"people are waiting longer to get pregnant but if we can imagine that there is a vault of your eggs by the time you're born you have 1 to 2 million in your reproductive years 300,000 this means if you ..."

"fertility doctor which means that I help people grow their family or plan for their family no matter what that looks like but my mission started because early in my career I realized I was seeing peop..."

"social cultural backdrop to this because the conversation around fertility and infertility to me and this might just be a sort of perspective bias seems to have suddenly increased over the last couple..."

"and are we having less sex than we used to I think people are having less sex yes especially as they age in the reproductive age range it depends people when they get married tend to be having less se..."

"Double the rate that it did the 40 years prior so when we start looking at more recently the rate of decline is accelerating and that's got to be the world around us and you in 2020 founded the fora F..."

"some more color on how that feels because you you know how that feels I do know how that feels so I had four pregnancy losses before I have my two children and this was a long time ago and I was in th..."

"diagnosed for me when my husband was off in a bachelor trip in Las Vegas and I had to receive a medication in order to try to stop the pregnancy from growing but there was still a risk of the tube rup..."

"the word guilt there there's um complex set of emotions that I've had described when someone finds out that their their pregnancy or even their sort of their sexual organs more broadly are struggling ..."

"without intervention that really crashes down a piece of your own identity and and who you saw yourself to be who you wanted to be and trying to struggle with that true identity crisis at that moment ..."

"one of them in that relationship has some has some issues which are complicating their chances of getting pregnant and when I heard that God I can't imagine how that person feels in that relationship ..."

"carried that guilt that shame that broken feeling alone like it was just her so let's get into it then let's do it let's talk about fertility where do we need to start I was going to assume where I ne..."

"always like to start with the ovary and understanding the difference in eggs and sperm so we'll do sperm first and we'll do eggs okay do you know how many sperm you make in a day do I know uh how abou..."

"counts in three months why does it take 18 days I thought if in my little idiot head I thought that I make my sperm okay today and then if I ejaculate that's the sperm out no yeah those sperm those sp..."

"hard for the good guys to do their job okay so there is so you do need to keep ejaculating to remain to optimize your fertility your chances of fertilizing an egg yes oh I didn't know that and how oft..."

"this goes for sperm or egg the hormone access from the brain to your gonad your gonads are either your testes or your ovaries your brain is constantly interpreting signals from your whole body and is ..."

"we breathe from the type of you know kitchen wear that we use what we put in and on our body all of it makes a little bit of a difference and we know some people if you live in an area with high pollu..."

"potentially what about phones and laptops oh I love this one okay so that's a great question and people ask about it two ways to look at it there was a study that was published last year that actually..."

"think that helps us understand some of the radiation aspect of the phone and if that is impacting sperm heat of the testicle is of course something very very different I do think you talked to Reena a..."

"factor what about hot baths if we're having lots of hot baths if it's daily and you sit in there for you know more than 15 minutes then I would cut that down to not be daily I see this a lot in Austin..."

"might be permanent let's talk about eggs let's talk about eggs you have this um wonderful example where I guess it's a bit of an analogy called The Vault yes I've got um some marbles over here in a ja..."

"eggs left women only ovulate about 400 to 500 eggs over the course of their lifetime so if you're born with 1 to two million and you only ovulate 400 to 500 that seems like confusing math so the way t..."

"have FSH and lh2 FSH controls the production of sperm for you and LH the production of testosterone but for women FSH controls the stimulation of one follicle so this follicle will grow and this one w..."

"really for two reasons one is that all women run out of eggs when you run out of eggs you're an ovarian failure also known as menopause average age of menopause is 51 to 52 I've seen somebody have men..."

"to get them all to grow not just the one you are normally going to ovulate take those eggs out of the body and then next month when your body gives me another group of 10 I'm going to get them all to ..."

"fertilize do not implant or misc carry at age 40 if you see a positive pregnancy test your chance of miscarriage is 50% because they've been sitting here even if you're very healthy just time and norm..."

"Jesus Christ it's not information to scare people but it is information that nobody talks about well as you were sat here talking to me about this the opposite of confronting the truth is Regret yes a..."

"same age and they have different ovarian reserves meaning they have a different number of eggs left in their vault they're going to send out a different number of eggs each month how many eggs are the..."

"is the same however it means you have more opportunity of time to try to grow that family and ultimately a greater chance of success when it comes to IVF or egg freezing because the factors that deter..."

"considered four drinks a week four drinks a week so if I have four glasses of champagne a week yep so you have four glasses tonight at dinner you've hit moderate that is I mean most people especially ..."

"in so microwave meals in plastic you know you take the plastic and you microwave it shouldn't do it how do we we know this have they have they done research on this or is this just so there is researc..."

"States as well so things like endometriosis or other inflammatory or autoimmune diseases what um what ways do we voluntarily increase our inflammation is that dietary predominantly yes so number one i..."

"interpreted we talked about stress earlier stress impacts the brain in a similar way there's different types of stressors very similarly you have your acute stressor the bear you have the stress of ev..."

"diet's going to be one of the hugest things that people can make a change in processed foods refined sugar processed Meats those are not natural foods and those are things that come with a lot of chem..."

"healthiest fertility diet high in fruits and vegetables fruits and vegetables are fiber sources they are antioxidants they are helping our body function appropriately they're helping our gut function ..."

"I say that if you do meatless Monday the rest of your meals for the week you should have one serving a meat per day that's going to make you just force you to eat more fruits and vegetables and then o..."

"the other thing we didn't talk about regarding lifestyle choices is exercise oh yes now there's kind of two schools of thought here because I have some friends who exercise a lot and they have seen a ..."

"so the eggs inside the follicle exactly and so the follicle gets bigger as the egg gets more mature sure it makes more estrogen that estrogen at a high enough level and it's very specific 200 PS for 5..."

"because that's the mechanism behind a lot of birth control but when you think about progesterone starts being made from this Corpus ludum perfectly timed after you ovulate to open and close that impla..."

"your body is going to stop sending out FSH and LH altogether it is going to say that the calories you're receiving to the energy you're expending do not match up and you cannot support being pregnant ..."

"lot of talk on hit exercise or moderate activity and for the regular person whatever you will stick with is the best if you're trying to get pregnant you should not be trying to stress your body to ne..."

"long periods of time um my partner shed quite openly um on her social media channels her battle with this and she I think she had a couple of dietary changes she had some struggles with eating and tha..."

"period your ovary is already starting to grow the egg that's going to ovulate in that month and as that egg makes estrogen that's what stops you from bleeding okay so when you have your period That's ..."

"ovulate the egg lives for 24 hours it has to be fertilized while it is in the fallopian tube in those first 24 hours sperm can live in the female reproductive tract for 5 days so that is why we will t..."

"what's the first thing I wanted to say the first thing I want to to ask is how long on average do different age groups need to try before they hit the Bull's Eye if you're age 30 and you're trying to ..."

"embryos for the future which we can absolutely do and we do that for people sometimes so that they can go have fun with their sex life again two you feel like you have to track your cycles and time in..."

"call IUI or intrauterine insemination and this is where you take the sperm and you're putting it inside the uterus so instead of intercourse we are taking an ejaculated sample and then processing it a..."

"I think that this is why he changed his mind he had who knows well he didn't get he didn't get paid for this right so it was out of the goodness of his heart he just met them and gave the sample so pa..."

"talking about PCOS yes what I've I've got a very close friend of mine that struggled a lot with PCOS and I've been there with them um as they've been diagnosed and as they've kind of battled with that..."

"the Vault every month the brain doesn't know you have more eggs so it is sending out the same amount of FSH as it normally would for a normal egg count but that FSH is getting diluted amongst the more..."

"to see that you have these Androgen symptoms that are negatively impacting quality of life immensely and then as you gain weight the estrogen confuses the brain and it sends out even less FSH so you g..."

"estrogen and progesterone but two they also make something in the liver called sex hormone binding globulin that binds to testosterone drops your testosterone levels and clinically they make you feel ..."

"reliably or regularly ovulate in your reproductive years that you're wanting to and that's not your fault it's not a failure of you it's not your fault some people truly do need intervention to try to..."

"a higher risk of PCOS certainly you can back into PCOS by by being overweight and what I mean by that is often patients will present they'll be diagnosed with PCOS but the ideolog is a little bit diff..."

"they're born with more eggs and they go through menopause at the same age so what's happening is they're simply just losing eggs at a more rapid Pace because they have more and what impact does that h..."

"cancer so endometrial cancer is a very significant risk in women with PCOS who do not have periods and this is why you will see people come in and say that you need to take progesterone or you must be..."

"you're going to be fatigued feel cloudy you're not going to feel like yourself replacing estrogen in somebody whose ovaries are not making it whether it's because the brain's not sending the signals t..."

"those cells are going to migrate out the Fallopian tubes which is pretty normal if you can imagine the uterus is Contracting it's squeezing some of those cells are going to migrate out and in cells fr..."

"everybody who has Indo has pain pain with intercourse is another one especially in certain positions so not pain with like insertion or penetration but but deep pain so he's like oh the classic is whe..."

"endometriosis we don't know what markers to cheuck in your blood yet so the only way to diagnos the disease is by looking doing surgery putting a camera in somebody's abdomen and physically seeing the..."

"so it's one of these places where it is very tough because we don't want people suffering in pain but also getting pregnant is so difficult in those circumstances in prevalence of endometriosis we say..."

"can then have you have a period and suppress your endometriosis I don't care that you're not ovulating now cuz I can give you some estrogen and grow the lining and then just put the embryo back in at ..."

"than people who are your age who weren't so that's one strategy if you know you have it you have to know you have the disease or have a high suspicion that you do in order to be preventing ovulation a..."

"because if you want four kids and you start at age 30 and you have no problems and you have your kids really closely together so you what 30 32 when's your next one 35 36 when are you having baby four..."

"difference between me freezing eggs and sperm versus freezing the embryos so this is a good point so freezing embryos even if you're going to try to naturally get pregnant later is helping you know th..."

"if I have 20 eggs now I go to thaw them whenever we're ready and now I have two that don't survive so I have 18 I'm going to go inject them with the perfect sperm and I would have on average fertiliza..."

"the problem with eggs is if I have 20 eggs in the freezer how many embryos do I have you don't know yet I'm making a whole lot of assumptions yeah and what's the the cost difference of freezing eggs i..."

"think um I had this conversation with my partner but I I was scared to have the conversation because turning to my partner and going hey babe I think we should you should freeze your eggs and I should..."

"and what I mean by that is maybe you freeze your eggs and maybe you don't but you owe it to yourself to be the one to make the decision and you can't make make it unless you understand how many eggs d..."

"success if you're missing a full chromosome that's going to end up in a miscarriage if you have extra chromosomes like an extra or copy of chromosome 21 is Down syndrome that carries its own risks and..."

"complication down the road interestingly if you transfer to embryos of course you have a higher chance of twins you don't see much of a change in the pregnant rate just the Twining rate but even witho..."

"knowledge if the female orgasms does that increase the chance of fertility we do know that orgasm does help uterine contractions help get the sperm to the eggs faster so we do know that so how do we k..."

"recommend that somebody stops contraception before they're ready to get pregnant that way you can understand are your periods coming regularly what are the signs and symptoms that something could be w..."

"goal Natalie thank you we have a closing tradition on this podcast where the last guest leaves a question for the next guest not knowing who they're going to be leaving it for and the question that ha..."

"understand and I tell my patients that same thing over and over that in the journey it doesn't make sense but that's not your job in the journey to understand the wise it's to to keep going and not gi..."