Fertility Myths vs Facts: Egg Freezing, IVF, & What Every Woman Should Know

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Hey, all Molly Sins.

And I'm Amisha Gormley.

We're two girls obsessed with one thing.

Beauty.

And by that, we mean everything that makes you look and feel beautiful.

We're calling on our favorite health experts, industry insiders and friends

to answer all your beauty questions.

With a drink in hand.

Definitely with a drink in hand.

You're listening to lipstick on the rim with Molly Sins.

I'm really excited about today's episode.

Okay, ladies, we are talking about something that I genuinely believe every woman deserves access to.

Clear, honest information about her own fertility.

It's one of those topics that is either avoided altogether or completely blown out of proportion online.

And it leaves so many women that end up feeling confused, overwhelmed, or honestly even scared.

I think the last part scared is what I know I came from at times.

Today, we're going to be breaking down the fertility myths.

A lot of you have DM deaths.

You know, we have a wide range of listeners.

I know we talk a lot about Perry Minipals, Minipals, but today we're going to be talking about fertility.

Breaking down the myths, the real facts, the information.

That we both wish, honestly, both of us would have had earlier.

With the goal of helping women feel informed, feel empowered, and a little less alone.

Which is honestly why today's guests feel so important.

Dr. Lucky Seacon, welcome to lipstick on the rim.

Welcome. We are so excited.

She just came out in a few months ago, January 2025.

It's called the Lucky Egg.

I love the cover.

I love the cover.

I love the title, understanding your fertility and how to get pregnant now.

And I think what gives her such a unique perspective is that not only the doctor, but you're the patient.

Yes, I've been the patient.

And I think for women walking into that room, and we always would say like with Scott when we would walk into Dr. Shaheen Gidear's office,

and I'm good when you walk in in that office.

From the moment you walk in, and I remember going down that hallway,

which we're going to discuss everything of the numbers, the ovarian reserve,

but walking down that hall, I've never been so conscientious.

It was like, oh my god, at 38 years old, I am old to be starting a family.

Yeah.

And it was very scary.

It's never a good position to be coming at any problem with is fear and feeling like you're running at a time.

That's not a good feeling.

But to have a doctor that has perspective and can say I've been in your shoes is kind of incredible.

Yeah, and I think it made me a better doctor.

Honestly, going through secondary infertility, I had no problem having my first.

But I knew all too well that because of training and education,

and how long it took for me to be personally in a place where I was ready to have kids,

I actually was really proactive.

And I went through IVF for osembrose with my husband,

and lo and behold, what I thought might happen happened when I was older, I was actually 38 as well.

And I found it harder to get pregnant.

It just was like my body was different, everything was different.

And I ended up relying on what I froze to overcome that.

But getting to that point wasn't as straightforward as I had hoped it would be.

And I definitely went into it cocky thinking, I know what to expect, how hard could it be?

I mean, even if it's challenging, I'll know what the solution is.

But it's one thing to intellectualize and think that you know everything.

You need to know and have the answers.

And it's another thing to actually be the patient.

And have feelings that I always tell my patients, this is not your fault.

It's nothing that you did or didn't do.

But I think it's just such a human nature tendency.

And when I felt that way, even with all the education and training that I had,

it was a real eye opener for me.

What do you think the fertility conversation at the moment has exploded?

15 years ago, you know, it was not suggested to me to freeze my eggs.

There were like, we have embryos.

We're on the verge of egg freezing.

I mean, in the last 15 plus years, fertility has exploded just because the advancements.

Yeah.

Can you talk a little bit about that?

Yes.

I mean, the success rates of IVF have changed dramatically from when it was invented only in the 1970s, really.

It was like single-digit success rates.

There was no coverage from an insurance standpoint.

It was like this experimental procedure.

And I think back to the women who were the first pioneers, the women that said,

okay, I'm going to try this because I desperately want to build my family

and how courageous and how hard that must have been to be like,

we have very little faith that this is going to work.

It's like 5% chance, right?

Now, it's a different situation.

We have gotten a lot better at growing embryos in the lab,

figuring out what they need in the lab environment,

being able to genetically test them and weed out all the ones

that would never have been destined to implant or stay implanted,

so that lowers miscared rates.

And we're able to say to patients, if you have a tested embryo

and it looks really good under the microscope, there's a 60 to 70% chance

you're going to be pregnant by next week, right, after the procedure.

And not only have we gotten better at it, we've gotten a lot safer too.

We're only usually putting back one embryo at a time.

So this idea that IVF always leads to twins and triplets

is really a thing of the past.

And I think because it's gotten safer and so much more effective

and now there's more insurance coverage, everything is much more normalized,

it is just becoming much more mainstream

and something that people are comfortable taking that leap of faith toward.

Do you think that we have more infertility now than we did 15, 20 years ago?

Or do you think that we're just now talking about it more?

Women are getting married later, like it feels like it's changed a lot.

And is it the foods that we eat, the medications that we're taking,

environmental, or is it just, it's always been this?

Yeah.

But we've just not had an open conversation.

It's always been a problem, right, for a variety of reasons.

There's so many different reasons why a couple or an individual might have a hard time getting pregnant.

It might be that they have blocked fallopian tubes.

There's no way for the sperm and the egg to meet.

There could be sperm quality issues, 50% of the time,

50% of couples will have some sort of sperm quality.

It's not the woman.

Yeah, exactly.

It's 50%.

I remember a couple of my friends were like, it's not me.

It's blamed me.

Yeah, I know.

It can feel like this blame game.

But I think the biggest factor that is the reason behind why it is more prevalent is age, right?

If you look at your mom's generation, your grandmother's generation,

what age were they in their peers having their first child, early 20s?

Early 20s, exactly.

Right.

And so this has dramatically shifted for us.

And I think that instead of feeling shame about it and blame and saying,

why haven't I found the right partner?

Why am I not financially in a position where I feel like I can start trying?

Society has shifted and we're the first generation that has been tasked with kind of what feels like the impossible.

It's like, okay, great.

We're on equal footing with men when it comes to education and our jobs.

Go out there and compete.

But also be aware of your biological clock and make sure you do all these other things too.

And it's like, we really, as millennials, I believe are the first generation that have had to really navigate finding a balance.

And unfortunately, for a lot of women, there was no formalized education or guidance in how to do that.

And so I love that we're talking about this more.

And this is something I talk a lot about in my book.

Is this idea of people striving to have it all, but not understanding that our bodies, our biology,

haven't necessarily evolved with that idea.

A lot of my friends and our friends are in their mid to late 30s.

And they are really wanting this conversation.

They're freaking the fuck out.

They are panicking that they haven't met the one.

And I feel like I am them when I'm listening to this conversation.

I'm like, you're going to have your baby.

Yeah.

It might not look the way you think in your mind.

But if you want to have a family, you will.

But you have to also start to try to calm down, get your checklist.

And I think that's ultimately why your book has been so successful.

It's called The Lucky Egg.

And women are scared, right?

I remember I woke up one day and I'm like, I want a family.

I was 35.

I wasn't dating anybody.

It had actually been dumped.

Again, what can a woman do?

She's 30 years old.

She doesn't want to have a baby.

She's 25 years old.

Are there certain things you would be like, freeze your eggs?

How would you road map that?

I think the first step, and this might sound really obvious,

but it's actually something that I see a lot of people not taking the time to do,

is to carve out mental space and time in your life to actually think about what do you want?

I see a lot of women in New York where I practice,

where they're at the top of their game,

and they're just so busy on the hamster wheel of life.

And then by the time they actually contemplate,

hey, what do I want out of my personal life?

What are my personal goals?

They're coming to me at a time where I may tell them,

hey, your biology is going to kind of dictate how this goes a little bit.

And nothing can be more frustrating and devastating to a lot of women

because they're thinking, I did everything right.

I mean, I focused on achieving,

but this is one area of life where the amount of effort you put in,

does it necessarily equate to what you get out?

So I think taking the time, even if you're not physically in a place,

you don't have the right partner,

you don't feel like it's a good time for you to actually start trying,

still think about what you want,

and try and prioritize what's most important to you,

because then the rest of what you need to do will crystallize, right?

And if it looks like it's probably not realistic

that you're going to be able to start trying or building your family until after 35,

and you might find yourself in your mid 30s, in your 40s,

trying for maybe number one, two, or whatever your goal is,

then yeah, I think egg freezing is a major part of the conversation.

And when should women, if you could take your pick,

if a woman walks in your office, would she be 20,

would she be 25, would she be 30?

What would you suggest?

So everyone always says the earlier the better.

I know, what does that mean?

Exactly.

Because do I think it's healthy or necessarily a good thing

for people to graduate high school, and everyone just go and freeze their eggs?

No, I think it takes a certain level of emotional maturity.

There's a lot that is put on the patient in terms of the medications you're taking

and needing to follow up, and you're going through a procedure.

I would say the youngest age of a patient whose eggs I froze was in their early 20s,

but that was usually for a medical problem, right?

I would say for just trying to plan ahead, mid to late 20s is really the ideal time.

You're kind of in your reproductive prime years where not a lot of changes happen

with the number of eggs that we can get to in one given cycle of effort.

And the quality of the eggs is kind of at their maximum potential.

But that's not to say it's not successful if you do it in your 30s.

I think late 20s to early 30s is kind of the sweet spot where people have that

emotional maturity to actually go through this two week long process.

And I'm not a doctor that sugarcoats it like it's a lot.

It's also say, I think women think it's this crazy long process.

I'm like, if you're not putting it back in, it's two weeks.

Yes.

Yeah.

And people have a mess of like in your mind, I'm like, no, I can't do this.

It's not again, it's two weeks.

Right.

And they think that they need to be off of work for that entire two weeks, which is not true.

I mean, it sounds like you have gone through this process.

You know, you're taking shots in the comfort of your home morning and night,

maybe, and you're coming in not every day for scans and blood work.

But it is a lot.

And if the conversation ends with, you know what?

I'm thinking about all my options.

And now I've learned about egg freezing.

And I've decided it's not the step I want to take.

Fine.

But at least you're never going to turn around 10 years from now and say, you know what?

I wish I had looked into that.

I wish I had contemplated it.

It's like you made a really thoughtful decision.

I do think that unfortunately there is a lot of stuff in the news.

Sometimes that a lot of IVF can cause breast cancer.

There's that that has been in the news lately, especially.

I literally turned the TV on the other day and I heard someone talking about it.

Is that fact-based or it's just it's a myth.

It's a really bad fear mongering myth that's done a lot of damage.

Because I think those types of fears that aren't actually based on reality

and what we're actually seeing when we look at long-term data following patients

who have gone through IVF, even several rounds.

For decades and decades up until age 50 and beyond,

we're not seeing a link between breast cancer.

And it makes sense to me.

The reason why people are thinking about it is because breast cancer is one of those types of cancer

that can be hormonally driven.

And when you're going through this type of processes two weeks of shots,

whether you're freezing eggs or going through IVF to try to get pregnant,

you're taking these shots and it's causing your ovaries to stimulate at a higher level

than what you would normally experience if you're ovulating one egg.

And you have higher estrogen levels.

But it's for a very transient period of time.

It's like two to three weeks.

So it's not the same as chronic long-term exposure.

So to me, it makes total sense that it wouldn't be a risk factor.

And we have the data to actually prove that, especially from countries like Denmark

that do a really good job of keeping registries and tracking outcomes over many, many years.

And there are multiple studies that have provided really reassuring data.

But I think these types of myths are particularly damaging

because it's the reason why a lot of people will delay seeking care.

They're afraid about all of these things are seeing on social media

that aren't actually true.

Another common fear that I hear about is,

you're going to take all these eggs out

and you're going to put me into menopause earlier.

And I would say, that's also not a thing, either.

I get why people think that.

But if you actually understand what we're doing,

I wish I knew how to get more eggs out.

But I'm limited to working with whatever your body makes available.

And those eggs would have been kind of tossed out at the end of that cycle

regardless of whether we extracted them or not.

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For each of the topics below and I want to discuss this,

we want to know the single best takeaway you want women to walk away with.

AMH and ovarian reserves.

So what I want people to know about AMH or ovarian reserve,

this is looking at egg quantity, right?

It's no secret.

Society loves to remind women that we have a biological clock.

And for most people, the most obvious aspect to that

is that you're born with a stock pile of eggs, like 1 to 2 million.

By the time we get into menopause, we have less than 1,000.

And that's when your body stops being able to ovulate you stop getting periods.

Most of us who are in our, quote unquote, you know,

reproductive age years are in between those two time points.

And you basically each month are bringing a small number,

a very limited subset from the stock pile in a process I can't control

and you can't control with supplements or anything that you're trying to do.

It's just like rationing.

The more you have in your stock pile, especially earlier in life,

the more you bring to the surface.

And what AMH is or a follicle count on an ultrasound,

both of those things, the blood test AMH and a follicle count,

are telling you kind of a relative sense of how much is getting rationed

or becoming available each month.

I only care about that if you're going through egg freezing or IVF.

Otherwise, what's happening when you're ovulating?

You're only releasing one of those eggs.

Anyway, so two people who are the same age,

let's say I have 235 year old patients in front of me,

and one has a high AMH level, a high follicle count,

and the other one has a very low one.

They're both ovulating each month.

They're on equal footing in terms of who's going to get pregnant first.

It's really about age and egg quality.

So a friend of mine was going through IVF.

She went through, I think one round.

They told her her AMH number was below one, very low.

Probably would not be successful at IVF.

Probably, again, fear would never get pregnant.

She did the round of IVF.

She had two kids, naturally, 40 and 42 right after.

Yeah.

I mean, that is one of the more damaging myths.

And I don't know why sometimes people hear that from fertility doctors.

I'll tell you, the only thing that really matters

about a very, very low AMH is, yes,

it can make it harder to respond to the stimulation

and harder to get enough eggs out.

But that's not going to dictate whether or not you're

able to ovulate a healthy egg.

And there are many studies that have shown,

looking at thousands and thousands of women

that their AMH does not predict their ability to have a baby.

And I think it's just this label that a lot of people walk around with

and they think, oh my god, what did I do?

I think that's why some girls in their early 30s

don't want to get the number.

I know.

Yeah.

Yeah, I mean.

I also think, you know, one of the things here is egg quality versus quantity.

And I think sometimes people are like, I had so many eggs.

Right.

But like, okay, well, were they good or were they not good?

I'll tell you the thing that I hate to hear is when someone says,

I was told, you know, I'm 40.

I was told I have the eggs of a 25 year old.

And I'm like, how did they tell you that?

There is no test for egg quality.

Yeah.

Like, that's the biggest thing to really get out there in terms of good information

because there's so many people getting these labs interpreted

in a way that doesn't actually make sense.

And either it gives them really false confidence to make decisions

in a way that maybe isn't as proactive as they should be

or it can make them panic when they have nothing to panic about.

Egg freezing.

So egg freezing, I think is a wonderful technology.

It's a form of fertility preservation.

It is no longer something that's regarded as experimental.

A lot of women used to come to me.

I would say 10 years ago, shoulders slumped.

I can't believe I'm doing this.

I'm 37.

I thought I'd be in a different place in life.

And now I'm seeing a lot younger women coming in, sometimes with a partner.

And I'm like, oh, so are we talking eggs?

And they're like, oh, he's just here to support me.

I'm doing eggs.

And I'm like, oh, okay.

I think the thing that people should know about it is it's not a guarantee, right?

When you're freezing eggs, you're freezing potential.

And human reproduction is inefficient.

When you ovulate one egg, you don't expect the first time.

You pee on a stick.

It's going to be a positive, right?

Everyone knows from their friends or from their own experience of trying to get pregnant.

Persistence will hopefully pay off.

And it's all about knowing when to call it and to seek help, right?

But it could make sense in your 20s and early 30s to try for up to a year.

That's okay.

And when you think about each egg that you freeze, those are similar to the eggs that you would have ovulated.

And not every egg that you ovulate is capable of getting fertilized and turning into a healthy embryo.

So it's all about making sure you have a good number for your age and for your presumed egg quality.

And that's where counseling from your doctor.

And then also sharing what are their clinic success rates?

You know, we have women that come back all the time each week to thaw out their eggs.

So I'm telling them about real world data, not just theoretically.

You know, this is what we think the numbers will shake out to be.

I think the numbers thing was so important too because I remember someone saying to me,

well, how is there a lab?

And I kind of didn't understand what that means.

So it means how many babies are becoming babies out of that lab?

Yeah, lab is very important.

I'm so glad you brought that up because that's probably the least talked about that.

A lot of people will talk about how does the clinic look?

Like what does the waiting room feel like, you know, do you like your doctor?

How do you communicate with the care team?

All of those things matter.

But I think what matters the most more than sometimes if you like your doctor is the quality of the lab.

There are a whole team of people called embryologists that are behind the curtain.

You hardly ever meet with them.

You might see them on the day of your procedure.

But they're the ones that are handling your eggs and sperm and turning them into embryos

and the quality control of that environment and how many cycles they do in a given year.

I mean, would you rather go to a surgeon for a procedure who only does 50 cases a year or 5,000?

I mean, it makes a difference.

I think also one of the things that's important to talk about,

and this is just a conversation I have with a friend, is knowing your mother's history.

Absolutely.

And having open conversations because I have a friend of mine who, you know, has gone through some stuff

and she was like, oh, well, I didn't know that my mom went into early menopause.

Yeah.

And I will tell you if you have a first degree relative that went into premature menopause,

menopause before age 40,

that is associated with several full times higher risk anywhere from four to six times higher risk of that individual

that has that family history of also experiencing that.

Does it mean you will experience it?

But it's a red flag that should be on your radar that you should share with your doctor.

Similarly, you see a lot of relationships when it comes to family genetic history

and factors like endometriosis, polycystic ovary syndrome, even fibroid.

So there are many gynecologic conditions that can impact your fertility that can run in your family.

Genetic testing.

Yes.

So genetic testing is a loaded term,

and I think there's a lot of confusion because you could be referring to a lot of different things.

When I'm thinking as a fertility doctor, I'm thinking about two big things.

One is, if I'm looking at a couple, or if I'm talking to a patient who's thinking about using a sperm donor or an egg donor,

I care about the genetics of both prospective,

whoever's providing the sperm and the egg, right?

Because we all carry genetic mutations,

and I'm taking you back to high school biology.

Remember, Punnett squares, where you're like,

okay, if you carry this mutation, it doesn't affect you, but you carry one copy.

But if you have a partner that carries the same thing,

there's a one in four chance that you could have a child with two copies of a mutated gene.

So I will run panels where I'm testing for like 400 conditions and saying,

hey, okay, there's a two to four percent chance that you could overlap as a couple.

And if we find out that you do match up,

you could do nothing with that information and say,

okay, at least I know what to test the pregnancy for at the end of the first trimester,

to find out if I'm going to have an affected child.

That's usually a more excruciating choice, right?

Because you're waiting a long time to get that information.

But you could also say, I don't want to go through that.

I want to create embryos, and now I can genetically test the embryos

because I know what to look for, and I can say, you know what?

These embryos would result in cystic fibrosis,

which is a terrible lung disease, right?

And that's on the panel.

But these ones only carry one copy or no copies,

and these would not result in a child with that problem.

I see this help so many families that have really strong family histories of cancer,

so one of the patients will come in and say,

I know I carry the BRCA mutation,

and I have a much higher elevated risk of, you know,

having breast cancer or ovarian cancer in my lifetime.

And I'm just, you know, wanting to do whatever I can to prevent passing this on,

because you can tell with BRCA.

Yeah, if you know you carry something that could result in a reproductive risk to a future child,

as long as you know what to look for,

we can take an embryo in the lab.

We can remove some of the outer cells and send it off for genetic testing,

and we can build a specialized test to zoom in and look for that gene mutation.

So I have helped families stop the propagation of cancer predisposing mutations in their family line from continuing,

which is so powerful.

That's insane.

I didn't realize that.

So if anyone is listening who has a strong family history multiple first degree relatives,

it just seems like there's a pattern.

The first step is go to your doctor and say,

can you test me with all the panels we know about?

And if you're a carrier, it's not just important for fertility and forward planning,

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It might mean insurance will start covering you going in for earlier screenings and checkups.

You might decide to do like a risk-reducing surgery that's what Angelina Jolie did.

She knew she carried a gene mutation,

and she had a strong family history of breast cancer,

and she got a double mastectomy as a preventative measure.

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Fertility myths, true or false, we Dr. Lucky.

Fertility is just a woman's problem.

Definitely false.

50% involves a male factor.

And a third of cases of infertility involve a male factor alone.

I didn't know that.

Yeah, well speaking of, a low egg count means you're infertile.

So we talked about this, and it couldn't be further from the truth.

You know, how many people are walking around on the sidewalk outside

with a low AMH and have no idea?

Because they never got it tested, because they had no issue getting pregnant, right?

We don't really understand exactly why some people have lower AMHs than others.

We know there's a genetic component.

Some of it can be environmental.

There are certain lifestyle factors that definitely don't help.

Like we know cigarette smoking, even vaping can deplete how many follicles you have

and make you lose eggs at a faster rate.

And you could go into menopause earlier.

So for sure, there are things that we can avoid.

And there's definitely a role for a lifestyle in trying to slow the rate at which things happen.

But biological aging and the decrease in our egg count is very natural.

And it tends to speed up as we enter early 30s and early 40s.

And it's not something we should be afraid of.

It's just we should be understanding what it actually means.

Spirms don't have a biological clock.

That's false.

Yeah, just because men make new sperm for the rest of their lives.

Unlike us, we don't make new eggs, right?

We're born with our stockpile.

They are always making new sperm cells every 74 days.

But that doesn't mean that they're not experiencing aging.

It's just a different mechanism than our biological clock.

So over time, they accumulate mutations which can be passed down in sperm's DNA to their children.

And so what is being older for a man when it comes to fertility?

It's different than for women.

We talk about this inflection point at 35.

It doesn't mean you fall off a cliff, but things start to change a little bit faster, right?

And then even more so in your 40s for men, there isn't an agreed upon definition.

Some studies say 45 and older and some say 50s.

But certainly as men are able to father children throughout their whole lives,

we start to see a relationship between more and more problems cropping up

in the health outcomes of their children, especially neurodevelopmentally.

And when you think about men having kids in their 50s and 60s,

there is a relationship there.

And you were seeing that.

Yes, it's definitely something that's been seen in the data.

And also men should be caring about their lifestyle as well

because they are contributing to some of the outcomes we see in the pregnancies of their partner, right?

Because their genes are contributing to building the placenta,

which is a really magical organ that forms temporarily

for the purpose of connecting mom to baby

and to help the baby grow healthy in a healthy way.

A lot of the complications that can happen in pregnancy arise from the placenta

not functioning properly.

And so male chronic health conditions that are not well controlled

or smoking a sedentary lifestyle, being obese,

all of these things can relate to not just health outcomes for their children,

but also potentially pregnancy complications.

Birth control causes infertility.

False.

There's no situation where I've ever seen a patient with infertility

and I've treated thousands of patients where I'm like,

oh, it was the birth control, right?

Birth control often is just preventing you from ovulating.

It doesn't help you stockpile your eggs

because you're still recruiting a bunch each month from that pantry

that stockpile we talked about and then they're kind of getting thrown away.

You're just not releasing an egg.

And even the IUD which you're still ovulating in the background,

that's just preventing sperm from getting to the egg.

To remove it, the effects are automatically reversible.

Stress causes infertility, just relax.

All of that is so triggering to so many people

because it's just like empty words.

And I will tell you, I treat a lot of type A,

high-powered women and very stressful jobs.

And when you're talking about day-to-day stress,

like the normal stress of life,

that is not thought to be related to infertility.

That is not thought to be something that makes you lose eggs faster

or that has a negative impact on the quality of your eggs

or your risk of miscarriage.

That's a big one.

When people go through miscarriages,

the first place their mind goes is,

I probably should have slowed down at work.

I wish I wasn't doing XYZ.

I'm here to tell you that there is no single shred of evidence

that being stressed in your day-to-day is causing your infertility.

Now, if you have profound stress

where it's like extreme caloric deprivation,

like you're going through a war or a famine,

there's really profound stress that can affect the health of pregnancy

and the ability to get pregnant.

But I'm talking day-to-day stress.

It's just not a thing.

And being stressed about being stressed is not going to be helpful.

A woman walks into your office.

She's 30 years old.

What do you do?

What do you tell her?

What's the advice that you would give her?

So first off, when I have a conversation with the patient,

I'm asking them a ton of questions.

I want to know where they're at in life.

Why are they here?

What are they hoping to gain from this visit?

And then they'll tell me, are they partnered?

Are they single?

What's going on in their life, you know, personally in their work situation?

What's important to them?

And if it's someone that says to me,

I know I want to be a mom.

I feel extremely confused by all of the conflicting information I'm hearing.

And I'm basically here for a biology 101.

I want you to just fill the fertility knowledge gap.

That's what I'll do.

And I'll also do an ultrasound,

because I'm a big believer that you can learn a lot

about the reproductive system by just looking.

You know, doing a vaginal ultrasound,

it's not a standard thing that's done across the board.

When I talk to women every day,

sometimes they'll be like, yeah, my GYN does one,

you know, every year or every couple of years.

And then I meet women in their 40s

who are like, you're the first person ever doing the scan on me,

only because I'm coming in to talk to you about fertility.

That's why I wanted to talk to you about it,

because I think I got given a scan the very first time I went to talk to someone.

But I don't think women, I don't think women know you need a scan.

Yes, I think so.

And this might be viewed as controversial, right?

Because doctors are supposed to follow guidelines

and you think about public health and how resources are used,

and what will people's insurance cover?

But forgetting about all of that,

what do I think is the right thing to do as an expert

who is sat across my desk from thousands of women?

And I've often been the first one to tell them,

oh, you have PCOS.

Oh, I see evidence of endometriosis.

You can't always see that on a scan, but sometimes it's obvious.

Oh, you have a huge fibroid taking up all the space

in your uterine cavity.

Like this is a problem that needs to be removed

and this is why you're having these problematic periods.

I don't know why I as a subspecialist

who is focused very specifically on fertility

and often the one telling them

that they have a major gynecologic condition.

And so I do hope that having these conversations

will empower people to ask questions and say,

hey, can I just get a scan?

You know, whether the GYN is doing it for you

or they order it and you go to a radiologist and get it done,

maybe it'll come back normal.

But if we find something,

it's a lot better than feeling blindsided

at the moment, at the 11th hour

when you're in a fertility crisis.

I think I said this in the beginning.

I think you have a unique perspective

because you're not just a specialist,

but you're a patient.

What surprised you the most going through IVF as a patient?

The lack of control.

I think, like I said, I went into it cocky.

I was like, I am doing it at the clinic that I work at.

I am besties with my doctor.

I already know all the science, like what could go wrong?

And one of my first cycles,

I just didn't get as many eggs as I thought.

I didn't end up getting enough embryos

and I was happy that I got something

but it was way lower than what I thought.

And I was like, that's weird.

And then I went through another attempt

where they were like, you're not really responding.

We're going to stop the meds.

And I had taken these shots for about two weeks.

Stopped the shots.

And was like, that was anticlimactic.

Okay, but that's okay.

And I was a little bit worried at that point.

Then I did another one where we just pushed forward,

even though the response was low,

because it was like, well, let's just see what we can get.

Got two eggs and got the call a week later

that nothing turned into an embryo.

Like the cycle was done.

And that hit me like a ton of bricks.

I cried in my office.

I closed the door.

And I was like, I just want to get out of here and go home.

Like, I feel so ashamed.

Like my body's not doing what it's supposed to be doing.

And I just didn't anticipate that outcome.

And that was why when I wrote this book,

of course, it's filled with so much science

and practical information that feels like a road map.

But there's so much mental health support built into it.

Because I think the mental health struggle

of someone who already has a child

but is doing this as a preventative measure

for the future because they just know better.

And then has this like,

you turn situation where they're like,

oh, everything's going to be easy and fine.

And then it's not.

That's a different mental health struggle than the woman

who's going through her fifth failed round of IVF.

Or someone who has recurrent pregnancy loss.

Or someone that's been told,

you know what?

Some of these issues you have.

Maybe it's going to be too hard to overcome.

And we need to talk about things like surrogacy, right?

Each of those types of pivots or challenges

come with their own set of mental health baggage.

Yeah.

And the stories we tell ourselves

and the way it can make you feel

and the things that you struggle with

are very unique to each situation.

So every chapter, every topic

has a mental health slant to it.

I love it.

What does IVF improve

and what does it promise?

So IVF, nothing will promise you anything, right?

But IVF can give you more control.

It can.

It has the potential to.

Because when you think about what's happening

when you're trying to get pregnant on your own,

just by ovulating, right?

It's kind of like playing the slot machine.

All you can do is pull the lever and say,

okay, I'm ovulating like,

let's try in this next two-day window,

whether that egg that you release actually

interacts the way it's supposed to with the sperm,

gets fertilized, turns into an embryo,

makes this way to the uterus,

is a healthy embryo that can actually implant

all out of your control.

That's like everything lining up on the slot machine.

So often you have to play multiple times.

And I'm not encouraging you, I'm like,

but you get the analogy.

Yeah.

With IVF, you're saying, okay,

I'm kind of sick of this really low efficacy approach.

Let's go in and grab as many eggs as we can

because each of these eggs feels like a long shot.

It's like playing the slots.

But let's try to control and expose them to sperm

and cultivate them into embryos.

And so you're still going to see drop-off and attrition,

but because you're starting off with more numbers,

that is going to help make this really inefficient process more efficient.

And then when you get to the embryo stage,

you do have the ability nowadays

to genetically test those embryos.

And something we haven't talked about,

which is really important to know,

is that nobody makes perfect embryos.

Even in our 20s, when it's as good as it gets,

20 to 25% of those embryos are thought to have genetic errors,

where it's just not able to implant or stay implanted.

So very powerful tool is called PGT, pre-implantation genetic testing,

where you can just kind of biopsy a small part of the embryo

without hurting it, the part that would become the placenta,

just a few cells, send them off for analysis.

And you can say, okay, these ones are healthy

and these ones aren't.

And the ones that aren't.

Sure, not implanting, something like that.

It can lower your risk of miscarriage.

It can streamline your path to pregnancy

in a process that's often really, really inefficient.

And I think it can also give people

a lot of reassurance for the future,

because you can freeze the extra embryos.

Before you know what the holidays are going to sneak up on us,

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A woman is looking to get pregnant.

Do you suggest acupuncture supplements?

What is kind of that checklist a woman can do?

So I talk a lot about this in the book and I have a whole table

because I think sorting through all of the noise,

especially when it comes to supplements.

And I get why it's there.

It's this idea of wanting to control whatever you can.

And we all want to be good students and put our best foot forward

in anything we're trying to do, right?

And so there is a role for certain supplements.

I would say prenatal vitamin is first and foremost,

everyone needs to be on that preconception.

Ideally, three months preconception containing folic acid.

In the supplement chapter, I actually list out what are the nutritional requirements

as per the American College of OBGYNs.

And it doesn't mean you have to take a supplement for each of those things.

Some of it can be obtained just from your diet, right?

But if you don't have the healthiest diet or it may not be as well-rounded,

maybe you're vegan or vegetarian, here are the things that you need to be taking

in these amounts.

I think a really solid prenatal vitamin with folic acid is key.

And folic acid is actually the form you want.

There's a lot of misinformation online about that.

That's the one ingredient that's actually been proven to prevent a certain type of birth defect

of the baby spinal cord, and that's really important.

And then outside of that, the data is not very good in support of the other supplements.

But I put it all in there and basically in the table say,

this is how it's proposed to work because sometimes people are taking things

and they don't even know what it's proposed to do.

Here are the dosages that have been studied and that are typically taken.

Here are the side effects because we don't talk about that enough with supplements, right?

They are still, you know, something that have medicinal properties

and can have interactions with the other drugs that you're taking.

And that's important to know.

What do we know?

What's been studied?

And then here's what the data actually shows.

And I will say the best fertility supplement that has the most data

and it's still not perfect is probably co-enzyme Q10.

Right, there's animal data.

I took it.

Yeah, animal data and human data where they've looked at women going through treatment

and they've compared.

And there's actually randomized control trial data, which is like the strongest level of evidence

where it seems that there could be an association with better outcomes,

whether you're trying on your own or with treatment.

And so that's something I tell my patients I say take 600 milligrams a day.

It's definitely not harmful and if it could be helpful, why not?

But there are some that have potentially harmful side effects and interactions

and have way less data to support.

And I put it all in the table so that people can actually just get informed

and then make a decision for themselves.

I'm actually curious because I went to an acupuncturist, I had a miscarriage

and I ended up going to an acupuncturist who specialized in fertility.

And full disclosure, like it wasn't voodoo because I can't remember if it was Columbia

or one of the hospitals she worked at as an acupuncturist within the OB world.

Yeah, so the hospital established New York City Hospital

did have her come in doing acupuncture.

Yes, so I'm not anti-acupuncture.

I think supplements in acupuncture are not synonymous, right?

I think that there are different levels of evidence.

When you think about something that might not have all the evidence to show,

okay, there's a one-to-one relationship.

This is definitely improving success rates.

You have to ask, is there any harms?

And I don't think there's any harms to acupuncture.

I mean, I'm someone as a Western medicine doctor who's done acupuncture

when I had a terrible migraine and I was like, I'm taking all the meds

and it's not breaking, so let me go do this.

It still didn't work, but I tried it, right?

And why would it be harmful?

I just don't see any way that it could be harmful.

So I talk about this with my patients every day.

They're like, do you mind if I tried?

Of course, go for it.

I would say if it stresses you out to have another needle in your body, right?

Yeah.

And maybe if it's not covered by insurance

and it's just like you're racking up costs of everything you're doing

to try to get towards this goal,

I wouldn't stress about it and say, oh my gosh,

this is going to make or break your cycle.

But I would never tell a patient to not do acupuncture.

And I have had patients where they're like, my lining looks thicker this cycle.

You know, I've noticed different changes in my menstrual cycle.

The studies haven't yet to show that doing acupuncture before an embryo transfer

is associated with improved outcomes.

But it does improve people's stress.

And it does make them feel more relaxed.

And I think there is a benefit to that.

Can we end on that?

Yes.

That positivity.

Yes.

It's part of it.

That manifestation, like I have so many women in their early 40s say to me,

it's never going to happen.

And I'm like, but you have to stop believing that.

Yeah.

I think there's a lot of fear.

There's a lot of narrative about, you know,

how likely something is to work.

Again, the reason I named my book The Lucky Egg is because I see miracles happen all the time.

And I see people who walk around with like a label.

I have a low AMH or I'm in my 40s.

And I will tell you that you're not a statistic.

You're an individual with an individual situation.

And there's a lot of information we don't have until you actually try.

Are you actually go through a process?

I think it's all about being mentally flexible.

I think when we have a rigid thought pattern where we're like,

oh, my AMH is less than one.

I'm above 40.

I'm in a box.

You know, that's not helpful.

That's not helpful as a fertility doctor to think that way.

And it's definitely not helpful as you the patient or the person going through this.

Give yourself some grace to, you know, like life is hard enough.

And I think that we need to stop this culture of self blame.

And I think that the backlash of a lot of prior books, especially those not written by experts

and these formulas of saying like, this is what you have to do.

And then you will get to your baby.

It breeds a message of an undertone of, well, the reason why you don't have your baby

or the reason why you had a miscarriage is because you didn't do these things.

And we need to get away from that because there's so much of this that is not in your control.

And that doesn't have to be a negative message.

That should be something that absolves you of that guilt and shame and self blame.

You know, this is not your fault, you're where you're at.

All we can do is look forward.

And if you have an open mind, there's so many different ways that this could work for you and work in your favor.

We always ask every guest before they go, if you could give advice to your 10-year-old self, what it wouldn't be.

Oh my God, where do I even begin?

The girl from Brampton, Mrs. Saga.

Yeah.

The girl.

Yeah, who didn't realize her power in the moment.

You know, who I kind of felt lost at that age.

And I think about it a lot because now my daughter's eight.

And so I'm very conscious of like, what is she going through in like just finding your place in the world.

What I would tell myself is if you find your, you're going to find your purpose.

And your purpose is going to be to try to help other people and everything else will just kind of figure itself out.

And just find a purpose.

Like that is really the key to life.

I feel very much fortunate to be turning 43 in a few weeks and to be able to say, I found my life's purpose.

And what I do for my job is very aligned with my true purpose in life.

And I think that that is a form of attaining happiness that a lot of people strive for.

And I'm really, really happy in my career and what I'm able to do for women and my patients.

I mean, you're changing lives and having a lasting impact.

I mean, it's unbelievable.

I'm understanding your fertility and how to get pregnant now.

It's on shelves.

It's getting on Amazon.

It's a great book.

Dr. Lucky, C.Conn.

You're awesome.

Thank you.

Really, really helping so many women.

Thank you.

You know, you're amazing.

Make sure and follow Dr. Lucky.

It's lucky.

L-U-C-K-Y.S-E-K-H-O-N.

Make sure and buy her book, The Lucky Egg.

You guys will see you next week.

See you next week.

Maybe you'll be pregnant.

Thanks for listening to Lipsick on the Rim with Molly Sims and my writer-die, Emisha Gormally.

We are so excited to bring you guys along on this journey with us.

You can find us on Instagram and TikTok at Lipsick on the Rim and at Molly B Sims.

Or you go to my blog where you can dive just a little bit deeper into my favorite products,

trends, and more at MollySims.subsac.com.

And don't forget to check out our video episodes on my YouTube channel, Molly Sims.

This podcast, its production, was Sony Music.

I wanted to give a special thanks to my team, Rosie Cummings, Kenna Ryan,

So if you think of working in everyone at Sony Music, don't forget to listen and follow

wherever you get your podcasts so you never miss out on the fun.

Sabrina.

Karen.

I have been listening to a new show from the binge called Fatal Fantasy.

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