view on them?
Speaker 1: So I try to stay away from recommending any particular
Speaker 1: brand as a doctor, Okay, okay, because I think it's
Speaker 1: important for me to not be biased in that regard.
Speaker 1: But always, you know, I think one that contains fulloic acid.
Speaker 1: If you go to the American College of Obgyn website,
Speaker 1: there's actually a list of nutrients and amounts of nutrients
Speaker 1: that are the daily recommended amount for women who are
Speaker 1: trying to get pregnant or in the first trimester, and
Speaker 1: so whether you're getting that for diet or from supplementation,
Speaker 1: I think it doesn't matter how you're doing it, but
Speaker 1: it's really important to try to hit on all of
Speaker 1: those major vitamins and micronutrients. When you think about other
Speaker 1: supplements that have been looked at, first of all, correcting
Speaker 1: any known deficiencies. We already talked about it a little
Speaker 1: bit like iron. Vitamin D is another one that plays
Speaker 1: an essential role in many aspects of human reproduction as
Speaker 1: well as early pregnancy health, and so many of us
Speaker 1: are vitamin D deficient. So I would say start by
Speaker 1: correcting deficiencies. You know, if you have a B twelve deficiency.
Speaker 1: A lot of times the earliest sign of these things
Speaker 1: is looking at a complete blood count and seeing, okay,
Speaker 1: some of your levels are off, and you can indicate
Speaker 1: whether you know whether that's actually causing anemia or whether
Speaker 1: there's just subtle changes in your complete blood count that
Speaker 1: may lead down a further line of investigation to say, hey,
Speaker 1: are you deficient in fold eate vitamin B twelve? Are
Speaker 1: these things that we can correct with supplementation or changes
Speaker 1: in your diet. Coenzyme Q ten is probably one of
Speaker 1: the more studied vitamins when we think about supplements for
Speaker 1: fertility and it's an antioxidant. It doesn't have the perfect
Speaker 1: data that I would love to recommend it wholeheartedly, but
Speaker 1: it definitely has a pretty favorable side effect profile, doesn't
Speaker 1: seem to have a lot of interactions with medications or
Speaker 1: major side effects, and there are some pretty well designed studies,
Speaker 1: large scale studies that have shown a relationship between taking
Speaker 1: six hundred milligrams of coenz im Q tena day and
Speaker 1: higher pregnancy rates and women undergoing treatment. So it's specifically
Speaker 1: been looked at for a lot of women who may
Speaker 1: be older or are dealing with diminished to varying reserve.
Speaker 1: But it's not the end albeit at all, And it's
Speaker 1: not something that I'm like, this isn't going to work
Speaker 1: if you don't take this, But it's probably got the
Speaker 1: most evidence behind it versus some of the others. And
Speaker 1: in my book, I have a whole table where and
Speaker 1: this was the chapter that the writing almost killed me
Speaker 1: because it's really depressing as a doctor, as someone who's
Speaker 1: scientifically minded to comb through so much bad data, you know,
Speaker 1: I was just like, I can't believe this is touted
Speaker 1: to be like the end all, be it all of supplements. Meanwhile,
Speaker 1: there's like hardly any human studies, right, So this table
Speaker 1: goes through all of the different types of supplements that
Speaker 1: have generated any buzz when it comes to improving male
Speaker 1: or female fertility, And I put, how is this proposed
Speaker 1: to actually help? Because a lot of people are taking
Speaker 1: these things without even knowing what is today the proposed benefit.
Speaker 1: What is the typical dosage that's been taken and recommended.
Speaker 1: What do the studies actually show a lot of the
Speaker 1: studies shown really little effect, or you know, are really
Speaker 1: poorly designed or have really small numbers. So when you
Speaker 1: actually look through it, I think that that gives you
Speaker 1: the necessary context and information to make informed decisions. I
Speaker 1: will say, there isn't one single supplement that I'm like,
Speaker 1: this is vital and if you don't take it, you
Speaker 1: know your fertility is going to be doomed. That just
Speaker 1: isn't a thing in my field.
Speaker 2: Okay, good to know. I think that'll help with other people.
Speaker 2: Do that ease about it?
Speaker 1: Yes?
Speaker 2: I definitely move on to egg freezing, and then we
Speaker 2: mentioned it earlier. But first of all, there's obviously egg
Speaker 2: freezing and then there is embryo freezing. Now, are is
Speaker 2: it two different processes that a woman has to go
Speaker 2: through or is it pretty much the same process that
Speaker 2: both in tail.
Speaker 1: So it's same, it looks same for the female partner. Okay,
Speaker 1: So the first step to egg or embryo freezing, and
Speaker 1: these are the two methods that we know of that
Speaker 1: are effective at trying to preserve someone's fertility for the future.
Speaker 1: The first step looks the same and it involves trying
Speaker 1: to go in and capture a bunch of eggs, basically
Speaker 1: salvaging them. Remember I said at the beginning that there's
Speaker 1: a stockpile of eggs that you're born with. At any
Speaker 1: given time point, only a very limited subset of eggs
Speaker 1: are allowed to escape from that pantry, so to speak.
Speaker 1: And it's almost like rationing. That's why I use the
Speaker 1: word pantry, because it's like your body allows you to
Speaker 1: release only as many as you can afford to release.
Speaker 1: So earlier in your life, when you have more in
Speaker 1: your stockpil, you bring more to the surface, and later
Speaker 1: in life when you have less than your stockpile. Because
Speaker 1: we don't make new eggs over time, you can't regenerate eggs,
Speaker 1: then you bring fewer to the surface. Now, when I
Speaker 1: do an ultrasound on someone and I'm looking at through
Speaker 1: ovaries and I'm counting those bubbles of fluid that we
Speaker 1: call follicles, those are the eggs that we're pulled out
Speaker 1: of the stockpile, and so counting them only matters if
Speaker 1: you're going through a process like an egg retrieval for
Speaker 1: fertility preservation or for IVF to overcome in fertility, And
Speaker 1: the first step is taking shots. The shots that you
Speaker 1: take for eight to ten days approximately are mimicking that
Speaker 1: same signal your brain sends to the ovary to get
Speaker 1: one of them to normally mature and then later ovulate.
Speaker 1: But we have you take those shots at a slightly
Speaker 1: higher level in an effort to select everything that's been
Speaker 1: pulled out of the stockpile. So the first step is
Speaker 1: you want to mature them. And just like when you
Speaker 1: have a banana that ripens, it's easier to appeel. When
Speaker 1: a follicle becomes larger, the egg inside of it is
Speaker 1: more likely to be mature and capable of being fertilized
Speaker 1: by sperm one day. So we're bringing you in during
Speaker 1: the course of these eight to ten days of shots,
Speaker 1: which you're typically taking at home on your own or
Speaker 1: the help of a nurse. Right, and then you're coming
Speaker 1: in for periodic monitoring visits. These are usually done early
Speaker 1: in the morning so that we can get same day
Speaker 1: results where we're doing a scan and blood work, engaging
Speaker 1: how is your body responding, And at a certain point
Speaker 1: we'll say, Okay, it looks as good as it can
Speaker 1: possibly get. I think we're going to capture as many
Speaker 1: of the eggs as we can. Let's go in and
Speaker 1: get them out. And that is a very minor procedure.
Speaker 1: It takes ten minutes or less. You're put to sleep
Speaker 1: with light sedation through an IV. An antithesiologist is watching
Speaker 1: the entire time, and all we're doing is if this
Speaker 1: is the vaginal canal going to the uterus, right, the
Speaker 1: ovaries sit very low down on either side. Under ultrasound guidance,
Speaker 1: we kind of angle the ultrasound this way and we
Speaker 1: use a long, thin needle. Under ultrasound guidance, we're basically
Speaker 1: popping each bubble and just draining the fluid to pick
Speaker 1: up the egg from each one on either side. So
Speaker 1: there's no incisions on your abdomen. This is not a
Speaker 1: major surgery, and you wake up in the recovery room.
Speaker 1: And I'm speaking from experience having gone through this. I
Speaker 1: did embryo freezing with my husband at thirty four. I
Speaker 1: woke up in the recovery room like I can't believe
Speaker 1: it's over, you know, And it felt like the best
Speaker 1: nap of my life. I woke up crampy, kind of tired,
Speaker 1: went home and slept for five six And that day
Speaker 1: they can take the eggs out and we can either
Speaker 1: freeze them as eggs, which are as single cells, so
Speaker 1: you can actually test the quality. You can just know, hey,
Speaker 1: I have some mature eggs, okay, and you can freeze them.
Speaker 1: Or if you have a partner or you want to
Speaker 1: do this with a sperm donor, we can take sperm
Speaker 1: and we can inseminate those eggs. We can put them
Speaker 1: with the eggs and fertilize them, let them grow for
Speaker 1: a week. And as they're growing, they're separating into two
Speaker 1: cell types, cells that become the baby and cells that
Speaker 1: would one day become the placenta. That's an embryo that
Speaker 1: in plants. We can even remove some of those outer
Speaker 1: cells and send them off for genetic testing or not
Speaker 1: and freeze them at the embryo stage. But embryos you
Speaker 1: can assess the quality because you can do that genetic testing. Okay,
Speaker 1: you know that anyone can have an embryo form from
Speaker 1: their eggs, even in their twenties that has missing or
Speaker 1: extra DNA. These are typos and errors that happen as
Speaker 1: part of human biology, and they become more prevalent as
Speaker 1: we get older. But that's the advantage of embryo freezing
Speaker 1: is that you're further along in the process. Not every
Speaker 1: egg that you eventually saw fertilize and try to turn
Speaker 1: into an embryo. We'll get there, because again, human reproduction
Speaker 1: is inefficient, and that inefficiency isn't magically solid for just
Speaker 1: because you're doing this high tech process. So when you
Speaker 1: think about freezing eggs, I wouldn't even call it an
Speaker 1: insurance policy or a backup plan. I would call it
Speaker 1: a head start if and should you ever need IVF
Speaker 1: in the future. How lovely is it to be able
Speaker 1: to say, well, we have a larger cohort of eggs
Speaker 1: and what I'm typically going to be able to get
Speaker 1: in one round of effort now at this older age,
Speaker 1: and they should have a higher conversion rate from eggs
Speaker 1: to healthy embryos because they were from when you were
Speaker 1: in your twenties or early thirties versus now, And so
Speaker 1: it's not to say every egg will be guaranteed to
Speaker 1: be successful. So having enough eggs based on the age
Speaker 1: you are when you freeze your eggs is really essential.
Speaker 1: And there's a lot of unknowns that you're willing to
Speaker 1: accept for flexibility though, because you can come back and
Speaker 1: use those eggs with whichever partner once you turn them
Speaker 1: into embryos, you're not able to undo that, so you're
Speaker 1: kind of committed.
Speaker 2: So you make it sounding much more of an easier
Speaker 2: process than I feel, because so many of my friends
Speaker 2: have been considering it. But I'm not sure, and it
Speaker 2: feels like a scary process. But it's essentially a fifteen
Speaker 2: day ish period that you're going through.
Speaker 1: Yeah, and I don't want to sugarcoat it. I mean,
Speaker 1: was it the most favorite thing that I ever did?
Speaker 2: Yeah?
Speaker 1: I mean you feel bloated, You definitely have some side effects.
Speaker 1: You have some cramps even a few days after the procedure,
Speaker 1: but it's not the months and months of shots that
Speaker 1: a lot of people assume.
Speaker 2: And there's no negative effects on the body after you've
Speaker 2: done it.
Speaker 1: It's no, It's very transient because remember the eggs that
Speaker 1: come to the surface, they're always getting thrown away at
Speaker 1: the end of the cycle. So this isn't depleting your
Speaker 1: egg count, this isn't putting you into menopause faster. This
Speaker 1: is us just salvaging what would have already been wasted
Speaker 1: in that cycle. And it's not something that is ever
Speaker 1: going to affect your future fertility. Even if you feel
Speaker 1: bloated and you have some water weight gain, all of
Speaker 1: that will dissipate as the hormones leave your body about
Speaker 1: two weeks later. You get a period about one to
Speaker 1: two weeks after the egg retrieval and everything resets.
Speaker 2: Okay, oh my god. Yeah. Definitely put people to ease
Speaker 2: their minds, to ease that this process, because I feel
Speaker 2: like it feels like such a big decision to make,
Speaker 2: but actually it's just safeguarding as all.
Speaker 1: Yeah, I'm just gaving myself to you to think it's
Speaker 1: a big decision, and it's also a big cost, right.
Speaker 1: Not everyone has insurance coverage to do this, So I
Speaker 1: do think it's a big decision. But I think it's
Speaker 1: an important thing to consider and at least learn about
Speaker 1: if and should you ever find yourself or if you
Speaker 1: think you're someone who might find yourself realistically in a
Speaker 1: place where you're trying to build your family in your
Speaker 1: late thirties, forties and beyond, then it's a smart thing
Speaker 1: to do. I mean, I did this at thirty four.
Speaker 1: I had already had a child, but I just felt
Speaker 1: really overwhelmed getting back into work and trying to balance
Speaker 1: it all. And I said to myself, as a fertility doctor,
Speaker 1: I'm going to take my own advice because I don't
Speaker 1: see myself being in a place where I'm ready to
Speaker 1: try again for another two to three years, and inevitably
Speaker 1: I'm going to be thirty seven thirty eight, it could
Speaker 1: be a little bit harder to ovulate that healthy egg
Speaker 1: that I need to ovulate. So let me do this.
Speaker 1: And I'm so glad I did, because I did end
Speaker 1: up having secondary infertility. It was harder for me to
Speaker 1: get pregnant, and it wasn't surprising as to why, but
Speaker 1: I was so I was less stressed, and I felt
Speaker 1: really at ease with the fact that I already had
Speaker 1: done the hard work of creating the embryos.
Speaker 2: Yes, I would have to move on to IVF. What
Speaker 2: do you feel is the biggest misconception that people have
Speaker 2: about IVF.
Speaker 1: I think there's a lot of fear. Right so you
Speaker 1: already talked about, oh my gosh, how long is this
Speaker 1: going to take, how evasive is it, how hard is it?
Speaker 1: I think people overestimate that. I think this is there's
Speaker 1: this idea of like IVF long haulers, Like there's all
Speaker 1: these people that you hear these nightmare stories of oh
Speaker 1: my gosh, they've done so many cycles, and sometimes I
Speaker 1: think patients feel my patients will say like I want
Speaker 1: to try this, but I don't want to be someone
Speaker 1: that's doing cycle after cycle left and I'm like, you're
Speaker 1: not signing up for that. I mean, you're going to
Speaker 1: try this and then let's see what the outcome is
Speaker 1: and then make a thoughtful decision depending on how you
Speaker 1: felt going through the process, what the results were, how
Speaker 1: much progress we made. Is this something we need to
Speaker 1: try again. Yeah, some people get what they need out
Speaker 1: of the first round off IBF. There are many people
Speaker 1: where it takes more than one round because not every
Speaker 1: egg that they extract is going to fertilize, grow into
Speaker 1: an embryo, and sometimes if you're starting with a small
Speaker 1: number or you have significant egg quality issues, you may
Speaker 1: end up in a position and I did for one
Speaker 1: of my cycles when I was trying to do this
Speaker 1: just preemptively where I only had two eggs retrieved and
Speaker 1: none of them turned into embryos. And that was a
Speaker 1: cycle where I had nothing to show for it. So
Speaker 1: that can be really difficult. And I think people sometimes
Speaker 1: go into IVF thinking the success rates are really high,
Speaker 1: so this is going to be the solve, and they
Speaker 1: might be blindsided to find out, hey, it didn't work,
Speaker 1: and I need to try this more than once. So
Speaker 1: I think it's a balance of don't be so overly
Speaker 1: pessimistic and assume you're going to be sucked into this
Speaker 1: IVF world where you're just going on this non stop
Speaker 1: train of IVF. No, you can make thoughtful decisions. There's
Speaker 1: no like you're not like a past exactly, and there
Speaker 1: should be an ongoing conversation with your doctor, not just
Speaker 1: something that you're like a passive passenger and all of this.
Speaker 1: But also it's not always rosy like. Sometimes it takes
Speaker 1: time and it's and while science has gotten us very far.
Speaker 1: It's not the solf you know, sometimes it takes more
Speaker 1: than one round to get there. There's a lot of
Speaker 1: fear around IVF and this misconception that it could cause
Speaker 1: breast cancer. That's a huge one as well, and that's
Speaker 1: just not a thing. You know that the data shows
Speaker 1: that there isn't a relationship between women who have done
Speaker 1: a round of IVF, even several rounds of IVF, who
Speaker 1: have been followed for decades in their lives, they don't
Speaker 1: have a higher risk of developing breast cancer. There is
Speaker 1: an underlying risk factor where we know that the more
Speaker 1: ovulations you've had in your lifetime is related to risk
Speaker 1: of breast cancer. And so I think there might be
Speaker 1: with a without iv ACT, right, But I think when
Speaker 1: people initially used to ask this question, you know, if
Speaker 1: you're looking at a population of patients going through IVF,
Speaker 1: they might be older at time of first time that
Speaker 1: they're trying to get pregnant. So there's a lot of
Speaker 1: like confounding variables and things. And when we've looked into
Speaker 1: the data, and we've looked to countries like Denmark that
Speaker 1: have done a good job of keeping registries and following
Speaker 1: long term outcomes. IVF is very safe in the long term.
Speaker 1: It's not going to impact your fertility, and it's not
Speaker 1: going to impact your risk for things like breast cancer.
Speaker 2: Okay, And are there any helistic treams that you recommend
Speaker 2: alongside when people getting IVF, like acupuncture or anything that
Speaker 2: you've noticed has helped along that journey.
Speaker 1: I think acupuncture has been a wonderful tool for a
Speaker 1: lot of my patients. Now I'm going to be forthcoming
Speaker 1: and say that there isn't one singular study that's well designed,
Speaker 1: large that's like this really moved the needle and intended
Speaker 1: in pregnancy rates for women. But it's certainly not harmful.
Speaker 1: And I do know that a lot of my patients
Speaker 1: find it very relaxing. They feel like it helps with
Speaker 1: stress relief, It helps them feel less anxious. Maybe some
Speaker 1: of it is placebo, but you know, the idea is
Speaker 1: that it can improve blood flow to certain areas of
Speaker 1: the body. This is an ancient form of Chinese medicine.
Speaker 1: You don't always know everything there is to know. I've
Speaker 1: gone to acupuncturists for migraines, you know, as a Western
Speaker 1: medicine doctor. So I don't think there's a downside. I
Speaker 1: think if there are things that aren't going to hurt
Speaker 1: and could be helpful, even if it's like on a
Speaker 1: mental health front, then I'm all for it.
Speaker 2: And why not? Yeah, exactly talking about mental health, I
Speaker 2: feel like, you know, we mentioned the women who have
Speaker 2: tried and tried and they just feel really betrayed by
Speaker 2: their own bodies. Yes, do you have any advice for
Speaker 2: women who are trying to you know, we build trust
Speaker 2: with their own body after they feel like their bodies
Speaker 2: failed them, Like how to rebuild that relationship with their
Speaker 2: body off to something like this?
Speaker 1: Yeah, I mean I think the first thing is and
Speaker 1: you have to drill this into your brain because trust
Speaker 1: me as an expert who tells women this all day
Speaker 1: every day. When I went through my own fertility journey,
Speaker 1: it was such a human nature knee jerk reaction to
Speaker 1: automatically look inward and blame myself. And so I'm here
Speaker 1: to tell you it is not your fault. You know,
Speaker 1: whatever you're experiencing, it's not because of something you did
Speaker 1: or didn't do. And that maybe confusing coming off of
Speaker 1: you know, our conversation about lifestyle, but in reality, age
Speaker 1: timing genetics play have much more of a weighted role
Speaker 1: in all of this than the things that you can control,
Speaker 1: and it's not fair. This is a hard thing to
Speaker 1: uncouple in our mind because so much of our life
Speaker 1: is about the effort we put in and then seeing
Speaker 1: the product right, and fertility is not one of those things.
Speaker 1: And I think you can set the conditions as much
Speaker 1: as you can, you can put your best fit forward
Speaker 1: as much as you can, but it can be really
Speaker 1: unfair and it doesn't discriminate. So it is not your
Speaker 1: fault and you're definitely not alone. One in six couples
Speaker 1: have infertility. There are so many women. At least ten
Speaker 1: percent of women have endometriosis, ten percent of women have pcos.
Speaker 1: There's a reason why we're talking about this so much,
Speaker 1: and it's because we're blowing the lid off of all
Speaker 1: of these issues. Because I think there's a revolution where
Speaker 1: women are like, we're tired of being you know, so
Speaker 1: secretive about something and feeling ashamed of our bodies. It's
Speaker 1: time for us to openly share and change their because
Speaker 1: it really isn't our fault, and I think there shouldn't
Speaker 1: be pressure or a rush to heal. It's going to
Speaker 1: be a natural process. And I think something we don't
Speaker 1: talk about enough is, you know, the journeys that don't
Speaker 1: end in a baby. Right. We've seen people like Jennifer Anison,
Speaker 1: high profile people share that they went through their own
Speaker 1: fertility journey where they tried and despite all of their
Speaker 1: access and the resources that they had, it wasn't successful.
Speaker 1: And I think people really lauded that and thought, wow,
Speaker 1: if this can happen to her, And this really shed
Speaker 1: light on this issue because there is a bias towards
Speaker 1: sharing the positive endings, the happy endings, and those stories
Speaker 1: because that's uplifting and what people want to hear. But
Speaker 1: this doesn't always work for everyone. And I think there
Speaker 1: is often a way to overcome issues if you're willing
Speaker 1: to pivot, you know, there's usually a way for us
Speaker 1: to help you get there. But sometimes there can be
Speaker 1: really difficult circumstances, and sometimes people aren't open to all
Speaker 1: of the different options. You know, it's really your choice,
Speaker 1: and you're entitled to the vision of what you wanted
Speaker 1: for your family building journey. And I don't think that
Speaker 1: it's helpful to tell people, well, you can always use
Speaker 1: donor egg, or you can always adopt or you can
Speaker 1: do surrogacy. It's easier, said, than.
Speaker 2: Such an emotional tie to It's so much deeper than
Speaker 2: just the baby itself. It's like how you feel about
Speaker 2: your own body. It's exact how woman feels her responsibility
Speaker 2: is or her duty is. Like there's so much identity.
Speaker 1: Yeah, and sometimes you have to do a lot of
Speaker 1: work to undo that yes, and realize that you're more
Speaker 1: than your fertility.
Speaker 2: I think that's really hard, especially in certain cultures, but
Speaker 2: just the culture of women, like in society even now,
Speaker 2: it's so hard to for women who have been brought
Speaker 2: up thinking that this is the n actual progression of
Speaker 2: life and this is how it should be, to really
Speaker 2: uncouple themselves from.
Speaker 1: Them absolutely, and I think the burden shouldn't be on them.
Speaker 1: I think it needs to be on society. Right, when
Speaker 1: are we going to stop asking women? Are you trying?
Speaker 1: So when you start trying, it's like you don't know.
Speaker 2: That probably like every time I post it, Oh my god,
Speaker 2: I'm not okay, I get it. Yeah, you guys want
Speaker 2: to see a baby have your own. Now.
Speaker 1: I've become so hyper sensitive working in this field that
Speaker 1: sometimes I'm in the line at Starbucks and I'm like
Speaker 1: overhearing someone's conversation, just cringing. You know, I think that people,
Speaker 1: even who aren't in the fertility journey could benefit from
Speaker 1: reading my book because there's a whole section on how
Speaker 1: to be a sensitive partner or family member or friend.
Speaker 1: Had the best show up for the people in your
Speaker 1: life that are facing this challenge.
Speaker 2: Thank you so much. This has been amazing. I really
Speaker 2: appreciate all the insight that you've given, but also just
Speaker 2: the hope that you've probably shared with so many people
Speaker 2: that are on this journey of whether it's fertility, whether
Speaker 2: it's trying to get pregnant. You know, there's so many
Speaker 2: steps to this, and I think you've really helped not
Speaker 2: just you know, go through it here, but in your book.
Speaker 2: It's such a I mean it's a hefty book and
Speaker 2: it's just filled with so much goodness that's so useful.
Speaker 1: I promise it's an easy read.
Speaker 2: No it is. It's such an easy wead, but I
Speaker 2: really appreciate how in detail it is, Like we need
Speaker 2: this because there is so much to it, and I
Speaker 2: think it's really important to have all the knowledge you
Speaker 2: can possibly have then feel empowered like knowledge is power,
Speaker 2: and to have that about your own body as a
Speaker 2: woman is just so important.
Speaker 1: Absolutely, something we see a lot online is like click beat,
Speaker 1: you know, feeling like what the video you're about to
Speaker 1: watch is going to answer her and solve all your problems.
Speaker 1: And I really wanted to create a resource that actually,
Speaker 1: in detail answered people's questions right, And this is this
Speaker 1: goes beyond the character limit on a caption or the
Speaker 1: three minute limit on an Instagram reel. You just can't
Speaker 1: give that level of nuance in detail. So that's why
Speaker 1: I wrote this book.
Speaker 2: Aways a way too precious and complicated to be able
Speaker 2: to do it in that amount of time.
Speaker 1: Exactly. I think this is like a health class two
Speaker 1: point zero and I hope it'll help a lot of people.
Speaker 2: Thank you so much, Lucky, I think really appreciate it.
Speaker 2: And if anyone listening, go get your copy of The
Speaker 2: Lucky Egg Understanding Your Fertility, How to Get Pregnant Now
Speaker 2: by Doctor Lucky Second.
Speaker 1: Thank you, thank you, thank