Latest / The Body Pod / The Fertility Formula: How to Boost Fertility, Balance Hormones & Understand Your Body with Dr. Natalie Crawford

Transcript

The Fertility Formula: How to Boost Fertility, Balance Hormones & Understand Your Body with Dr. Natalie Crawford · The Body Pod

• 0:00
  Speaker 1: Hi everyone. My name is Haley and this is Lara,
• 0:02
  Speaker 1: and welcome to the Body.
• 0:04
  Speaker 2: Pod doctor Natalie Crawford. We are honored to have you
• 0:14
  Speaker 2: on the podcast today, and I know what a wanted
• 0:17
  Speaker 2: woman you are and how demanding it is to be
• 0:20
  Speaker 2: a fertility doctor, so we greatly appreciate you giving us
• 0:25
  Speaker 2: your time.
• 0:26
  Speaker 3: Well, thank you so much for having me.
• 0:28
  Speaker 4: I'm really looking forward to this discussion and honored to
• 0:30
  Speaker 4: be here.
• 0:31
  Speaker 1: This is I feel like I'm just so excited because
• 0:34
  Speaker 1: we just had the podcast before the podcast, and I
• 0:37
  Speaker 1: feel like I'm just like you're my girl.
• 0:40
  Speaker 3: We are kindred spirits and house. It's going to be
• 0:42
  Speaker 3: a good show.
• 0:43
  Speaker 1: This is got to be a good show. Yes, I
• 0:46
  Speaker 1: love it, Lara.
• 0:47
  Speaker 2: So this is a subject very near and dear to
• 0:51
  Speaker 2: my heart because I have gone through my own IVF
• 0:53
  Speaker 2: struggles and I was looking on your website and there
• 0:59
  Speaker 2: were so many things that you touch on before you
• 1:02
  Speaker 2: even become a patient of yours that I wished I
• 1:06
  Speaker 2: knew in the beginning. For example, if your partner is
• 1:12
  Speaker 2: on testosterone or any hormone replacement therapy, they do not
• 1:19
  Speaker 2: the sperm count goes down to basically nothing. So there
• 1:22
  Speaker 2: was a year of my life that I was trying
• 1:24
  Speaker 2: to conceive and I had no idea, And so I
• 1:29
  Speaker 2: really think that how you are approaching IVF and the
• 1:34
  Speaker 2: process and how you fuse science and lifestyle and functional
• 1:38
  Speaker 2: medicine together is probably bringing people mad success. And I
• 1:45
  Speaker 2: just have to give you kudos for the way that
• 1:48
  Speaker 2: you are.
• 1:52
  Speaker 4: Doing this well, Laura, thank you so much, and I'm
• 1:55
  Speaker 4: so I mean big hugs for everything you've been through
• 1:58
  Speaker 4: because it is not for the faint of heart. But
• 2:01
  Speaker 4: I think there's a lot of big, lofty goals I have.
• 2:04
  Speaker 4: But I do think I am sick of hearing the
• 2:07
  Speaker 4: I wish I had known this information sooner, I would
• 2:11
  Speaker 4: have done something different. I hear that phrase all the time.
• 2:15
  Speaker 4: I see people who are I see men go in
• 2:18
  Speaker 4: who have low libido. They're trying to get pregnant. They
• 2:20
  Speaker 4: tell a doctor this and they are literally put on
• 2:22
  Speaker 4: testosterone making their sperm count zero. So people are also
• 2:26
  Speaker 4: trying to get help and going to people who don't
• 2:28
  Speaker 4: have the right expertise to help them.
• 2:31
  Speaker 3: And we are seeing.
• 2:32
  Speaker 4: This crazy world when it comes to fertility, where if
• 2:36
  Speaker 4: we walk back, you know it's a fellowship.
• 2:38
  Speaker 3: After OBG I in.
• 2:39
  Speaker 4: I mean, I had four years of obigui in and
• 2:41
  Speaker 4: then three years of ARIA because it is a very
• 2:43
  Speaker 4: specific fund of knowledge. And to act like everybody can
• 2:47
  Speaker 4: just go be a fertility expert because they want to
• 2:50
  Speaker 4: can be very harmful. And I see patients who don't
• 2:53
  Speaker 4: know enough because and they don't know how to advocate
• 2:56
  Speaker 4: for themselves. And of course it's not their fault, it
• 2:58
  Speaker 4: is society's fault. When are we supposed to learn this information?
• 3:03
  Speaker 4: And I went through my own fertility journey and felt
• 3:06
  Speaker 4: so underprepared. I was on birth control for so long,
• 3:09
  Speaker 4: and then when it was time to start getting pregnant,
• 3:11
  Speaker 4: you said, I'm sure I'll get pregnant really fast and
• 3:13
  Speaker 4: it'll be easy and I'll just stop the pill.
• 3:15
  Speaker 3: And I really think that I want, and.
• 3:20
  Speaker 4: I think it's going to take people behind me, all
• 3:23
  Speaker 4: of us pushing together. But I'd love to change how
• 3:26
  Speaker 4: we approach fertility as a field because right now it's
• 3:29
  Speaker 4: very reactive, meaning you must fail first. You have to
• 3:32
  Speaker 4: have you have to try and have failure, not get
• 3:36
  Speaker 4: pregnant for twelve months, or have all this pregnancy loss
• 3:39
  Speaker 4: like I did before you even get testing. Just imagine
• 3:43
  Speaker 4: for you, like what if we said, oh, you'd like
• 3:46
  Speaker 4: to get pregnant, let's do some standard testing first and
• 3:48
  Speaker 4: make sure there's no big problem. And if a Seman
• 3:50
  Speaker 4: analysis was done at that time, you would have had
• 3:53
  Speaker 4: a different story because it wouldn't be let's try for
• 3:56
  Speaker 4: a year. Now, you qualify for testing and you find
• 3:59
  Speaker 4: out that is no or low sperm, and then you
• 4:03
  Speaker 4: can start doing something about it. Right, you're at such
• 4:05
  Speaker 4: a deficit. And I understand that when the fertility industry
• 4:11
  Speaker 4: came to be about, it was a reaction to a problem. Right,
• 4:14
  Speaker 4: people weren't getting pregnant and when are we going to
• 4:16
  Speaker 4: do this? But the truth is in fertility rates are rising,
• 4:19
  Speaker 4: more people are struggling to get pregnant. We see more
• 4:22
  Speaker 4: misinformation where people are kind of doing the wrong thing
• 4:25
  Speaker 4: and they don't even understand. And I think we have
• 4:28
  Speaker 4: to say, hey, things need to be done different. Having
• 4:30
  Speaker 4: a child is a life goal for so many people.
• 4:32
  Speaker 4: Your fertility is a marker of your overall health and
• 4:35
  Speaker 4: your hormonal health, and we really should be having these
• 4:38
  Speaker 4: discussions a lot earlier. So thank you for supporting that
• 4:41
  Speaker 4: and for having me on.
• 4:43
  Speaker 2: Yes, why do you think the numbers are rising?
• 4:48
  Speaker 4: There's a few different reasons, but I think the biggest one,
• 4:51
  Speaker 4: I'll be honest, is that our lifestyle, the current modern lifestyle,
• 4:55
  Speaker 4: is so inflammatory. We see an increase in chronic disease
• 4:59
  Speaker 4: and autoimmune disease, environmental toxins and chemicals, the foods that
• 5:04
  Speaker 4: the majority of people consume, hustle culture, right, everybody's stressed
• 5:08
  Speaker 4: and not sleeping. These things all come together to create
• 5:12
  Speaker 4: a very pro inflammatory world that most of us live
• 5:16
  Speaker 4: in without even fully realizing because we're so used to
• 5:19
  Speaker 4: this is just how life is. But what's happening is
• 5:22
  Speaker 4: that inflammation on a cellular level is actually damaging against
• 5:26
  Speaker 4: sperm quality and putting us in a place where it's
• 5:29
  Speaker 4: going to be harder to get pregnant. And we're seeing
• 5:32
  Speaker 4: a decline in sperm counts, we're seeing an increase in
• 5:35
  Speaker 4: miscarriage rates. And I don't think that this is just, oh,
• 5:38
  Speaker 4: this is all coincidental, This is all connected. I always say,
• 5:42
  Speaker 4: we have to acknowledge the same place that we do see.
• 5:44
  Speaker 4: You know, people are starting their families later, and there's
• 5:48
  Speaker 4: more talk about infertility, which is good, right. The more
• 5:51
  Speaker 4: we talk about something, the more aware somebody can be.
• 5:54
  Speaker 4: But people who say, oh, infertility rates are just higher
• 5:57
  Speaker 4: because people are trying later. That's a false narrative because
• 6:00
  Speaker 4: we see this globally, that infertility rates are rising. We
• 6:03
  Speaker 4: see it even when we control for age, And to me,
• 6:06
  Speaker 4: that means, hey, if you are trying later, which a
• 6:09
  Speaker 4: lot of times it's out of our hands, it's when
• 6:11
  Speaker 4: we I'm at a life partner, it's when we felt,
• 6:14
  Speaker 4: you know, emotionally, physically ready to get pregnant. Then it's
• 6:17
  Speaker 4: even more important that we're armed with information before we
• 6:20
  Speaker 4: start trying because time may not be on our side
• 6:23
  Speaker 4: in the same way, and we have to have an
• 6:25
  Speaker 4: even greater you know, kind of advocacy journey and ownership
• 6:30
  Speaker 4: of our own health when we're trying to get pregnant
• 6:32
  Speaker 4: if we are starting at a later age. But the
• 6:35
  Speaker 4: truth answer to that, it's reason why you know, my
• 6:37
  Speaker 4: book is coming out in the spring and it's called
• 6:39
  Speaker 4: The Fertility Formula. Chapter one is how inflammation hijacks your
• 6:42
  Speaker 4: fertility Like it's it is something that should be at
• 6:45
  Speaker 4: the forefront of our discussion about how the choices we
• 6:49
  Speaker 4: make every day, even without realizing it, can be helpful
• 6:54
  Speaker 4: or they can be harmful. I think so many humans
• 6:58
  Speaker 4: think that the life's choices are kind of net neutral. Right,
• 7:02
  Speaker 4: there's a few things that are like very bad, and
• 7:04
  Speaker 4: maybe there's some things that are good, but they feel
• 7:06
  Speaker 4: like so much is just net neutral, doesn't really matter.
• 7:10
  Speaker 4: Or how many times have I heard somebody say, I'll
• 7:11
  Speaker 4: just do IVF. I'll just do IVF, it won't matter.
• 7:15
  Speaker 4: But even in IVF, we are working with the eggs
• 7:18
  Speaker 4: in the sperm that we're given against firm quality or
• 7:21
  Speaker 4: that DNA integrity or the competency or how these cells
• 7:24
  Speaker 4: can function. Those things are in your body. I can't
• 7:28
  Speaker 4: change that, and so we really need to help people
• 7:31
  Speaker 4: take ownership of their fertility and their health by giving
• 7:35
  Speaker 4: them the information so that they can make the choices.
• 7:37
  Speaker 4: I tell every patient, I'm not here to tell you
• 7:40
  Speaker 4: you know what to do or what not to do.
• 7:41
  Speaker 4: I'm here to educate you and give you the science
• 7:44
  Speaker 4: and help you understand why making certain decisions could be
• 7:48
  Speaker 4: good or bad. And then at the end of the day,
• 7:49
  Speaker 4: you get to make decisions, but you should be doing
• 7:52
  Speaker 4: it from a place of knowledge, because you can't make
• 7:54
  Speaker 4: decisions on data you don't know. So the idea that
• 7:56
  Speaker 4: you should just have to make all these choices without
• 7:59
  Speaker 4: ever knowing why or how it impacts your fertility or
• 8:02
  Speaker 4: your hormones. That's a disservice that I think people are
• 8:05
  Speaker 4: falling into right now, and it's not their fault, but
• 8:07
  Speaker 4: it's kind of how society is.
• 8:10
  Speaker 1: Okay, So you mentioned that this is rising globally, which
• 8:13
  Speaker 1: is not surprising. But I always obviously just from being
• 8:17
  Speaker 1: in America, see the food quality and you know, we
• 8:23
  Speaker 1: are in the land of abundance in America everywhere, and
• 8:29
  Speaker 1: no wonder we have this inflammation. But does America have
• 8:34
  Speaker 1: a bigger problem than some other countries.
• 8:37
  Speaker 4: Yeah, we'll say globally, we'll say that. You know, we
• 8:40
  Speaker 4: used to say infertility rates were one out of eight.
• 8:42
  Speaker 4: Right now globally they're one out of six. In the US,
• 8:45
  Speaker 4: if you're trying to get pregnant for the first time,
• 8:46
  Speaker 4: it's one out of five. So right, So yeah, the
• 8:49
  Speaker 4: answer there is that we have a bigger problem than
• 8:52
  Speaker 4: other places, and it is not surprising.
• 8:54
  Speaker 3: And we think about.
• 8:55
  Speaker 4: The world that we live in, the normalization of process foods,
• 9:01
  Speaker 4: and it's not even you know, people say, oh, I
• 9:04
  Speaker 4: don't eat at McDonald so I'm not doing that bad,
• 9:06
  Speaker 4: or you know, they think about processed food is this
• 9:08
  Speaker 4: very finite thing, but they don't realize the protein bar
• 9:11
  Speaker 4: they're shoving in their bag and you know, the prepackaged meal.
• 9:14
  Speaker 4: And this kind of the lack of time and the
• 9:18
  Speaker 4: deep prioritization of our own bodies and health, especially when
• 9:21
  Speaker 4: it comes to food choices. How that can have such
• 9:24
  Speaker 4: a ripple effect when it comes to our body.
• 9:27
  Speaker 1: So this lifestyle and this just makes me think because
• 9:31
  Speaker 1: we are we're in hustle culture, and we are praised
• 9:35
  Speaker 1: for the hustle, and so you get this cycle of inflammation,
• 9:41
  Speaker 1: not a lot of time, so we have stress, but
• 9:44
  Speaker 1: then we're choosing poorly. Then we have these different you know,
• 9:47
  Speaker 1: alcohol to numb the stress that we're having, or other
• 9:52
  Speaker 1: medications or just poor food choice. All of that. If
• 9:56
  Speaker 1: we simplify and we look back to fifty years ago,
• 10:01
  Speaker 1: what a different lifestyle it was and what we've where
• 10:04
  Speaker 1: we've had all of these amazing, you know, updates to
• 10:08
  Speaker 1: society that have benefited us. There's this flip side that
• 10:13
  Speaker 1: are we getting sicker? Do we have more you know,
• 10:16
  Speaker 1: all of these issues that you've just mentioned so super interesting.
• 10:20
  Speaker 1: It's it's a tough one in the day and age
• 10:23
  Speaker 1: it is.
• 10:23
  Speaker 4: And it's one thing that I find if you, if
• 10:26
  Speaker 4: you help people understand the why and the science and
• 10:29
  Speaker 4: we talk about cells and we talk about it in
• 10:31
  Speaker 4: a way where people we give the benefit of knowledge
• 10:34
  Speaker 4: that you can understand hard topics if we explain them,
• 10:37
  Speaker 4: there's going to be a lot more motivation to actually
• 10:39
  Speaker 4: make lasting change to some of these things that we
• 10:43
  Speaker 4: do every day that cause inflammation that we have normalized.
• 10:47
  Speaker 4: I can't tell you how many times a patient will
• 10:49
  Speaker 4: say to me, I only need five hours of sleep.
• 10:52
  Speaker 4: I only need five hours, No big deal, not they
• 10:55
  Speaker 4: just they a'm saying, but they wear almost like a
• 10:58
  Speaker 4: badge of honor right that I can and I can
• 11:00
  Speaker 4: be so productive. I can do all of these things.
• 11:03
  Speaker 4: I can starve my body of sleep. You know when
• 11:06
  Speaker 4: my body heals inflammation and prepares the day, and that
• 11:09
  Speaker 4: it's not going to have these lasting consequences. And I
• 11:12
  Speaker 4: never want anybody to hear something and think, like cause
• 11:16
  Speaker 4: my infertility. No one thing is going to cause something
• 11:19
  Speaker 4: like this or cure it. But the sum of our
• 11:23
  Speaker 4: choices that you make every day, and some of them
• 11:26
  Speaker 4: are so habitual we don't even think about it, can
• 11:29
  Speaker 4: add up to really being helpful or harmful when it
• 11:34
  Speaker 4: comes to your cellular health and your fertility. And that's
• 11:36
  Speaker 4: the discussion that I think we should be promoting much earlier.
• 11:40
  Speaker 4: You shouldn't have to fail and be going through IVF
• 11:43
  Speaker 4: and dropping all this tens of thousands of dollars, or
• 11:47
  Speaker 4: have a bad cycle only then to learn, oh, I
• 11:50
  Speaker 4: should be doing X, Y Z. This discussion should be
• 11:52
  Speaker 4: had so much earlier because we know that you know,
• 11:56
  Speaker 4: fertility is a marker for overall health. If you have infertility,
• 11:59
  Speaker 4: of a higher of diabetes, heart attack, stroke, cancer, these
• 12:03
  Speaker 4: really scary sounding things, and I had infertility, so I
• 12:07
  Speaker 4: hate that statistic. But it's not that infertility causes them, right,
• 12:10
  Speaker 4: We'd be false to think that infertility causes those. It's
• 12:14
  Speaker 4: an underlying why What do a group of people with
• 12:17
  Speaker 4: infertility have in common? Many of them have a higher
• 12:21
  Speaker 4: inflammation in their life, and that inflammation over time, that
• 12:25
  Speaker 4: chronic inflammation has consequence, right, and so we've got to
• 12:29
  Speaker 4: stop that pathway a lot earlier.
• 12:31
  Speaker 2: Okay, So give us some example, some examples. If I'm
• 12:34
  Speaker 2: your patient or your best friend and I am wanting
• 12:38
  Speaker 2: to conceive, what do you advise?
• 12:42
  Speaker 4: Okay, let's get through this in a few different ways,
• 12:43
  Speaker 4: and I'll try to be more succinct than I normally am.
• 12:46
  Speaker 4: But I think that number one get the narrative that
• 12:50
  Speaker 4: some people have good luck and they get pregnant, so
• 12:52
  Speaker 4: some people have bad luck. I don't love that luck
• 12:54
  Speaker 4: you have no control over. And even if you can't
• 12:57
  Speaker 4: control the overall outcome, you can control a lot of
• 12:59
  Speaker 4: the journey. I'll admit when I had pregnancy less at first,
• 13:02
  Speaker 4: I was a very passive role like this is what
• 13:04
  Speaker 4: I'm supposed to do, and this versus saying number one,
• 13:08
  Speaker 4: we're going to understand our body. You deserve to understand
• 13:10
  Speaker 4: what's normal, so you can know what's not you can
• 13:13
  Speaker 4: advocate for what is not. So learning how to advocate
• 13:16
  Speaker 4: for yourself, learning what is normal, identifying red flags that's
• 13:20
  Speaker 4: going to be, you know, key number one to let's say,
• 13:22
  Speaker 4: taking control of your fertility, your hormonal health. So you've
• 13:25
  Speaker 4: got to start to say, I need to learn how
• 13:28
  Speaker 4: to track my cycle and need to know what's happening
• 13:29
  Speaker 4: in my cycle and need to leverage that as a
• 13:32
  Speaker 4: vital sign. I need to then say, okay, what's normal
• 13:36
  Speaker 4: for me, and therefore what's abnormal? And a lot of this,
• 13:39
  Speaker 4: you know, discussion about inflammation is starting to recognize a
• 13:43
  Speaker 4: lot of the signs of inflammation.
• 13:45
  Speaker 3: And we're all different.
• 13:46
  Speaker 4: All three of us probably have different triggers that would
• 13:48
  Speaker 4: make us feel you know, bad or inflamed in some
• 13:52
  Speaker 4: ways because our cells and our bodies are wired different.
• 13:55
  Speaker 4: There's some universal truths, but recognizing that you shouldn't have
• 13:59
  Speaker 4: every single day, you shouldn't have headaches and be tired,
• 14:02
  Speaker 4: and have afternoon fatigue, and feel bloated and have GI
• 14:05
  Speaker 4: distress and have brain fog and a lot of these
• 14:09
  Speaker 4: things that especially as women, because we get gas lit
• 14:12
  Speaker 4: and we get dismissed, we have normalized this is just
• 14:16
  Speaker 4: how I feel. Or when my period comes and it's
• 14:19
  Speaker 4: so painful I can't go to work, or I bleed
• 14:21
  Speaker 4: through my clothes. We don't hold discussions about normality, so
• 14:25
  Speaker 4: we suffer without getting help. So what is normal? How
• 14:29
  Speaker 4: do I leverage my period as a vital sign? And
• 14:32
  Speaker 4: what is inflammation and what could be causing it? And
• 14:35
  Speaker 4: really learning to advocate for your health is a big
• 14:38
  Speaker 4: piece when it comes to this inflammation piece, And we say,
• 14:42
  Speaker 4: I think the heart of your question was more what
• 14:44
  Speaker 4: should we be doing earlier from a lifestyle standpoint in
• 14:47
  Speaker 4: how do we take ownership of decreasing inflammation? And I
• 14:50
  Speaker 4: always say there's some level of inflammation you may not
• 14:53
  Speaker 4: be able to control. Like we'll say a patient with endometriosis.
• 14:55
  Speaker 4: This is a disease that causes inflammation. So the idea
• 14:59
  Speaker 4: that you can make lifestyle changes to eliminate inflammation is false.
• 15:05
  Speaker 4: But what you shouldn't be doing is adding to the pot. Right,
• 15:07
  Speaker 4: especially if you have autoimmune disease or an inflammatory disorder
• 15:10
  Speaker 4: and you know you are going to have higher levels
• 15:13
  Speaker 4: of inflammation than your bestie, we now certainly don't need
• 15:17
  Speaker 4: to be adding to making it worse. So it's even
• 15:20
  Speaker 4: more important in these patients with autoimmune disease or you know,
• 15:24
  Speaker 4: inflammatory disorders, to say, how do we kind of cut
• 15:28
  Speaker 4: this cycle off earlier? Number one is going to be
• 15:31
  Speaker 4: sleep free.
• 15:32
  Speaker 3: Right. This doesn't take money, It doesn't.
• 15:35
  Speaker 4: Take huge, you know, huge change, but it is change,
• 15:39
  Speaker 4: and it's an active change to say I need to
• 15:41
  Speaker 4: sleep more. You need to get at least seven and
• 15:43
  Speaker 4: a half hours of sleep a night. That's not I'm
• 15:45
  Speaker 4: sitting in my bed on my phone, right, that's actual
• 15:48
  Speaker 4: sleeping time. Sleep is when you know your body heals.
• 15:53
  Speaker 4: It's when you know your cortisol levels lower, melatonin raises.
• 15:56
  Speaker 4: That's an antioxidant. So I always say aimation gets healed
• 16:01
  Speaker 4: at that time your body. You know, glucose levels lower,
• 16:04
  Speaker 4: you become more insulin sensitive, meaning your cells can respond
• 16:08
  Speaker 4: better to hormonal cues. And if you're not sleeping enough,
• 16:11
  Speaker 4: you're going to start your day in a deficit, so
• 16:13
  Speaker 4: you have to work backwards to this. You know, dark room,
• 16:16
  Speaker 4: sound machine, a cool environment. If you have a partner,
• 16:20
  Speaker 4: also a team sport. You know, if you're going to
• 16:22
  Speaker 4: bed at ten and they're not coming in the room
• 16:24
  Speaker 4: till one am, like this is not going to be
• 16:26
  Speaker 4: conducive to a good sleep environment. And putting your phone
• 16:31
  Speaker 4: charging it away from your bed and really making sure
• 16:33
  Speaker 4: you're getting enough sleep time, which means starting that wind
• 16:36
  Speaker 4: out routine earlier. I think important for people to know
• 16:39
  Speaker 4: for fertility specifically, you know, getting at least seven and
• 16:42
  Speaker 4: a half hours of sleep has been associated with shorter
• 16:44
  Speaker 4: time to pregnancy, meaning get pregnant better. People who get
• 16:48
  Speaker 4: less sleep have a harder time even with IVF. And
• 16:51
  Speaker 4: when we look at your circadian rhythm, you know your
• 16:53
  Speaker 4: body's like a toddler and it loves predictability. So going
• 16:57
  Speaker 4: to bed around the same time every day and waking
• 17:00
  Speaker 4: up around the same time every day really helps your
• 17:03
  Speaker 4: body feel like it's going to get the rest that
• 17:05
  Speaker 4: it needs, and we see improved outcomes when it comes
• 17:08
  Speaker 4: to fertility treatments for people who have a we'll say
• 17:11
  Speaker 4: less variability to their sleep schedule, they're able to adhere
• 17:14
  Speaker 4: to a circadian schedule much better. For me, morning sunshine
• 17:18
  Speaker 4: kind of helps with this, right, so morning sunshine and
• 17:21
  Speaker 4: then also an extra kind of dark sleep environment. I
• 17:24
  Speaker 4: in my adult life love a sleep mask like that
• 17:27
  Speaker 4: wasn't something anybody ever told me before, but that really
• 17:30
  Speaker 4: helps kind of quiet my brain be less stimulated. But
• 17:34
  Speaker 4: I think this is something that everybody can do. You
• 17:36
  Speaker 4: probably have to think about what time you need to
• 17:39
  Speaker 4: wake up and when you go to bed. And I'm
• 17:41
  Speaker 4: sure you guys see this too, but especially when it
• 17:44
  Speaker 4: comes to hormonal health, we shouldn't sacrifice sleep at the
• 17:47
  Speaker 4: expense of I'm going to get up early and work out,
• 17:50
  Speaker 4: because what I see as people are sometimes doing double harm.
• 17:53
  Speaker 4: They're not sleeping enough and then in a sleep deficit
• 17:56
  Speaker 4: they're trying to work out and of course so often
• 17:58
  Speaker 4: for women, there's still this idea that working out is
• 18:01
  Speaker 4: to achieve a certain body.
• 18:03
  Speaker 3: Size, and a lot of times we're still working out
• 18:05
  Speaker 3: with a.
• 18:05
  Speaker 4: Very cardio mentality, right because of just generationally what has
• 18:11
  Speaker 4: been accepted as working out. And I say, number one,
• 18:14
  Speaker 4: let's sleep more. Number two, the type of exercise you
• 18:17
  Speaker 4: do matters. I mean, yes, move your body over, not
• 18:20
  Speaker 4: move your body. But if we're talking about hormonal health, specifically,
• 18:24
  Speaker 4: building and using skeletal muscle is one of the best
• 18:27
  Speaker 4: things you can do for yourself. And this typically means
• 18:30
  Speaker 4: you know, strength and resistance training at least three times
• 18:33
  Speaker 4: a week, right, like you can do other things. We
• 18:35
  Speaker 4: all have different preferences. Skeletal muscle allows your I'm just
• 18:40
  Speaker 4: gonna ramble, guys, so you can do.
• 18:41
  Speaker 3: It kind of like buy all my soapbox right now.
• 18:44
  Speaker 4: Warning, Skeletal muscle allows your body to utilize glucose without
• 18:49
  Speaker 4: needing insulin. And so this is a minute where I
• 18:52
  Speaker 4: know you guys have talked about this and know this,
• 18:55
  Speaker 4: but like, let's think for the public, right, we talked
• 18:57
  Speaker 4: about reproductive hormones all the time, but let's talk about
• 19:00
  Speaker 4: sulin really quickly, because Insulin exists to allow your cells
• 19:03
  Speaker 4: to use glucose. So if you eat food gets broken down,
• 19:06
  Speaker 4: glucose is fuel for a cell. It's what your cells need.
• 19:09
  Speaker 4: It's not a bad thing. Insulin is what allows glucose
• 19:12
  Speaker 4: to go into this to the cell. So I like
• 19:14
  Speaker 4: to think about it as like a salesman knocking on
• 19:16
  Speaker 4: the door. Knocking on the door, door opens, glucose can
• 19:19
  Speaker 4: go in. Well, what happens is when you're eating food
• 19:22
  Speaker 4: choices that are highly processed, they have what's called the
• 19:24
  Speaker 4: hypelycemic load, or you're eating lots or high frequency, you
• 19:28
  Speaker 4: have glucose available more and glucose is a stimulus for insulin,
• 19:32
  Speaker 4: so then you have higher insulin levels. And it's almost
• 19:35
  Speaker 4: like seeing a salesman come to your door every day,
• 19:37
  Speaker 4: knock on the door.
• 19:37
  Speaker 3: What are you going to do.
• 19:38
  Speaker 4: You're going to stop answering, You're gonna say, I know
• 19:40
  Speaker 4: what that is, I'm not going to answer the door.
• 19:42
  Speaker 4: And that is insulin resistance, where the cell gets starved,
• 19:45
  Speaker 4: it wants more glucose. There's glucose out in the blood stream,
• 19:49
  Speaker 4: but the cell's not answering the door because it's so
• 19:51
  Speaker 4: sick of the salesman, your body because it's cellularly starved,
• 19:55
  Speaker 4: actually starts breaking down glucose in your liver, raising blood
• 19:59
  Speaker 4: levels even more. And then this high insulin causes you
• 20:02
  Speaker 4: to deposit visceral fat, so fat around your intestines because
• 20:06
  Speaker 4: it's worried why your cells are getting starved, and insulince
• 20:09
  Speaker 4: highly inflammatory, so you really get stuck, even if you
• 20:13
  Speaker 4: don't have diabetes or something like that. This is what's
• 20:16
  Speaker 4: called insulin resistance. And so when you build a new
• 20:20
  Speaker 4: skeletal muscle, what happens is you don't need the salesman
• 20:24
  Speaker 4: anymore because this allows it gives glucose the key. So
• 20:28
  Speaker 4: when you're using that skeletal muscle, glucose can get into
• 20:30
  Speaker 4: the cell without insulin. So suddenly you can lower glucose level,
• 20:34
  Speaker 4: allows insulin to drop, and then the cells get more sensitive. Right,
• 20:37
  Speaker 4: if the salesman's not there every day, suddenly you're gonna
• 20:39
  Speaker 4: start answering the door again.
• 20:41
  Speaker 3: And so sleeping helps lower some of your glucose.
• 20:44
  Speaker 4: Right, that's why you tell you stop eating before you
• 20:46
  Speaker 4: go to bed, kind of get a better interval.
• 20:48
  Speaker 3: Some I don't love the word fasting, but time restricted eating.
• 20:52
  Speaker 4: Where like it's dark outside, you don't eat, give your
• 20:55
  Speaker 4: body a little bit of a rest and allow glucose
• 20:57
  Speaker 4: to come down. Building using skeletal muscle can use some
• 21:00
  Speaker 4: of that glucose. Allow yourselves to become more sensitive. And
• 21:04
  Speaker 4: this is another one where I call the foundation of
• 21:06
  Speaker 4: your day sleep, stress, and exercise, because stress causes your
• 21:12
  Speaker 4: body to free up more glucose. And this is just
• 21:15
  Speaker 4: something that when we think about it, the stress we
• 21:18
  Speaker 4: have now is so different than the stress that you know,
• 21:20
  Speaker 4: humans were made to it have.
• 21:22
  Speaker 3: So if you were to see a.
• 21:23
  Speaker 4: Bear, you know, in the wild, you had to run
• 21:25
  Speaker 4: from it. So our stress hormones and our stress system
• 21:28
  Speaker 4: activates to free up glucose from places, so you have
• 21:31
  Speaker 4: fuel to run from the bear and go be successful.
• 21:35
  Speaker 4: And two things happen at once now. One is that
• 21:40
  Speaker 4: we don't run from the bear. You know, our stress
• 21:42
  Speaker 4: situation is an email, and we sit here and we
• 21:44
  Speaker 4: get an email and it's really stressful, and our brain
• 21:47
  Speaker 4: spins about it and glucose gets freed up and we
• 21:50
  Speaker 4: don't go use it. So we are kind of propagating
• 21:53
  Speaker 4: this inflammatory insulin resistance system by these stressful exposures because
• 21:58
  Speaker 4: they're not managed one acknowledge that when you have stress,
• 22:04
  Speaker 4: a short burst of movement can be hugely advantageous for
• 22:07
  Speaker 4: helping you recover from that stress. So if you say, hey,
• 22:11
  Speaker 4: I'm going to go take a quick walk or do
• 22:13
  Speaker 4: some squats at my desk, or just something that's going
• 22:15
  Speaker 4: to use up that glucose that's been released, you are
• 22:18
  Speaker 4: now using your physiology in a positive way. Because the
• 22:21
  Speaker 4: idea of Laura, you should just avoid stress because it's
• 22:25
  Speaker 4: bad for your fertility is almost a laughable concept because
• 22:29
  Speaker 4: stress is it's inherent, right, Like the world is stressful.
• 22:34
  Speaker 4: So instead saying like I'm going to have better stress mechanism,
• 22:37
  Speaker 4: so one will say, hey, when I have these events,
• 22:41
  Speaker 4: I'm going to go move my body in some way
• 22:44
  Speaker 4: use up some glucose. Acknowledge that you know, drinking alcohol
• 22:48
  Speaker 4: or eating more food, stress eating or actually the worst
• 22:51
  Speaker 4: things that we can do for this process. Right, Instead,
• 22:54
  Speaker 4: I'm going to use some of that glucose that's been freed.
• 22:56
  Speaker 4: Kind of get a nice reset, and you'll recover from
• 22:58
  Speaker 4: the stressful event.
• 23:00
  Speaker 2: Star.
• 23:00
  Speaker 4: I also think we have to build in stress reduction
• 23:03
  Speaker 4: techniques because the world is stressful. And yes, there's a
• 23:06
  Speaker 4: place for saying say no to things you don't need
• 23:09
  Speaker 4: and try to craft out an environment that is less stressful.
• 23:12
  Speaker 4: And I think that's good for us all in hustle culture
• 23:14
  Speaker 4: to kind of think about that. We don't have to
• 23:16
  Speaker 4: say yes to everything, but there's seasons of life where
• 23:19
  Speaker 4: you have things that are stressful you don't have control over,
• 23:21
  Speaker 4: or that you do need to say yes to things.
• 23:23
  Speaker 3: And so acknowledging that I need to.
• 23:26
  Speaker 4: Have a cortisol reduction and I need to like not
• 23:30
  Speaker 4: be on my phone. You know, whether this is meditation, mindfulness, acupuncture, yoga,
• 23:36
  Speaker 4: a walk, sitting outside with the birds. I mean, we're
• 23:38
  Speaker 4: all wired different and all of those things can achieve
• 23:41
  Speaker 4: the goal of that feeling. And so you know, these
• 23:46
  Speaker 4: three things right here my foundation of the day. That's
• 23:49
  Speaker 4: step number one that didn't require a huge Oh, I
• 23:53
  Speaker 4: have to learn about toxins and get new beauty products
• 23:55
  Speaker 4: or change the foods I eat. I mean, those things
• 23:57
  Speaker 4: are important and hugely impactful. But before we even start those,
• 24:01
  Speaker 4: we should start looking at how we're setting up our day,
• 24:05
  Speaker 4: because we're probably making choices on these foundational tenants that
• 24:09
  Speaker 4: are harming us without even acknowledging how inflammatory they are.
• 24:15
  Speaker 2: Well on top of life stress, trying to get.
• 24:18
  Speaker 3: Pregnant, infertility stress.
• 24:21
  Speaker 2: IVF was one of the most stressful, emotional, mental things
• 24:26
  Speaker 2: I've ever gone through. So how do you help your
• 24:31
  Speaker 2: clients or pet your patients navigate that you know?
• 24:34
  Speaker 4: Infertility stress has been likened to getting you know, a
• 24:37
  Speaker 4: cancer diagnosis and as far as the stress that it
• 24:41
  Speaker 4: causes to you personally and to your family.
• 24:43
  Speaker 3: And I think it.
• 24:44
  Speaker 4: Makes sense because nothing causes you to question your life,
• 24:49
  Speaker 4: who you are, what your life is going to look like,
• 24:52
  Speaker 4: you know, as going through infertility and being faced with
• 24:56
  Speaker 4: a reality that you almost didn't even know what's possible.
• 25:00
  Speaker 4: I think for infertility stress, it's multifactorial on how to
• 25:03
  Speaker 4: approach it. Number one, walking through a forest blind will
• 25:07
  Speaker 4: always be harder than walking through with a map. So
• 25:11
  Speaker 4: have whoever is leading your journey, your doctor, your clinic,
• 25:15
  Speaker 4: trusts them. That doesn't mean we blindly follow their advice.
• 25:18
  Speaker 4: But if you have questions that are never getting answered,
• 25:20
  Speaker 4: if you never can get FaceTime with your team, if
• 25:23
  Speaker 4: you don't know that they have your interests at heart,
• 25:26
  Speaker 4: please go get a second opinion first and foremost, you know,
• 25:29
  Speaker 4: having a map, knowing what you're doing, and why you're
• 25:32
  Speaker 4: doing it can make the process less stressful, even if
• 25:36
  Speaker 4: you know that doesn't always cover the outcome, it's going
• 25:39
  Speaker 4: to be a lot easier of a journey. So trust
• 25:41
  Speaker 4: where you are and you're not married to your fertility doctor.
• 25:45
  Speaker 4: If that is not the place for you, please please
• 25:47
  Speaker 4: please get a second opinion. I think from there you
• 25:51
  Speaker 4: know knowing that you are controlling what you can.
• 25:53
  Speaker 3: So when we do.
• 25:54
  Speaker 4: Talk about a lot of these lifestyle factors and decreasing inflammation,
• 25:58
  Speaker 4: man do them. If you have infertility, don't don't spin
• 26:01
  Speaker 4: your wheels wasting time thinking like should I do this
• 26:04
  Speaker 4: or shouldn't I do this? Just say, you know what,
• 26:07
  Speaker 4: in this season of life, I don't have the mental
• 26:09
  Speaker 4: band space to be questioning all these decisions. So I
• 26:12
  Speaker 4: Am just going to start to live a more anti
• 26:14
  Speaker 4: inflammatory life and know that I'm doing the best that
• 26:18
  Speaker 4: we can possible and not let that stress me out.
• 26:21
  Speaker 4: My number three, I always tell people to do what
• 26:24
  Speaker 4: I didn't do, and this would mean that please consider
• 26:27
  Speaker 4: telling the people in your life who would show up
• 26:30
  Speaker 4: for you what you are going through. And I know
• 26:33
  Speaker 4: that is a huge vulnerability and that's very hard. When
• 26:36
  Speaker 4: I went through pregnancy, loss and infertility. I didn't tell anybody.
• 26:41
  Speaker 4: It made it so much harder.
• 26:43
  Speaker 3: I was in this.
• 26:44
  Speaker 4: Oh, I didn't tell tell you I was pregnant. How
• 26:47
  Speaker 4: am I gonna call you and tell you I'm miscarrying?
• 26:49
  Speaker 4: I just felt very alone. It's already so isolating to
• 26:54
  Speaker 4: watch your friends and family get to a life stage
• 26:57
  Speaker 4: you want to be at and so allow them to
• 27:01
  Speaker 4: show up for you. Somebody can't show up for you
• 27:02
  Speaker 4: if they don't know what you're going through. And this
• 27:04
  Speaker 4: doesn't mean you have to share your story on the internet.
• 27:06
  Speaker 4: People can, and that's incredible and vulnerable.
• 27:10
  Speaker 3: But think about you know.
• 27:11
  Speaker 4: Your best friend, your mom, your sister, that coworker you're
• 27:13
  Speaker 4: so close with. When you open up and you do
• 27:16
  Speaker 4: share with them, you know most people will show up
• 27:18
  Speaker 4: in ways that you know you need. Right if you
• 27:21
  Speaker 4: tell your best friend at work, like they're going to
• 27:23
  Speaker 4: be more at to be able to say, oh, you
• 27:26
  Speaker 4: have you know your retrieval next week, let me let
• 27:28
  Speaker 4: me be the lead on that project, or let me
• 27:30
  Speaker 4: do this. And so we have to give people the
• 27:33
  Speaker 4: benefit of a doubt a little bit, but let some
• 27:36
  Speaker 4: of them. In the contrast to this, I will say
• 27:38
  Speaker 4: is if you are listening and you have somebody in
• 27:40
  Speaker 4: your life going through infertility, or you've been through it
• 27:43
  Speaker 4: and now somebody's going through I think one of the
• 27:46
  Speaker 4: most impactful things we can do is show up in
• 27:48
  Speaker 4: meaningful ways by making it yes for somebody to say
• 27:52
  Speaker 4: yes to our help. Because the TEXTA says, oh my gosh, Laura,
• 27:56
  Speaker 4: I'm so sorry you're going through IVF. Let me know
• 27:58
  Speaker 4: what I can do. I mean, that's so sweet, but
• 28:00
  Speaker 4: that now the burden's on you and you have to
• 28:02
  Speaker 4: say what is too big of an ask or what
• 28:05
  Speaker 4: am I going to ask them to do? Or are
• 28:06
  Speaker 4: they available? And it feels too much. So instead I
• 28:08
  Speaker 4: always tell people like, show up in a very tangible
• 28:11
  Speaker 4: make it an easy yes, Laura. I'm you know, I'm
• 28:14
  Speaker 4: driving through Starbucks. Can I grab you something and drop
• 28:16
  Speaker 4: it by? Or Hey, I would love to take you
• 28:18
  Speaker 4: to dinner on Thursday night to this place. Or if
• 28:21
  Speaker 4: your partner is out of town, I know they're out
• 28:23
  Speaker 4: of town next week, I'm free to go with you
• 28:25
  Speaker 4: to the doctor and write down, you know, take notes
• 28:27
  Speaker 4: for you right, give somebody something you're willing to do
• 28:31
  Speaker 4: that you can do and show up for. But make
• 28:33
  Speaker 4: it easy for them to say yes to that help
• 28:35
  Speaker 4: because it is very meaningful. But too often people put
• 28:38
  Speaker 4: the burden on the person going through in fertility and
• 28:41
  Speaker 4: you're already juggling so much and trying to make all
• 28:45
  Speaker 4: of these decisions and choices that that can feel like
• 28:49
  Speaker 4: too much to the cup as well, and then you're
• 28:51
  Speaker 4: not getting support that you could get.
• 28:54
  Speaker 2: Yeah, that's great advice. I want to know what you
• 28:58
  Speaker 2: think about when a woman should be tested early fertility testing.
• 29:05
  Speaker 2: Should we be doing it in our twenties to get
• 29:08
  Speaker 2: ahead of the april? When when should a woman do it? Yeah?
• 29:13
  Speaker 4: I know frequently say I think the entire fertility industry
• 29:16
  Speaker 4: is wrong and we should be revising how we're doing everything.
• 29:19
  Speaker 4: I don't think we need to be as reactive and
• 29:20
  Speaker 4: we should be proactive. If you want to have children
• 29:24
  Speaker 4: one day but not yet so you say you're in
• 29:26
  Speaker 4: your twenties, you say this is a life goal. I
• 29:29
  Speaker 4: think every woman should consider testing their AMH, which is
• 29:32
  Speaker 4: a marker of their ovarian reserve. And I think that
• 29:35
  Speaker 4: we should, you know, really learn how to track our cycles.
• 29:37
  Speaker 3: Now.
• 29:38
  Speaker 4: Obviously, when it comes to cycle tracking, if you're on
• 29:41
  Speaker 4: hormonal contraception, you can't track your cycle, so there's seasons
• 29:43
  Speaker 4: of life, right, and if the priority is preventing pregnancy
• 29:47
  Speaker 4: and a hormonal contraceptive is the best choice for you, good, right,
• 29:50
  Speaker 4: that's fine. But presuming that that's not usually most women
• 29:54
  Speaker 4: their entire twenties learning how to track your cycle so
• 29:57
  Speaker 4: that you can get an earlier evaluation for cy abnormalities,
• 30:01
  Speaker 4: even if that means, you know, taking a break from contraception,
• 30:04
  Speaker 4: if that makes sense in your social life, so that
• 30:06
  Speaker 4: you can kind of see how your cycle is.
• 30:08
  Speaker 3: Your period gives you a lot.
• 30:09
  Speaker 4: Of warning signs when it comes to both ovulation and
• 30:12
  Speaker 4: egg count and other markers, but we don't ever learn
• 30:15
  Speaker 4: to leverage that. I have to admit AMH testing is
• 30:19
  Speaker 4: for some reason extremely controversial. So let's dive into this.
• 30:22
  Speaker 4: AMH is a blood test. It's not very expensive and
• 30:25
  Speaker 4: it's very easy to do. It is a hormone made
• 30:27
  Speaker 4: from the cells that surround each follicle, so your eggs
• 30:30
  Speaker 4: grow inside follicles inside you're ovary. You're born with all
• 30:33
  Speaker 4: your eggs. Every month. I like to think about your
• 30:36
  Speaker 4: eggs kept in a little vault inside your ovary, and
• 30:38
  Speaker 4: every month a group of eggs is sent out of
• 30:40
  Speaker 4: the vault, and so you see all these follicles, one
• 30:44
  Speaker 4: of these will be chosen to ovulate, the rest of
• 30:46
  Speaker 4: them die the next month. Another group core concept is
• 30:50
  Speaker 4: when you have more eggs remaining, more come out every month,
• 30:53
  Speaker 4: and as we start to get older, fewer come out
• 30:55
  Speaker 4: every month. Eventually we'll be out of eggs. And this
• 30:58
  Speaker 4: is ovary and failure or menopause. Well, our ovary does
• 31:01
  Speaker 4: have kind of some period abnormalities between brain and ovary
• 31:04
  Speaker 4: connection at both high accounts and low accounts. Right, it's
• 31:07
  Speaker 4: meant to work right here in the middle, and this
• 31:10
  Speaker 4: is why our cycle can be very enlightening to us.
• 31:13
  Speaker 4: But AMH is made from the cells surrounding all the
• 31:16
  Speaker 4: follicles outside the vault. So in a very simplistic form,
• 31:20
  Speaker 4: if you have more ex remaining you can do a
• 31:21
  Speaker 4: blood test, you have a higher AMH, and if you
• 31:23
  Speaker 4: have fewer ex remaining, you have a lower AMH. To me,
• 31:27
  Speaker 4: this sounds like a no brainer, right, like we should
• 31:29
  Speaker 4: check this. And if you are low, especially as a
• 31:32
  Speaker 4: young woman, and you want to have kids one day
• 31:34
  Speaker 4: and not yet, you might absolutely do different things if
• 31:38
  Speaker 4: you find out this information. Because twofold one why is
• 31:42
  Speaker 4: it low and two like, should you consider freezing negs?
• 31:46
  Speaker 4: Or maybe maybe you'd be like me, maybe you were
• 31:48
  Speaker 4: married young, but you're just we're waiting for a family.
• 31:51
  Speaker 4: But theoretically you could start earlier if you knew you
• 31:54
  Speaker 4: had less time to grow your family. The reason why
• 31:57
  Speaker 4: it's controversial is the American College for Obgui says that
• 32:00
  Speaker 4: you shouldn't check AMH until somebody has infertility because it's
• 32:04
  Speaker 4: not a great marker of natural fertility. And what they
• 32:08
  Speaker 4: mean is that people with both a high and low
• 32:11
  Speaker 4: AMH can still get pregnant. Right If we think about
• 32:14
  Speaker 4: if you have five eggs outside the bault and you
• 32:16
  Speaker 4: have twenty, if you're ovulating one egg, you still have
• 32:20
  Speaker 4: the same chance of getting pregnant based on your age.
• 32:23
  Speaker 4: So why stress women out about a test that's not
• 32:27
  Speaker 4: a They say that's not going to cause infertility, and
• 32:30
  Speaker 4: a high AMH doesn't mean you'll have no problem getting pregnant, right,
• 32:33
  Speaker 4: because that's just one piece of the puzzle. I think
• 32:36
  Speaker 4: that's such a paternalistic view because they're making an assumption
• 32:40
  Speaker 4: with what you'll do with that data. They're making the
• 32:41
  Speaker 4: assumption that it's too stressful, and the bigger overarching question
• 32:45
  Speaker 4: for me is why is it low? If a twenty
• 32:47
  Speaker 4: five year old has a low AMH, there certainly could
• 32:50
  Speaker 4: be something that is causing a low AMH that also
• 32:53
  Speaker 4: could cause infertility. That her story might look very different
• 32:58
  Speaker 4: if she knows this information. Now, say autoimmune thyroid disease
• 33:02
  Speaker 4: or endometriosis, you know, smoking cigarettes. You know, maybe she
• 33:06
  Speaker 4: makes change, maybe she gets a diagnosis, Maybe she freezes
• 33:10
  Speaker 4: her eggs, maybe she doesn't. But what I find is
• 33:12
  Speaker 4: that by allowing you as an individual to make hard choices,
• 33:18
  Speaker 4: you are going to tolerate the outcome of that decision,
• 33:21
  Speaker 4: even if it's unfavorable, much better than being never in
• 33:25
  Speaker 4: a position to have the choice in front of you.
• 33:28
  Speaker 4: Because if I look at a twenty five year old
• 33:30
  Speaker 4: and I say, hey, you have extremely low AMH and
• 33:33
  Speaker 4: you're probably going to go into ovariant failure before your
• 33:36
  Speaker 4: planned time of getting pregnant at age thirty five, you know,
• 33:40
  Speaker 4: you might say I'm not gonna do anything about this,
• 33:42
  Speaker 4: like I'm not. I don't have a partner, I don't
• 33:43
  Speaker 4: want to freeze my eggs. Okay, so be it. But
• 33:46
  Speaker 4: at least you got to make that choice, because if
• 33:48
  Speaker 4: we let time make it and you just pop into
• 33:50
  Speaker 4: my office at thirty five and the time has passed.
• 33:54
  Speaker 4: Now we don't know what you would have done. Right,
• 33:55
  Speaker 4: you don't get the opportunity to make that choice. Most
• 33:58
  Speaker 4: women will actually do something different. There's no one right
• 34:02
  Speaker 4: or wrong thing. I've had people freeze their eggs. I've
• 34:04
  Speaker 4: had them start trying to get pregnant earlier. I've had
• 34:06
  Speaker 4: them change their entire lifestyle. But I have definitely had
• 34:10
  Speaker 4: women in their twenties find out that they are in
• 34:12
  Speaker 4: premature ovarian failure. And one of the hardest things is
• 34:16
  Speaker 4: to both that they never got the choice, They never
• 34:20
  Speaker 4: got the opportunity to conceive, you know, with their own eggs,
• 34:24
  Speaker 4: and even more so when they do say that they
• 34:27
  Speaker 4: had period changes. One of the top signs of having
• 34:30
  Speaker 4: a lower account is starting to ovulate earlier. So if
• 34:33
  Speaker 4: you say I used to have cycles that were every
• 34:35
  Speaker 4: thirty thirty one days, now they're every twenty four to
• 34:37
  Speaker 4: twenty five days. The simple explanation is when less eggs
• 34:41
  Speaker 4: come out of the vault, the brain doesn't know this,
• 34:43
  Speaker 4: and since that the same amount of the hormone fsh
• 34:46
  Speaker 4: follicle stimulating hormone to get you to ovulate, so it's
• 34:48
  Speaker 4: a stronger signal. Right, it's getting divided amongst five eggs
• 34:51
  Speaker 4: instead of twenty, and you should to ovulate faster. So
• 34:54
  Speaker 4: when women say, I, you know, my periods started getting
• 34:57
  Speaker 4: closer together and I went to my doctor and I
• 34:58
  Speaker 4: got dismissed about it, it that to me is also heartbreaking,
• 35:02
  Speaker 4: because that's the moment when your body was trying to
• 35:05
  Speaker 4: give you that red flag. You weren't taught about it,
• 35:08
  Speaker 4: you didn't know, you got dismissed. You did everything you could.
• 35:11
  Speaker 4: So this narrative of not checking your AMH until you
• 35:16
  Speaker 4: have infertility, I find to be very harmful. I think
• 35:19
  Speaker 4: you know, you can choose to do what you want
• 35:21
  Speaker 4: with the information once you have it. There's no reason
• 35:24
  Speaker 4: why we should presume what you would do, Like we
• 35:26
  Speaker 4: should just find out the data we can. We can
• 35:28
  Speaker 4: acknowledge the limitations of a test, right and say it
• 35:33
  Speaker 4: doesn't mean you'll have you'll be fertile, and it doesn't
• 35:35
  Speaker 4: mean you'll have infertility. But understanding that's one piece of
• 35:38
  Speaker 4: the fertility puzzle that we can actually test, I think
• 35:43
  Speaker 4: is so important and it's something that I do think
• 35:45
  Speaker 4: women in their twenties should get tested if they want
• 35:47
  Speaker 4: to have kids one day, and.
• 35:49
  Speaker 2: If they want to have kids, when should they freeze
• 35:51
  Speaker 2: their eggs.
• 35:52
  Speaker 4: So, I mean my standard answer is, hey, the moment
• 35:56
  Speaker 4: you're asking the question, is the best time to freeze
• 35:58
  Speaker 4: your eggs because you're never going to be as young
• 36:00
  Speaker 4: as you are now, which means your eggs is going
• 36:02
  Speaker 4: to be great quality and you're going to have more
• 36:05
  Speaker 4: of them because over time we have less eggs. The
• 36:07
  Speaker 4: scientific answer is that for the majority of people we
• 36:11
  Speaker 4: see that age thirty to thirty two, if you are
• 36:14
  Speaker 4: not ready to have a child, this tends to be
• 36:17
  Speaker 4: statistically when there's a you know, cost effectiveness. I mean,
• 36:20
  Speaker 4: you still get a good number of eggs, the genetic
• 36:22
  Speaker 4: normalcy is still high, and you know, your tendency to
• 36:25
  Speaker 4: need to use them tends to be higher. So there's
• 36:28
  Speaker 4: no one answer.
• 36:29
  Speaker 3: I think.
• 36:30
  Speaker 4: You know, I definitely have women in their twenties or
• 36:33
  Speaker 4: you know, they're going to mud school or grad school
• 36:36
  Speaker 4: and they just want to kind of freeze eggs. I
• 36:38
  Speaker 4: mean they are then freezing them when they are young
• 36:40
  Speaker 4: and have excellent egg quality and have a good number,
• 36:42
  Speaker 4: so they have a very high ROI on that investment.
• 36:46
  Speaker 4: I always say that egg freezing is not like an
• 36:49
  Speaker 4: insurance policy for your fertility. A lot of people mistakenly
• 36:52
  Speaker 4: say that, you know, I would say an insurance policy
• 36:55
  Speaker 4: pays off.
• 36:56
  Speaker 2: Right.
• 36:56
  Speaker 3: This is an investment.
• 36:57
  Speaker 4: It's like playing the stock market, which really depends on
• 37:01
  Speaker 4: the environment when you go to pull the money on
• 37:03
  Speaker 4: what the ultimate outcome will be, which has some variables
• 37:06
  Speaker 4: that you can't control. And that is how I frame
• 37:09
  Speaker 4: egg freezing. So the ROI on this investment we can
• 37:12
  Speaker 4: we try to use the data to make the best
• 37:14
  Speaker 4: guess we can. Generally, is it good to invest your money?
• 37:17
  Speaker 1: Yes?
• 37:18
  Speaker 4: Does it pay off for most people yes? Will it
• 37:21
  Speaker 4: always pay off for you?
• 37:22
  Speaker 3: We don't know.
• 37:23
  Speaker 4: There's some risk involved, and so framing it that way
• 37:27
  Speaker 4: kind of allows women to gauge what makes sense for them.
• 37:30
  Speaker 4: But I also say we don't have to view it
• 37:33
  Speaker 4: as a one time thing, meaning very often it makes
• 37:36
  Speaker 4: sense you want to have kids as a life goal,
• 37:38
  Speaker 4: you're pursuing some other path, or you don't have a
• 37:40
  Speaker 4: partner yet, let's freeze a group of eggs. Now, the
• 37:43
  Speaker 4: longer we wait till you're ready to have your family,
• 37:45
  Speaker 4: or the longer you know time is going by until
• 37:48
  Speaker 4: you want to use them, the higher the likelihood you
• 37:50
  Speaker 4: need them is. So suddenly you might say, maybe I
• 37:53
  Speaker 4: should do another cycle as I get older, right like,
• 37:56
  Speaker 4: as more time passes, we can always add to that.
• 37:58
  Speaker 4: So you know, I've had women very old freeze eggs
• 38:02
  Speaker 4: and had success. I've had women as old as forty
• 38:04
  Speaker 4: two forty three freeze eggs ended up having success for them.
• 38:07
  Speaker 4: I've had women, I mean, I've diagnosed fifteen and sixteen
• 38:10
  Speaker 4: year olds in ovarian failures.
• 38:12
  Speaker 3: So you know, you don't know what you don't know,
• 38:14
  Speaker 3: and I think it is.
• 38:17
  Speaker 4: We can make a lot of presumptions about what happens
• 38:20
  Speaker 4: on average, but by definition, average means some people have
• 38:24
  Speaker 4: it better, some people have it worse. And getting your
• 38:27
  Speaker 4: own personalized data and thinking about your own goals is
• 38:31
  Speaker 4: going to help you make the best decisions for your future,
• 38:34
  Speaker 4: which ultimately I'd rather you make that choice, even if
• 38:37
  Speaker 4: it ends up, you know, not working out for you.
• 38:39
  Speaker 4: You can say, you know what I knew, my amh
• 38:41
  Speaker 4: was low. I wasn't in a position to do anything
• 38:43
  Speaker 4: about this. This is where I am, and I can
• 38:45
  Speaker 4: live with that versus what I hear is gosh, I
• 38:48
  Speaker 4: wish i'd known this information, I would have made a
• 38:50
  Speaker 4: different decision.
• 38:52
  Speaker 1: This is really interesting because there's women. I mean, we
• 38:55
  Speaker 1: are our age group here listening to this podcastretty much
• 39:01
  Speaker 1: the majority are between thirty five and fifty five. I
• 39:04
  Speaker 1: would say ninety five percent, So you have some women
• 39:08
  Speaker 1: going through this, but then there's a heck of a
• 39:10
  Speaker 1: lot of women that for somebody like me that I'm like, well,
• 39:13
  Speaker 1: what do I want to tell my twenty one year
• 39:15
  Speaker 1: old daughter, because if we you know, did they have
• 39:19
  Speaker 1: it right eighty years ago when people were having babies
• 39:23
  Speaker 1: at eighteen and seventeen and you know, starting families and
• 39:26
  Speaker 1: that's what you did, Like, it's how do we shift that?
• 39:29
  Speaker 1: Because that's really hard too. When I had I started
• 39:33
  Speaker 1: having my children in my twenties and so it was
• 39:36
  Speaker 1: really easy for me. But I had a partner and
• 39:40
  Speaker 1: that worked out. But that's not what it's like for
• 39:43
  Speaker 1: the majority. Like we're getting married later, we're having more careers.
• 39:47
  Speaker 1: Like for the female it's this short like it's hard
• 39:51
  Speaker 1: because you're like, wow, I have this biological clock ticking
• 39:56
  Speaker 1: and then I have these other goals of independence and
• 39:59
  Speaker 1: what I want for my one wild, beautiful life. You know,
• 40:03
  Speaker 1: how do we coincide those Is it always better to
• 40:06
  Speaker 1: get I mean, it's definitely easier. It sounds like to
• 40:09
  Speaker 1: get pregnant when you're in your twenties obviously, versus maybe
• 40:13
  Speaker 1: your late thirties. But when does that geriatric? Doesn't the
• 40:16
  Speaker 1: geriatric pregnancy start at thirty four? I want to say
• 40:19
  Speaker 1: I was thirty four and I was in that category
• 40:21
  Speaker 1: thirty five.
• 40:22
  Speaker 4: Yeah, so if you are going to be thirty five
• 40:24
  Speaker 4: when you delivered, you would have carried that lovely advanced
• 40:27
  Speaker 4: maternal age a geriatric pregnancy kind of title. We have
• 40:31
  Speaker 4: to remember that some of these things, you know, medicine
• 40:33
  Speaker 4: is so interesting because it existed in a time before
• 40:37
  Speaker 4: the current technology we have, and so sometimes certain labels
• 40:40
  Speaker 4: or ways that we did things made sense in context
• 40:43
  Speaker 4: of how the world was, and it doesn't necessarily still
• 40:46
  Speaker 4: make sense today. We have to view it through that lens.
• 40:49
  Speaker 4: So advanced maternal age, we knew people had higher pregnancy
• 40:52
  Speaker 4: complications or more losses, and we didn't really know why.
• 40:55
  Speaker 4: Now we know it's because more of our eggs are
• 40:57
  Speaker 4: genetically abnormal. We're overall less health when we're over age
• 41:01
  Speaker 4: thirty five. That doesn't mean that you, as an individual
• 41:04
  Speaker 4: are going to have a hard time, or you shouldn't
• 41:05
  Speaker 4: get pregnant. But it definitely means do we need to
• 41:08
  Speaker 4: pay more attention to our overall health. If we're carrying
• 41:10
  Speaker 4: a pregnancy at forty, then maybe a twenty year old
• 41:13
  Speaker 4: can get away with more absolutely, But that doesn't mean
• 41:16
  Speaker 4: you're universally going to have bad outcomes. But from a
• 41:19
  Speaker 4: medical standpoint, that title allows us to screen for more
• 41:23
  Speaker 4: things and tests for more things to kind of make
• 41:25
  Speaker 4: sure you're not having some of these bad outcomes. And
• 41:28
  Speaker 4: I think ultimately that's good, even though the name of
• 41:30
  Speaker 4: things can be kind of bad and scary. I think
• 41:34
  Speaker 4: a few different things. You know, most women are learning
• 41:36
  Speaker 4: to track their cycles. Like we'll say the listeners of
• 41:39
  Speaker 4: your show, when they're going through perimenopause is when they're
• 41:43
  Speaker 4: now done with their family. Maybe they don't need to
• 41:45
  Speaker 4: be on kind of contraception anymore, their partner has a vasectomy,
• 41:48
  Speaker 4: and so they're kind of off contraception, trying to learn
• 41:51
  Speaker 4: to track their cycles or their cycles being wonky, or
• 41:54
  Speaker 4: they're asking is it perimenopause or menopause. There's absolutely no
• 41:57
  Speaker 4: reason why we should be learning that information. Age thirty
• 42:00
  Speaker 4: five to fifty five, right, we absolutely need to be
• 42:03
  Speaker 4: learning about our cycle and what's normal and abnormal younger.
• 42:07
  Speaker 4: So I think when it comes to my own daughter,
• 42:10
  Speaker 4: like when she is older, you know, making sure that
• 42:13
  Speaker 4: even though hormonal contraception, like it gave me a lot
• 42:16
  Speaker 4: of freedom, I loved it. I'm not an anti birth
• 42:18
  Speaker 4: control person, but the idea that like we should just
• 42:20
  Speaker 4: use hormonal contraception for a decade without ever like checking
• 42:24
  Speaker 4: into our body, I don't love that. So, you know,
• 42:27
  Speaker 4: I would say making sure she knows what a normal
• 42:30
  Speaker 4: period is, she knows how to track hers, and that
• 42:33
  Speaker 4: she takes breaks from contraceptive when it makes sense from
• 42:35
  Speaker 4: her so she can check in with her period important.
• 42:39
  Speaker 3: You know.
• 42:39
  Speaker 4: I think getting testing for her fertility, like checking in
• 42:42
  Speaker 4: AMH when she's young, she'll probably I think if you
• 42:46
  Speaker 4: are a parent and you can help your daughter freeze
• 42:49
  Speaker 4: her eggs when she's like graduating college or grad school,
• 42:51
  Speaker 4: if that's something she's doing, that is one of the
• 42:54
  Speaker 4: best gifts you can give because you are helping achieve
• 42:57
  Speaker 4: a goal that feels financially really high. For twenty year
• 43:00
  Speaker 4: old to drop you know, ten grand or so on
• 43:03
  Speaker 4: egg freezing feels like a lot so as a you know,
• 43:06
  Speaker 4: as a parent, that would be something that I would say, gosh,
• 43:10
  Speaker 4: instead of giving my daughter, you know, with jewelry or
• 43:13
  Speaker 4: trip or this or that, like that would be an
• 43:15
  Speaker 4: amazing kind of gift to gift your daughter upon graduation
• 43:20
  Speaker 4: or a life event, especially if they are chasing other
• 43:24
  Speaker 4: dreams that as parents we want to support. I want
• 43:26
  Speaker 4: to see our kids get you know, maybe pregnant in
• 43:28
  Speaker 4: their early twenties. We'd love for them to chase these dreams.
• 43:31
  Speaker 3: But trying to.
• 43:32
  Speaker 4: Help that feel like an easier way to do so.
• 43:36
  Speaker 4: I also think that you know, having open discussions about
• 43:40
  Speaker 4: reproductive health in general from a young age or even
• 43:43
  Speaker 4: going on is really important to know, like that your
• 43:48
  Speaker 4: child can turn to you. You know, also that we
• 43:51
  Speaker 4: as a society can say you, if you want to
• 43:54
  Speaker 4: have kids one day, you know, how do we help you?
• 43:56
  Speaker 3: How do we not?
• 43:57
  Speaker 4: I see so many people suffering and suffering in silence
• 44:01
  Speaker 4: or not knowing information things like you can get genetic
• 44:04
  Speaker 4: carrier screening to make sure you and your partner don't
• 44:06
  Speaker 4: carry the same genetic disease before you try to get pregnant.
• 44:09
  Speaker 4: And that's a medical recommendation that so few people do
• 44:13
  Speaker 4: because they don't know, and then I will end up
• 44:15
  Speaker 4: seeing people who co carry the same terrible disease. They
• 44:18
  Speaker 4: don't find out until they have a child who's very
• 44:21
  Speaker 4: sick or unfortunately who might die, and then they come
• 44:24
  Speaker 4: in for IVF with genetic testing, so preconception testing, so
• 44:28
  Speaker 4: things like genetic testing, which is going to change immensely,
• 44:31
  Speaker 4: I'm sure in the next decade. Testing ovarian reserve in
• 44:34
  Speaker 4: our twenties, considering freezing our eggs, but learning how to
• 44:38
  Speaker 4: track our cycle. These are the discussions to be had.
• 44:41
  Speaker 4: I do think we're doing a false disservice to somebody
• 44:43
  Speaker 4: who wants to have multiple kids to act like there
• 44:47
  Speaker 4: is no biological clock, right, because we know that it
• 44:50
  Speaker 4: gets harder to get pregnant as we get older. That
• 44:52
  Speaker 4: starts to become most apparent around age thirty eight and older.
• 44:56
  Speaker 4: So if we say, Okay, I'm waiting to have my
• 44:59
  Speaker 4: whole my first kid until I'm thirty five and I
• 45:01
  Speaker 4: want three kids, that math is going to be really
• 45:05
  Speaker 4: tough statistically without needing IVF, And so that opens the discussion.
• 45:11
  Speaker 4: Ivf's a heck of a lot easier if you have younger,
• 45:13
  Speaker 4: better quality eggs. That's where egg freezing earlier can make
• 45:17
  Speaker 4: a huge difference for people later. So there's no one
• 45:21
  Speaker 4: right or wrong. But I think if we're thinking about
• 45:22
  Speaker 4: the cit the lens of our daughter, empowering reproductive health
• 45:26
  Speaker 4: discussions talking about how healthy living impacts egg quality and
• 45:30
  Speaker 4: sperm quality later so that we we all want our
• 45:34
  Speaker 4: kids to be healthy and live a long time, but
• 45:36
  Speaker 4: kind of empowering them that starting that early is only
• 45:39
  Speaker 4: going to be more helpful. And having been an open
• 45:43
  Speaker 4: place for these discussions I think can be really helpful.
• 45:46
  Speaker 1: That's that's great. I love that, you know, giving it
• 45:51
  Speaker 1: as a gift, But do you see so for families
• 45:55
  Speaker 1: that are like, well, I you know, I'm the parent
• 45:57
  Speaker 1: and I don't have ten thousan dollars. I would love
• 46:01
  Speaker 1: to give that to my child, but I don't have it.
• 46:03
  Speaker 1: Is this do you think it's going to get more
• 46:07
  Speaker 1: achievable as far as finances, that there will be different options.
• 46:12
  Speaker 1: Do you say it on the horizon or it's still
• 46:14
  Speaker 1: worth this uphill battle with funds?
• 46:17
  Speaker 4: I mean, yeah, that would be on my fertility wish list,
• 46:20
  Speaker 4: that it could be something that is really accessible.
• 46:22
  Speaker 3: I think this is something to think about.
• 46:24
  Speaker 4: Depending online of work you know too, So we'll use
• 46:27
  Speaker 4: an example. Very competitive industries like tech industry right now,
• 46:31
  Speaker 4: fertility benefits are a large part of their recruitment packages.
• 46:35
  Speaker 4: So if you're going to go work at some tech company,
• 46:37
  Speaker 4: most of them are going to have coverage for egg freezing,
• 46:39
  Speaker 4: and that's great.
• 46:40
  Speaker 3: You should absolutely do it.
• 46:41
  Speaker 4: If your employer has benefits for fertility testing and treatment,
• 46:46
  Speaker 4: and you say I want to have a kid one day,
• 46:49
  Speaker 4: but not now, like leverage the benefit because the next
• 46:51
  Speaker 4: job may not.
• 46:52
  Speaker 3: Have it, I would know.
• 46:55
  Speaker 4: I would love to live in a world where I
• 46:58
  Speaker 4: thought that this would become a universal health benefit, or
• 47:02
  Speaker 4: I thought that the administration's current plan was going to
• 47:07
  Speaker 4: make this truly more accessible. The reality is like there's
• 47:11
  Speaker 4: there already are workplace benefits that exist. Until we really
• 47:14
  Speaker 4: incentivize businesses to include them, probably with tax breaks or
• 47:19
  Speaker 4: other breaks, which which is not a part of the
• 47:21
  Speaker 4: current plan, it's going to be hard pressed to see
• 47:23
  Speaker 4: universal adoption of this across different workplace benefits. So I
• 47:29
  Speaker 4: would love to see that in the future. I mean,
• 47:33
  Speaker 4: it's hard to get some states to even cover egg
• 47:35
  Speaker 4: freezing for cancer patients, right, and so if we're living
• 47:38
  Speaker 4: in a world where it's hard to get something to
• 47:40
  Speaker 4: prove for people of cancer who we know their fertility
• 47:43
  Speaker 4: is going to be impacted by their cancer treatment. I
• 47:45
  Speaker 4: think it's hard to imagine that we'd be in a
• 47:47
  Speaker 4: place where we have, you know, universal coverage for it,
• 47:49
  Speaker 4: even though I would love that so on my wish list,
• 47:52
  Speaker 4: but I think realistically I don't see it. But I
• 47:56
  Speaker 4: would say, there are you know, companies that do leverage
• 47:59
  Speaker 4: for time benefits, and so that is definitely something to
• 48:04
  Speaker 4: be aware of, especially if like maybe if you have
• 48:06
  Speaker 4: a daughter and they're interviewing for jobs, like say, hey,
• 48:08
  Speaker 4: this should be on the questions you ask human resources,
• 48:11
  Speaker 4: like do you have fertility benefits included? Do they cover
• 48:14
  Speaker 4: egg freezing? You know, I think we need to help
• 48:17
  Speaker 4: empower them that it's okay to hold those discussions as well.
• 48:20
  Speaker 2: What about the cost of IVF? Do you ever see
• 48:24
  Speaker 2: the cost of the medications or IVF itself going down?
• 48:29
  Speaker 4: So let's talk about you know, recently there has been
• 48:33
  Speaker 4: administrative focus on IVF and on a pro amd Serono
• 48:37
  Speaker 4: has agreed to start manufacturing some drugs here in the US,
• 48:40
  Speaker 4: which should help some and there should be some benefit
• 48:43
  Speaker 4: to people of the lowest socioeconomic group to save some
• 48:48
  Speaker 4: money on medications. I mean, to be fair, they'll probably
• 48:51
  Speaker 4: save one or two thousand dollars, which is amazing, but
• 48:54
  Speaker 4: drugs cost way more than that, as you know, and
• 48:56
  Speaker 4: it is the minority of people who benefit. I mean,
• 48:59
  Speaker 4: you think you have to make less than like eighty
• 49:01
  Speaker 4: thousand dollars to even qualify for that drug benefit. So
• 49:05
  Speaker 4: it's a step in the right direction. I mean, manufacturing
• 49:07
  Speaker 4: drugs in our company, speeding up FDA approval of novel
• 49:11
  Speaker 4: medications can be advantageous.
• 49:13
  Speaker 3: But I think.
• 49:14
  Speaker 4: That the technology for IVF is incredible, as somebody who
• 49:18
  Speaker 4: owns an IVF LAP. The equipment's crazy expensive. The skills
• 49:22
  Speaker 4: of a good embryologist, I mean it's crazy, right, So
• 49:26
  Speaker 4: the overhead is so high, and if you don't want
• 49:30
  Speaker 4: to sacrifice quality of care it is. It's probably not
• 49:34
  Speaker 4: going to be a less expensive process. Because tech is improving,
• 49:37
  Speaker 4: that's great. New equipment costs more money. I think we'll
• 49:41
  Speaker 4: see some decrease in drug prices if we can really
• 49:44
  Speaker 4: manufacture them here, and that will be good. But I
• 49:46
  Speaker 4: do think for the majority of people that's not going
• 49:48
  Speaker 4: to feel very impactful based on how expensive the whole
• 49:53
  Speaker 4: process is, and that's tough. There have been states who
• 49:57
  Speaker 4: are very successfully implemented, you know, mandate fertility care coverage
• 50:01
  Speaker 4: where they get up to three cycles of IVF if
• 50:03
  Speaker 4: you know, any employer in that state has to offer it,
• 50:06
  Speaker 4: and that can be I can hugely change somebody's fertility journey, right.
• 50:11
  Speaker 4: I do have to say that even in those states,
• 50:14
  Speaker 4: we see the number, we see that people still drop
• 50:17
  Speaker 4: out of fertility care and the reason why is emotional resilience. Right,
• 50:21
  Speaker 4: So the top reason why somebody walks away from a
• 50:23
  Speaker 4: fertility journey is not financial, it's not physical, it's not
• 50:27
  Speaker 4: it took too long. It is that, you know, mentally
• 50:29
  Speaker 4: and emotionally, I could no longer put myself through this.
• 50:32
  Speaker 4: And I think that should tell us that financial is
• 50:35
  Speaker 4: a huge piece of the puzzle. But there's a lot
• 50:38
  Speaker 4: more we need to do and how we support people
• 50:40
  Speaker 4: who are walking this journey.
• 50:42
  Speaker 2: I agree. And when you when you do go through
• 50:45
  Speaker 2: it and you realize what a miracle it is and
• 50:50
  Speaker 2: the science behind it and what you are doing, you
• 50:55
  Speaker 2: kind of don't think about the money because it's truly
• 50:59
  Speaker 2: a miracle what you guys are able to do and achieve,
• 51:03
  Speaker 2: So I just it does break your heart when people
• 51:07
  Speaker 2: aren't able to do it because of the cost. So
• 51:09
  Speaker 2: that's why I wanted to ask that question. What would
• 51:14
  Speaker 2: you say if I was your patient and for anyone
• 51:18
  Speaker 2: around my age, she's.
• 51:20
  Speaker 1: Forty eight, Well, actually I'm forty seven, all right, all.
• 51:24
  Speaker 3: Right, don't have major, don't have major.
• 51:27
  Speaker 2: So I am forty seven and I have a good
• 51:33
  Speaker 2: ach left, right.
• 51:35
  Speaker 4: Yeah, I think there's statistics exist to help us understand
• 51:42
  Speaker 4: the most likely scenario when it comes to fertility and
• 51:46
  Speaker 4: pregnancy in general. You know, one of my fellowship mentors
• 51:50
  Speaker 4: always said, I can give you any statistic I want,
• 51:52
  Speaker 4: but for you it'll be zero or one hundred. And
• 51:54
  Speaker 4: I think that's really really important, right that we talk
• 51:57
  Speaker 4: about numbers like this is a continuous barrier. But for
• 52:00
  Speaker 4: us as an individual, it is a yes or a no.
• 52:03
  Speaker 4: And so we have to keep that in mind, right
• 52:05
  Speaker 4: because even if I say one percent chance, which sounds
• 52:08
  Speaker 4: like zero, it is in fact not zero, and that
• 52:11
  Speaker 4: means that there is a chance, And we always have
• 52:14
  Speaker 4: to kind of look it through the lens of if
• 52:16
  Speaker 4: that's a goal for us or not. If we are
• 52:19
  Speaker 4: not having periods anymore at age forty seven forty eight,
• 52:22
  Speaker 4: then it might be a zero chance because at some
• 52:24
  Speaker 4: point your ovaries do run out of eggs, and we
• 52:26
  Speaker 4: are starting to approach that transition where the ovary may
• 52:30
  Speaker 4: not respond if you are not having periods or you
• 52:33
  Speaker 4: have extremely irregular periods, and we check blood and your
• 52:37
  Speaker 4: brain's FSH that hormone that gets an egg to grow,
• 52:41
  Speaker 4: is higher than forty. That is a sign that I
• 52:44
  Speaker 4: may not be able to get your extra grow with medications,
• 52:47
  Speaker 4: because the medication we give is FSH. So if we
• 52:49
  Speaker 4: kind of think about ovarian failure in menopause, your brain
• 52:53
  Speaker 4: is sending out all the FSH it can to beg
• 52:55
  Speaker 4: the ovary to make an egg and is not doing it.
• 52:58
  Speaker 4: So then we can't overcome everything. And that's why at
• 53:02
  Speaker 4: some point you're overy will stop responding. And once it does,
• 53:06
  Speaker 4: then we are out of options for your own eggs
• 53:08
  Speaker 4: and we can look at donor eggs or alternative options
• 53:11
  Speaker 4: to grow a family. But everybody does reach that critical point,
• 53:14
  Speaker 4: and sometimes it's like a flip switches. You know that
• 53:17
  Speaker 4: you did one cycle and you responded, and two months
• 53:20
  Speaker 4: later it's a different story. So as we start to
• 53:22
  Speaker 4: get into that really low account. We know we're kind
• 53:24
  Speaker 4: of approaching the end. If we are older, I say,
• 53:27
  Speaker 4: you're there is some age related accumulation of genetic changes
• 53:31
  Speaker 4: inside our eggs from wear and tear over time. Our
• 53:34
  Speaker 4: eggs are in our body our whole life. Can't change that.
• 53:37
  Speaker 4: But that's only half the puzzle when it comes to
• 53:39
  Speaker 4: egg quality, because the competency, the metabolic health of the
• 53:43
  Speaker 4: egg controls how it divides the mitochondrial health that gets
• 53:46
  Speaker 4: passed on to the embryo. So to me, like, those
• 53:49
  Speaker 4: are factors we should absolutely do everything we can for
• 53:53
  Speaker 4: so the older we are. If we can't change our age,
• 53:56
  Speaker 4: which nobody can. Then when you say, hey, these lifestyles
• 54:00
  Speaker 4: that we talked about earlier, plus right, eating diets high
• 54:03
  Speaker 4: and fruits and vegetables and fiber, and limiting process foods
• 54:05
  Speaker 4: and limiting added sugar, and you know, reducing environmental toxins
• 54:10
  Speaker 4: and chemicals and subtoxic substances like marijuana and alcohol and smoking,
• 54:15
  Speaker 4: those things only become more important because of you know,
• 54:19
  Speaker 4: the age related quality factor that we cannot change. So
• 54:24
  Speaker 4: and then I think realistic, you know, goals are really important.
• 54:27
  Speaker 4: There's this another place I say, there's no one right
• 54:30
  Speaker 4: or wrong choice for somebody. But you know, getting the
• 54:32
  Speaker 4: data you can is really important optimizing what you can.
• 54:36
  Speaker 4: Sometimes financially, it may not make sense for you to
• 54:39
  Speaker 4: do IVF right if you only are going to have
• 54:41
  Speaker 4: one egg permit. You know, if you have a really
• 54:43
  Speaker 4: low agg count, you might look at this and say,
• 54:46
  Speaker 4: I don't have an endless pot of money. This doesn't
• 54:48
  Speaker 4: make sense for me. But ultimately I think that that
• 54:52
  Speaker 4: decision should be yours, and so getting the data, doing
• 54:54
  Speaker 4: what you can. But we all know stories of SLASH.
• 54:57
  Speaker 4: We all see people who are older who have been
• 55:00
  Speaker 4: there's a zero percent chance, who then get pregnant naturally right.
• 55:04
  Speaker 4: And I think that's because you know, we can have
• 55:07
  Speaker 4: a low overall population based odds, and that becomes really
• 55:11
  Speaker 4: important when we're trying to stratify decisions and how we
• 55:15
  Speaker 4: spend our money and our time and our emotional energy.
• 55:17
  Speaker 4: But that doesn't mean that it's a zero percent chance.
• 55:19
  Speaker 4: So if you're still cycling, it still can happen. Focusing
• 55:22
  Speaker 4: on lifestyle is really important. IVF can absolutely be a
• 55:25
  Speaker 4: strategy as we're older, because if we're not in menopause
• 55:28
  Speaker 4: and we do have multiple eggs per month, it is
• 55:31
  Speaker 4: using the rest of the time better by getting them
• 55:33
  Speaker 4: out of your body and by doing genetic testing trying
• 55:36
  Speaker 4: to find those normal embryos can be a more efficient
• 55:40
  Speaker 4: use of the time that you have. So the last
• 55:42
  Speaker 4: thing I'll say here is we'll say just in general,
• 55:43
  Speaker 4: if you're forty and over, I recommend getting a fertility
• 55:46
  Speaker 4: evaluation right away. So if you are at a stage
• 55:48
  Speaker 4: and you want to be pregnant and you're forty and over,
• 55:51
  Speaker 4: do not just try to get pregnant for X amount
• 55:53
  Speaker 4: of time and then come to us. We know that
• 55:56
  Speaker 4: statistically you have a higher odds having certain things wrong.
• 56:00
  Speaker 4: Let's get testing done right away so that you can
• 56:02
  Speaker 4: make these decisions from a place of power and knowledge
• 56:04
  Speaker 4: versus kind of having to go through that failure first.
• 56:08
  Speaker 1: Wow, I'm so excited for your book to come out,
• 56:11
  Speaker 1: and I'm not even in the fertility world anymore, but
• 56:14
  Speaker 1: I feel like this is super helpful. As I said,
• 56:16
  Speaker 1: as I have an older daughter that isn't anywhere near
• 56:19
  Speaker 1: that right now, but knowing it's one in five, I
• 56:22
  Speaker 1: mean that number might go down to one and four no, no.
• 56:28
  Speaker 4: So yeah, I think if we don't make changes as
• 56:30
  Speaker 4: a society, we are going to see you know, this
• 56:33
  Speaker 4: rate of infertility is only going to get worse.
• 56:35
  Speaker 3: Yeah, well, and you.
• 56:39
  Speaker 2: Give a lot of support and freebies when people purchase
• 56:43
  Speaker 2: your book. It's on pre order right.
• 56:45
  Speaker 4: Now, correct, Yes, yeah, so the book is for is
• 56:49
  Speaker 4: pre order.
• 56:50
  Speaker 3: You can pre order it right now.
• 56:51
  Speaker 4: It comes out in April of twenty twenty six, and
• 56:53
  Speaker 4: it's called The Fertility Formula, So you can get it
• 56:56
  Speaker 4: at Natalie CRAWFORDIMD dot com slash book. But because there's irony,
• 57:01
  Speaker 4: you know, traditional book publishing, love and hate right, big reach,
• 57:04
  Speaker 4: it's incredible, takes a long time. So the irony of
• 57:07
  Speaker 4: them saying this book goes for pre order nine months
• 57:10
  Speaker 4: before you could be held in print not lost on me.
• 57:13
  Speaker 4: For a fertility book, and because it is something that
• 57:16
  Speaker 4: you know, if you hear all this and you want
• 57:18
  Speaker 4: to make changes now, you don't necessarily want to wait
• 57:20
  Speaker 4: until the book is in hand. So anybody who pre orders,
• 57:23
  Speaker 4: there's a hormone guide you can get immediate access to.
• 57:26
  Speaker 4: I have an IDF class that I've course that I've
• 57:28
  Speaker 4: had for a long time, really talking about nitty gritty
• 57:31
  Speaker 4: of protocols and questions to ask that you get access
• 57:33
  Speaker 4: to and then we're doing a pre order book club
• 57:36
  Speaker 4: where I have made modules from the book chapters to
• 57:39
  Speaker 4: kind of give you this information now and do a
• 57:41
  Speaker 4: deep dive on it, and then monthly Q and A calls.
• 57:44
  Speaker 4: So trying to support people who are supporting me and
• 57:47
  Speaker 4: buying the book, which is, you know, fulfilling one of
• 57:49
  Speaker 4: my life dreams by helping them get this information sooner
• 57:54
  Speaker 4: in anticipation of the book coming to their hands in April.
• 57:58
  Speaker 1: So exciting.
• 57:59
  Speaker 2: That's that's such a blessing because when you are going
• 58:01
  Speaker 2: through IVF, you do have so many questions and you
• 58:05
  Speaker 2: need support, and to get it from a doctor who's
• 58:10
  Speaker 2: a leader in the space is such a gift.
• 58:12
  Speaker 3: Ah, well, thank you.
• 58:14
  Speaker 4: It's a hard road to walk, you know, and I think,
• 58:16
  Speaker 4: unfortunately I wish everybody just had I wish all fertility
• 58:20
  Speaker 4: clinics would created equal. We'll just say that, but the
• 58:22
  Speaker 4: truth is I know that they're not, and I think
• 58:25
  Speaker 4: trying to help, you know, elevate this fund of knowledge
• 58:28
  Speaker 4: for everybody who is walking this road is one of
• 58:31
  Speaker 4: the things that I can do that can hopefully help
• 58:34
  Speaker 4: impact change.
• 58:36
  Speaker 1: Fantastic conversation today, Natalie, Thank you so much for your time,
• 58:41
  Speaker 1: and for your gifts and skill set that you are
• 58:45
  Speaker 1: sharing with the world. We are so happy to see
• 58:48
  Speaker 1: some of these big, important and emotional topics get to
• 58:53
  Speaker 1: broader audiences through podcasts and all of the YouTube and
• 58:59
  Speaker 1: information that you're so thank you for joining us today
• 59:02
  Speaker 1: and sharing with our listeners all of your information.
• 59:07
  Speaker 3: Thank you, guys so much for having me.
• 59:08
  Speaker 1: Truly, thanks for listening everyone.
• 59:11
  Speaker 2: If you enjoyed this episode, please consider giving us a
• 59:14
  Speaker 2: five star rating and sharing the Body Pod with your friends.