Armchair Expert with Dax Shepard - Race to 35: Day 5 + Andrew Huberman

Episode Date: November 9, 2022

Liz and Monica decide they can't get canceled in ep 5 (of 10) of Race to 35. They revisit a final destination moment from last night's shots and Liz declares she finally feels like a person after hearing words of encouragement from an Uber mom. Monica receives some encouraging news about her follicles and they lament about the stingy medication implementation. Then they get science-y with professor at Stanford, podcaster and friend of the pod - Andrew Huberman. Huberman talks about how to maximize egg and sperm health, he walks through the purpose of each relevant hormone, and they receive a call from a very special megalith. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Okay, hello. Oh, you're in a cute outfit. Thanks. I feel like a person today. That's good. It's exciting. Okay, I love that for you. At the very end, of course.

Oh, it's not even over. It's not over yet. It's not over, but we're more than halfway through. We are. We're day seven. I know. Which feels kind of wild to say. This is how we knew it was going to go, though.

I mean, also, it's not over. But we were like, it's going to be day one. And then all of a sudden, it's going to be day seven or eight or nine. Yeah. And it's day seven of nine. And then the trigger. Trigger shot and then retrieval. Yes.

Technically. Yeah. I had a really good conversation with my Uber driver on my way to my appointment. Okay, tell. That I didn't tell you about. I recorded it as a voice note so we can have it because, I mean, she was super big mom energy. She was like, oh, are you late for something? I was like, well, I have a doctor's appointment.

She was like, oh, for what? And I was like, oh, I'm just getting my ex frozen. She was like, oh, my God. I tell every woman in my Uber. She's like, I know it's crossing boundaries but any woman in her 20s i'm like do a gofundme on your 30th birthday do an egg freezing party everyone can donate what they want and do it when you're 30 because she says i'm of this generation that we had to have babies so we had babies with assholes or people we didn't really like and

we're no longer with them or we're stuck in that relationship or it's too late and so she said there's this amazing technology. Women should use it. And so we had this whole conversation. I recorded part of it. And she was like, here's my phone number. Oh, my gosh. I'm a mom.

Like her son is sick. So that's why she does Uber to like make extra money for the co-pays. And she was like, I kind of see myself as like an Uber mom. Oh, I love that. Isn't that sweet? Tessa. I think it's easy to get pretty negative about it, but it's like incredibly miraculous that there's this technology out there. It's incredible.

And if you think about it, we use technology to enhance our lives all of the time. Like there's something, I don't know if you've talked about it with your mom, but my mom is like staunchly feminist and everything and she thinks it's so great. But she is like, wow, like we had turkey basters. She is still kind of wrapping her head around the technology. So it can feel unnatural basically is what I mean. And I know I felt a little bit this way where I feel like I'm doing it the wrong way. Am I doing it the wrong way because I'm brushing with an electric toothbrush because it'll make my teeth better? Am I doing it the wrong way because I'm using an iPhone instead of a rotary phone?

Exactly. I mean, we might be doing that the wrong way, to be honest. We should be using rotary phones. I think we should reverse that. But I want the GPS and I want the part where I know where I am at all times. How was your appointment? Okay. Yeah. So we just both came from appointments this morning. I feel like every day we're there. Get blood drawn and dildos. My appointment was good. It was good. So last time it was looking like five. Okay.

There's a few more that have like grown in size. Me too. Yeah. That's great. So maybe there'll be more than five. And maybe there won't. Like again, it's all dependent on what they can actually retrieve from inside you. Anyway, so at least I was a

little hopeful. There's some other ones in the game now that weren't in the game a few days ago. So we like that. It's like the stock market. They're like, yeah, you have a lot of sevens and twelves. And I was like, what does that even mean? And by the way, I only have 20. I don't have 27. See, that's why I don't ask for things I won't remember. But she was like, oh, you have a lot of sevens and threes. And I was like, what does that mean? And so it's that they have to get to a certain size in order to be retrievable, which I didn't understand. And so some of them might have more grow that they're like, oh, this is a two, this probably won't make it, but it might turn into, we don't know. Exactly. So that's why when I went the other day, there was four, they were small. And she was like, normally by

now they would have responded. So basically she was kind of pessimistic about this, but then now they've grown. Oh my God, look at you. So we'll see. We'll see. Also a couple of things. Well, first of all, we almost got final destination last night. We almost died in like the most you way possible because we were doing shots. We're like getting good at shots. So it felt swift. It felt easy. We were even like having conversations about other things kind of at the same time, which has never happened before.

We have to be fully focused. So you, thank God, are on top of content. You're on top of social. You're good at it. And so you have a camera rolling while we do our shots. But my tripod is not in the best shape. She's been through it. The tripod is a disaster.

And like it was wobbly when you were trying to set it up, but it was like, okay. And then all of a sudden in the middle, it just comes crashing down on us. And I was like, if there was a needle in one of us right now, we would have been dead. Dead, for sure. It wasn't just like came crashing down slowly. For some reason, it whacked. I can't believe my phone didn't break. And you had just done your shot.

Yeah. It wasn't like, oh, we're preparing. It was like in between shots oh god i'm so sorry you have to be in my vicinity no i love it chaos but it was very much like oh this is for sure how we died trying to do a tiktok video yes a time lapse of our egg freezing and then we were laughing we were like this would be the news report two influencers dead this is their last video it's like egg freezing they're making an egg freezing podcast it's like the dumbest death it's so dumb it's so 2022 i'm so happy you're feeling back to norms i know i say

this you have been such an invaluable and instrumental part. Before I came to your apartment, I was in my bed crying. Last night. Last night, yes. And again, I just was like, whatever, I'm going to ride the wave, so I'm just going to cry in bed. And then I left you a voice note because I was mixed up with the medication. And I'm also sorry about that. I hope it didn't feel like you needed to fix my problem. I just was confused.

One of the medications, they just don't know how much is in the vials, which is insane to me. Okay, this is another problem. I just was confused. One of the medications, they just don't know how much is in the vials, which is insane to me. Okay. This is another problem. So first of all, I am going to play your voice memo, but before that, so they increased my medication today. Did they do anything to yours? No. Okay. So they have increased my fallostem. So yeah, we have a fallow stem shot. We have a menopur. This is how we get through it, guys. It's a menopur, but we've affectionately cut menopur as purr. I can't do that. I wish I could. I don't think we're allowed. I think it's right. I don't know. I just feel like anything that's not made up. Can we be allowed to do anything on our hormones?

Okay, let's do menopause. Let's be allowed. We're allowed. We should be allowed to do some cancel-y stuff at least a little. I agree. That should be a rule, a law. My menopure is staying the same two vials. And then I'm starting my Gardasol.

Not Gardasol. I think that's like a STD. I don't know. No, that's like a STD. I don't know. No, that's like HPV or something. Oh, my God. That's not what it's called. You're getting your HPV shot. What?

I'm just deciding to double up, and I'm going to go ahead and get my HPV vaccine. I would be late on the HPV vaccine. Yeah, I was going to say. I was like first in on HPV vaccine. Oh, I never got it. There was like a five-year period where they didn was like first in on HPV vaccine. Oh, I never got it. There was like a five-year period where they didn't really know, understand HPV. So I had to get a biopsy and colposcopy, which is where they put a camera up your uterus every six months or something crazy.

They were just like, we got to monitor it. It's not cancer, but like it's changing. And I was like, what do you mean it's changing? And now they're like, you don't even need a pap smear every year. Like they've totally relaxed it. I didn't need the vaccine i kind of had it that's so crazy i mean it's so prevalent like everyone has everyone has yes but i do think like they were just starting the vaccine when i got it i was young good for you you got on it wasn't having sex so anywho so so you have to get you're starting the third shot tonight.

So they told me I would start a morning shot on Wednesday. Do you have that? It's probably this. It starts with a G or another name. She said it goes by one of two names, whatever. It's the one in the blue box. Oh, okay, okay. I think that's probably what I'm, but they told me it's in the morning.

Yeah, yours is different. And I was like, this is not going to work because Monica is busy and has a life. But that one is easy. It comes preloaded everything. That's what she said. Okay, so that must be it. Okay, so I'm on it for longer than you. Interesting.

Okay, so that's different. But yeah, so I have to start that tonight. But then, okay, so there's this whole thing with the fallestim where you run out. I mean, we've already talked about this. This is what happened a few nights ago with the- My mistake, yeah. The big mistake. The big mistake of the summer. But I'm going to have four shots tonight. Whoa. Why four? Because of this stupid thing. So it's like I'm moving up in fall sim to 300 and my vials are 225. It's very frustrating that my nurse wasn't available

this morning. So it was another nurse. I don't know her name, so I can't out her, but I did not like her as much as my nurse. She's like doing the math on how much I have left and how much I need, because we got to get through Wednesday. Wednesday's it. What do you mean? Wednesday's all we need. Yeah. Yeah. Yeah. yeah yeah oh wow that's crazy yeah so she was like doing the math and she was like okay she's like I hate to over order I was like why do it like what do you mean for other people who is making this and why are they so stingy they're really stingy about it and I'm like you guys we're paying so much money. Give me the appropriate amount of medicine so that I don't have to stab myself 500 times. So I was very annoyed by that.

I get that. But then my nurse called. My nurse, who I love. Shout out Desiree. She called and she was like, I'm going to order you a 600. Desiree with the long nails? Yes. Oh, wow.

She's perfect. She's amazing. I know. I love her. But anyway, so that was upsetting. Okay. So you're getting a 600. So tonight.

For tonight. Yeah. I'm so sorry. There's a lot that's already annoying. Why wouldn't they just try and minimize the annoying? I know. They should bring us on as consultants. I've never paid this much money for something that's this frustrating.

Yeah. It's rough. You know? Okay, so speaking of you being frustrated, let me play the voice memo from last night. How many full list hymns do you have? Because they just told me that I like want to cry. It's just so confusing. Like they say they're 300 IUs.

An IU. What is an IU? But she's like, some of them are 450. And she doesn't know which ones, I guess. And so you're just supposed to poke yourself until it stops. And, like, I just wish they made this, like, a little bit less, like, crazy. Like, it's already hard enough and like i feel like one of the chart cartridges like disappeared and i don't know where it is we threw one of them out i guess

because we made that i made that mistake that one time so how many do you have one two three four five two six please tell me you have six oh my god i was crying inside the fridge i was just like and i feel bad because you're also dealing with so much and then i'm like sending you crying voice notes which like is so i've never done that this is what we're here for yeah this is what i'm here for for support i do think like i again for my ad fam, I find the detail. And again, today I forgot the box. Even this morning, I almost forgot the meds and then keeping them in a cold. And I was like, got to remember to take it.

If you do have difficulty with attention to detail, it's already overwhelming. It adds a whole other layer. This is why it should be part of it that a nurse comes or you go to a nurse. Like it should just not be more money if you struggle with like, yeah, attention to detail or if you're going to make mistakes and then it has like a lot of repercussions. Anyway, sorry, that's it. That's my ADHD. No, that makes sense. But I think like, look, the reality is that's not the case. Like we can't do that. So if you do struggle with attention to detail, I would say write everything down step by step and have that out every time you're

about to do it. So you have it all there. And like the video I took of my nurse helped us so much because we just watched it and did it with her. I totally get that because it does already frazzle your brain in a way when you're supposed to be paying so much attention. So you have to like kind of put in safety guards. Yes. And like write everything down, watch the videos. Yes. And put less on your plate because I was like trying to listen to a podcast. Well, and I was like, I need to stop everything and really sort of put down other things. And that's really helpful too, which I wish I would have done like earlier on and even in the process of knowing this was going to happen, taking off things that just are not urgent or don't need to be done right now or don't

need to be dealt with. That's really good. Like give it the space it deserves. But I was thinking that today, like so many women who are doing this have jobs. I know. And I was like, we just had to do this. We do have an interview in like eight minutes. So, you know, we are on a clock, but our clock is a lot more flexible.

And thank God for that. But I was kind of freaking out because there was a lot of people in the waiting room. And I was like, when am I going to get seen? Like, oh, no, are we going to have to push something? Then I just looked around the waiting room at all these women. And I was like, they probably all have jobs and they're all doing this. And they're all like, oh, my God, I'm late for a meeting. Oh, my God, everyone's on their their phone probably responding to emails like I was.

On Slack. Yeah. And the appointments change. Imagine someone who has like a physical job. Imagine like a daycare worker. Exactly. Who's lifting up kids. I don't think you could. Would you have to take two? Yeah. I guess that's why they ask for your profession and they would probably advise. It's this weird catch 22 where a lot of the people, not all, I want to talk about that too, but a lot of these women here who are doing this are here because they've engaged a hundred percent in their career. And now we're sitting here still very engaged in our careers. Then you're sitting here like, oh my God, I'm missing work. I'm missing meetings. I have to move stuff around. Oh my God. It's so unfair. I just like looked around at all these women like, wow, everyone's doing so much right

now. They're dealing with all these hormones and all this stuff going on in your brain. All this attention to detail that's put around while also maintaining a job. It's very hard. Yes, I agree. And yesterday I was trying to work. Yes. And that was a really hard day for me because I couldn't really.

And then you get stressed out that you're not working. And it's that too. Like, I just think there should be like a policy change. Women should take two weeks off. Should be able to. They don't even let you when you have a kid. Like, let's get real. Right.

Like, that's what's so crazy. This is nothing compared to that. 100%. You came across an interesting article about this. You know what I was trying to do is actually see if there was information about how the hormones impact you, which there is none. It's a lot of information about a lot of things. Like most of the egg freezing articles are all, here's what to expect. Like it's a very 101. There's a little bit about everything, but they don't go into detail into any specific thing, which I think is so kind of

fascinating and hopefully why this will be useful to people. But I was trying to look into the hormones and what are they, how are they affecting you, more details into that. And instead, I came across this article that was more general, and it said that studies show women aren't doing this because they're putting their career first, but most of the time it's just that they haven't met the right partner yet. So last week, there was a big Psychology Today article that says that there's the highest amount of lonely single men that has ever been. And one of the reasons why there's so many more single men, like a surplus of single men, is because women have really increased their standards when it

comes to dating. They want three things. I think it was like someone who's available, someone who's consistent, and someone who has emotional capacity and i think that that is really really interesting because i i relate i relate no it's like i feel like there's so many amazing women and i was re-watching the pilot of sex and city because i was sad and i couldn't kind of believe how it's the same thing in that show what was it 1995 the pilot and she says i can't believe how it's the same thing in that show. What was it? 1995? The pilot and she says, I can't believe there's so many amazing, beautiful, successful women and so few kind of marriageable men. I almost am like, I don't want to say this anymore. I feel bad for men who are listening. Like I don't want this to feel like an indictment, but I also don't

really understand why it's so hard. Well, I do think part of it, the reason it's hard is because there has been this standard for a long time and it's going to take some time and some real effort to move out of this paradigm where the man works and makes money and the woman fulfills all the emotional needs and, you know, deals with all the domestic. Like, we're still, that's brand new. It's brand new. And if you think about men who are now our age, they grew up in this insane, you know, boys will be boys and like, boys don't cry. And they didn't go to therapy. I mean, maybe they're just starting now. It's a whole new, you know, learning. And so you want to be compassionate and understanding, but it does make relationships harder.

It does. And I, yeah, I do think we're just going at a little bit of a different pace. Like women are handling their own shit in a way that they weren't before. And because of that, the standards have been raised and men have not reached that peak yet vulnerability-wise, emotionally. So I think there's a dissonance right now, but I hope it evens out eventually, especially with more conversations about all this stuff.

Yeah, a lot of women, I know my feed is full of, maybe it's because of my algorithm. Sometimes I feel too diagnosed by my algorithm. You know too much. But actually I don't relate to this. It knows too much. But actually, I don't relate to this. It's a lot of women who are saying, I am so happy alone. I don't even need, I don't want someone to come and mess up all the healing I've done. And I don't feel that way. I really love being in a relationship. That's never been what I've wanted for myself. No matter how independent I want to be and feel, I think women are very unhappy in this and men are unhappy in this too. And I think the more spaces there are for us to have these more candid

conversations, and maybe this is off topic, but I'm also sensing it's a post-pandemic thing where there's so much to be triggered by even outside of romantic relationships. I can't even really listen to the news and I'm a journalist. I have to like brace myself to take on the flood of information and tragedy. And so I think a lot of people are now just like staying away, right? They're on their phones instead of disassociating. They're on their phones. And even like younger generations, I was talking to these, because whenever I'm in at Gen Z, I'm like, tell me, I just, I'm so curious. And they're like, not even dating. They're like, we're too afraid. We just rather not even go there. Interesting. Wow. That's fascinating.

Okay. Well, wow. We covered a lot. Did I finish my idea? That after I left your place, I was crying in bed and then I went to your place and we were laughing and then I left and I was fine. That changed me. Such a support in so many different ways. So I hope everyone can find their Monica. I know. Find their Liz. Yeah. Well, we're going to transition now into the second part of this episode. Speaking of men, we have an amazing man on the show. You might remember him from Armchair Expert. You probably listened to his podcast. Andrew Huberman is here to talk to us about all things hormones. We have very specific questions. We have broad questions. It's going to be really fun. So please enjoy Andrew Huberman. So what is the number one question you get about from men? And what's the number one question you get from women about fertility? The number one question

about fertility that I get from men is whether or not testosterone therapy and related therapies will disrupt their ability to have children. And the truth is, yes, it will, unless they take certain steps to mitigate it. And then the number one question I get from women about fertility is what can they do to maximize egg health? And what can they do to determine whether or not their egg health and fertility has a long or a short arc. I should just preface all this by saying while I am not a reproductive endocrinologist, an MD or anything of that sort, I got my start in research science in the endocrine side of neural endocrine stuff, how hormones impact brain development and nervous system development in utero and in the parents, everything from genital

development to brain development. But over the years, I've gotten involved in various communities that look to hormone therapies and are curious about that. And we've covered a number of these topics on my podcast. So it's come up like, what can you do to maximize egg health? When should you freeze eggs? How late can you freeze eggs? Does PRP, platelet-rich plasma, do anything for ovarian health? What about NMN? So we could get into the weeds of all of this. We don't know any of the things you just said, so please tell us. Well, yeah. So I'll basically just speak in acronyms and then tell you what those acronyms are. Of course, if people are thinking about conceiving in the short term or in the long term,

obviously the most important thing to do first is to tell your primary care physician and to try and get in touch with a reproductive endocrinologist before you get in touch with a fertility clinic, because you want a two-pronged approach. You want to be able to compare recommendations and it can get very expensive to just work with fertility clinics. Certain things can be covered by insurance if you're also working through your primary care physician. Oh, interesting. Okay. So we can get down into the weeds of any and all of this, and then people can tell me all the things I said that were incorrect.

Oh, they will. Oh, yeah. That's one of the best parts about doing podcasts. Oh, I bet you get a lot of comments. And I have no relationship to any fertility clinic or anything of the sort. So disclosures first. We want all points of view and all different types of experts on everything. Okay. So since the biggest question is our biggest question, how do you maximize ovarian health during this process? Maybe it's too late before this process.

How should we have done that? Do that. Let's start with some kind of chronological norms, right? And when we say norms, we mean averages. We can look also to what the law and what medicine say is safe and why. And this is helpful as kind of bracketing the conversation. So to my understanding, and this might differ by state, it might differ by country, women can freeze their eggs up until about age 40. And I think it's going to be plus or minus two years, depending on where you live. So some clinics will freeze eggs in 42-year-old women. Some will not. They'll only do it in 40-year-old women.

I should just say most clinics will freeze embryos, fertilized embryos, for quite a bit later. In fact, maybe even indefinitely, because now the age at which women are conceiving through in vitro fertilization is much later. Yeah. And just so people know, because I didn't even know this, when you say embryo, it means you need a sperm donor or you get your partner to put it in the egg. Yes, a fertilized egg. Fertilized egg.

Correct. So we can talk about the process a little bit and the biology of it, because it's actually interesting there. And we can talk about what people are screening for, and you can save yourself a lot of time and trouble knowing just a few key terms. But what this means is that let's say you're a 32 year old woman and you know that someday you want children or you might want children. What should you do? Okay. Well, if you're in a relationship that's moving toward that, then you start working on that either natural in vivo intercourse to conceive. Then there'sI, intrauterine insemination. So this is taking sperm and using some sort of apparatus.

In the old days, the kind of the vernacular was like the turkey baster method. Yeah, we've literally just talked about it. This sort of thing, right? But there are other devices now that are designed more specifically for that, as opposed to a turkey baster. To put it in further in? Yeah, to get it intracervically as opposed to in the general region. Got it.

But if you think about intercourse, it's not intracervically. It's circacervically, around the cervix and near the cervix, very close to the cervix. I guess it depends on the anatomy involved, right? There are a number of jokes I've heard on the internet about that, but let's not go there. And then of course there's IVF, in vitro fertilization, where the eggs typically are

taken out, usually after a stimulation protocol. So giving a bunch of hormones to make a woman hyper ovulate, taking those eggs out and then putting sperm into the dish with them to fertilize them. Sometimes also encouraged, the sperm are actually mechanically encouraged to fertilize. So literally a good sperm, one that looks like it's got nice morphology, nice shape is what that means. You'll see this on the sperm report. Morphology just means shape, morph. They take the fast swimmers. They take the ones that aren't swimming kind of lopsided and off to the side. They look for the Michael Phelps. Got it. We're all looking for the Michael Phelps.

The tall sperm with nine gold medals or whatever. Exactly. Okay. And they'll physically push it up next to the egg. That's actually an interesting choice because it turns out that if you're looking at the frequency of mutations and chromosomal abnormalities that can essentially eliminate a given embryo, like it wouldn't be safe to implant. You would think, oh, you take the best sperm, you force it up against that egg. And of course, you're getting the best with the best. But my understanding of the literature is that statistically, that's going to lead to more chromosomal abnormalities in those eggs as opposed to putting a bunch of sperm in and running a competition with IUI, right, intrauterine insemination. Let's just say in vivo, let's just be clear about our anatomical terms. Instead of a

penis delivering the sperm, it's some sort of apparatus. Technology. Technology. Some other technology. Well, the penis is technology too. You're right. You're right. I'll do that. Some might argue it's a poorly evolved technology. Some might argue it's- It's a vestigial technology. Well, some people argue that because it's external to the body, it's not the safest place for a reproductive apparatus. I agree. It's very vulnerable to the elements. Yeah. For reasons which probably should go on another podcast.

Wait, no, I want to know why is the penis outside? The more interesting question perhaps is why are the testicles outside the body? And that's because sperm can only exist in a very limited temperature range. When men get cold, go into cold waters, they have shrinks. It brings the testicles closer to the body, keep them warm. When they're warm, it sort of just hangs there. Yeah, exactly. And of course, these are

some things that change over age and there's individual variability, but that's the reason. It's a little temperature modulator. There's this advice also out there that heat is bad for fertility for men, right? Yeah. I want to make sure that I don't talk too much about male reproductive health first, because I always tend to do that. It's probably some Y chromosome link deficiency in my brain, but to just make sure that we check that box now, it's true. Sperm are on a 60-day generation cycle. So if I were to sit in a really hot sauna today, in 60 days, more of the sperm that I would ejaculate

are going to have disrupted morphology and be dead. In the head. Now you can mitigate that. And this is true for hot baths and for hot tubs too. Now with a sauna, like I'm big into the sauna, I bring an ice pack in there. You do? I do. On your underwear?

Yeah, on the outside. I don't know if you need to tell us about your underwear. No, because you talked about that on the whole. Even men who aren't going into saunas, there's cool underwear for men who want bigger sperm or whatever. Yeah, so there's a brand out there I have no relationship to called Snowballs. Oh my God. This sounds like a sketch. There are a number of men who are using cold therapy, either ice baths, cold showers, or cold underpants or boxers to make their testicles cold. And then there does seem to be some effect in increasing testosterone and spermatogenesis,

generation of new sperm afterwards, but probably not from the cold directly. This is why biology gets interesting. There's the stimulus, which is the cold, but then there's after the cold, what happens? You get hyper blood flow to the area. You get what's called superfusion of the area. So it probably nourishes the testicles with more blood and probably leads to more generation of sperm. The testes seem to benefit from this transient cold. But if you're trying to conceive, you want to stay out of hot baths and hot tubs if you're male. And if you are going into the sauna, bring a cold pack in there or just bring

a jar with some ice water in there and set it between your legs and you're probably okay. Let's say a woman in her 30s knows she wants to have kids someday. And maybe her partner's not ready. Maybe they're not ready. It's not happening in the next year or two. My advice is that if people can afford to do it, because I always want to be respectful of the fact that not everyone has all this bougie healthcare and all this kind of stuff. There are a couple of things to do. First of all, get your follicle count done. It's really interesting. It's a little bit like measuring testosterone for men. There's this fear that women have about measuring their follicles. I've talked to a lot of women that I tell this to, and they're like, I don't want to get my follicle count. However, some women in their thirties will have, you know, I don't want to scare people. They'll have just two

follicles left on one side or one follicle left or something. And of course, when in your cycle you are, because remember the menstrual cycle has a follicular phase and a luteal phase, right? There's the part where the eggs grow and then there's part where an egg gets deployed and out and then lands in the uterine lining. And then if it's fertilized, then it takes to a pregnancy, hopefully, if that's what's wanted. And if not, then the uterine lining sheds, okay, and takes the egg with it. So number of follicles in the ovaries is key. And often in asymmetry in the two sides. I don't know why I'm pointing to my sides.

No. As far as I know, I don't have any ovaries. I've actually never been karyotyped. Karyotype is where you're either XX or XY. They're also XXY. Right. They're also XYY. Can check them out.

Right. So you have genotype, but that's karyotype. So you can be karyotype. Women are going to have one on each side, typically. Some women will have 20 follicles. Some will have four. Some will have eight. And there's a lot of shame around having fewer at a given age, but you want to know. And the reason you want to know is that IVF or getting eggs extracted and frozen, whether or not for fertilization then or fertilization later, involves doing, and frozen, whether or not for fertilization then or fertilization later, involves doing,

typically nowadays, it's either a high stim protocol. So this would be taking lots of injections of different hormones. And we can get into this and why and the cadence of it. But typically there are lots of injections on a daily basis of something called luteinizing hormone, LH. There are two hormones that you need to know if you're female. If you don't know these hormones, you need to know these besides estrogen. It's follicle stimulating hormone, FSH, very easy in the context of this conversation. It stimulates multiple follicles to grow. And then luteinizing hormone or LH, which also stimulates the ovary, facilitates follicular growth, but is more involved in estrogen production, et cetera. Incidentally, men also have FSH and LH, but those very same two hormones, which come from the brain and

pituitary, which is right above the roof of your mouth, but the brain stimulates it or some combination. I want to get into brain versus pituitary, but it comes down from the head, the cranium head to the, one of the fun things about podcasting for a couple of years and leaving the classroom is that you get to say all sorts of things. Although, you know, I always say, like, anytime we're talking about sex or reproduction, we want to set four conditions.

Oh, I like this. And this is really serious. It's got to be consensual, age appropriate, context appropriate, species appropriate. Oh, okay. Those are great rules. Just, you know, looking out for all the species out there. Yes.

Okay, ground rules. Luteinizing hormone and follicle stimulating hormone, LH and FSH, are involved in creating the maturation of the follicles. Those change across the month dramatically at the 28-day menstrual cycle. Knowing your cycle, how regular your cycle is, et cetera, very important. Now, if women go in in their 30s and they discover that they have a low follicle count, what that means is there'll probably be a high stim protocol. It's going to be lots of FSH injections, lots of LH injections. And these drugs go by different names, things like gonol and human chorionic gonadotropin, HCG. When you take a pregnancy test, you're looking for HCG. It's in pregnant women's urine. Guess what it also does? Stimulate testosterone in men. Guess why men used

to buy pregnant women's urine on the internet. No. That's a thing? Yep. But now they just buy something called HCG. Also goes by the name Pregnal. Okay. So there's a lot of names here. But for people who are just trying to get the top contour of this, what you want to know is how many follicles you have. And you want to do that at the appropriate phase of your cycle. And to do that, you have to work with an OBGYN. They're going to put a ultrasound or other sort of scope.

Transvaginal. We've been calling it a dildo. It's a giant dildo. I'm pretty sure it's got a camera. Yeah, a dildo with a camera and a long wire. They don't have Bluetooth yet. They don't. That would be an added fun part.

Foreign territory for me. But I have been in the clinic when this was done. I've seen this done and you get to look up on the screen and see how many follicles. And you get this grainy picture that looks a little bit like the ultrasound they would use to look for a child and the development of the child. And you get, oh, there's a follicle, there's a follicle.

And they're also looking at follicle size. And they'll get follicle morphology. This word turns out to be important. Again, the shape. Doctors know how to look for a particular shape. The follicles shouldn't be too big. They shouldn't be too small. They should be in certain distribution.

This is all the expertise of the OBGYN. Okay. Or the tech that's there. Can they be too big. They shouldn't be too small. They should be in certain distribution. This is all the expertise of the OBGYN or the tech that's there. Can they be too big? What's called a hyperplasia of that doesn't necessarily mean it's bad. It just means that the egg that would result from that would not necessarily be the healthiest one. Then what happens is, let's say someone has a lot of follicles. If it's a young woman, and here when I say young, I'm not being judgmental. I'm just saying, let's say before age 40, for fertility reasons, I would still consider young. And older than 40 does not necessarily mean too old by any stretch. Let's say that they have a lot of follicles.

They might do a moderate stimulation protocol or a low stim protocol. This means less FSH and LH injections. Sometimes they'll also suppress estrogen and then stop suppressing estrogen for the following reason. Here's the one thing you need to know about the menstrual cycle, and this is true for women and men. So the first part of the cycle, you just want to remember this for the whole cycle. Estrogen primes progesterone. So in the early phase of the cycle, you've got low estrogen and it's climbing,

climbing, climbing, climbing up. So estrogen's going up, going up, going up. And then there's this little peak a couple of days before ovulation, and then it drops, and then progesterone gets kicked into kind of high gear. So estrogen primes the progesterone. That switch from high estrogen to high progesterone triggers ovulation. There's a temperature increase associated with it, hence the apps that rely on temperature. Is this why sometimes you have like heat, what is it called? Hot flashes. Thank you. Hot flashes. There you. Hot flashes.

There's a well-described increase in libido that occurs. There's sometimes an irritability, but not always. Sometimes the irritability and the libido are tethered in a way that, you know, that sex can relieve some of that. There's a friskiness. Yes, absolutely. And I don't say that in the slang term of the word, but being in heat, you know, this notion, I mean, it's typically as we talk about dogs.

So there's an increase in temperature. That's that peak in estrogen is coming or is close. Then you get the progesterone and that leads to the luteal phase, the second half. Okay. So follicular luteal, estrogen primes progesterone. Every man, every woman, she knows. Why does oral contraceptive treatment work? What is oral contraceptive treatment?

There are a bunch of them. NuvaRing, Copper Wire, IUD. Most of them are estrogen. And what they do is they keep estrogen tonic constant so that you don't have the drop and it doesn't prime progesterone and you don't get ovulation. That's what most classic oral contraceptives do. Now there are other versions of this. I went to college in the nineties and it was this like wave of all these different birth controls and things like that. Yeah, I was single then. So, you know, you date different women and some like, I hate birth control. It gives me acne. Or I, I love the pill. Like, oh yeah, I love that. I never knew what that statement meant, but the, I love it. Okay, great. Or, or the copper, copper IUD is interesting.

Yeah. This is an, now we're talking about birth control, but do you know the origin of the copper IUD? No. The copper IUD is extremely effective, but the reason it works is that it's like a third rail. Sperm get in there and it's like, they just get- Oh my God, it's electrocution. Guess what prostitutes used to do back in the day? What? They would take a copper penny- No. And put it in their vagina. Yes. In an attempt, not always a successful one. By the way, don't try this with pennies, folks. You get- Do not try this at home. Do not do this at home. In an attempt to not get pregnant.

Okay, so estrogen, primes, progesterone. So what are they going to do? You're going to do a high stim, moderate stim, or low stim. High stim is a lot of hormones. Think about the super menstrual cycle. Tons of LH, tons of FSH, and they might even suppress estrogen so that they can really just let go of that suppression right before and just get a massive wave of ovulation.

Typically, you get a bunch of eggs. Those eggs are then frozen. And then sometimes they're called cryopreserved. And they're kept in little straws. If you ever wonder where they're- Oh, we didn't know that. Like little straws. Yeah, little straws.

Why are you sad about it? I don't know. I just, it's just, because I'm realizing that's what they're doing to me. They're luring my- Honestly, I think the whole process is beautiful. So I started off, as mentioned, endocrine type stuff, but then I moved to developmental neurobiology. I still teach this to medical students at Stanford. There is nothing more beautiful than embryology. That's really sweet. Because people aren't seeing the glimmer in his eyes.

I give that lecture once a year and I'll explain later how fertilization works and what it means. And I'll describe a few elements about it that to me still to this day, give me chills. It's just incredible, right? It's the most beautifully orchestrated phenomenon. And then here we are, it's like speaking and talking. It's incredible. Okay. So they'll collect eggs. They'll freeze them. They put them in these little straws. They're very comfortable in those little straws. So they'll put them in a minus 80 freezer. So it's really cold. Now at some point you need sperm, right? So the sperm could come from a sperm donor. The sperm could come from a partner. And there are two ways to do that. You can either take frozen sperm. So sperm banks freeze sperm, or sometimes they'll

put live sperm on there. There's still a lot of debate as to what's better. I want to be careful with disclosures here. I'm familiar with the process of freezing down sperm. And I can tell you why I did that. I'm not shy about doing that. I do think it's interesting and important for men to consider whether or not they want to do that at a certain age. Totally. The process of extracting eggs is usually done under light anesthesia. Sometimes it's done only locally and sometimes it has to be done multiple rounds. Here's one thing that I've learned. The cost of different clinics varies tremendously. What I just described in some clinics is $5,000.

In other clinics, it's $50,000. There are clinics that are really big on people dosing themselves up with acai, whatever. Yes, I read that in our comments. Yeah, there's some interesting data. Maybe I'll just fire off a few things that the data show can be helpful for egg quality. Quality peer-reviewed studies point to the fact that the obvious things are key. Sufficient sleep, sufficient sunlight,

sufficient exercise. I hate to say it, folks, but just recording an episode on alcohol, we haven't released it yet. Alcohol is a poison. You can have a few drinks per week if you're not pregnant. Right.

And if you're going to do this egg retrieval, my suggestion would be to abstain from alcohol in the month before you do it. The month? Oh my God. Well, listen, well, it also depends on how much you drink. The current data show, nobody likes it when I say this, but 10 grams of alcohol per week, maybe 20. So that's about two drinks is about the threshold after which you start getting some problems, cellular damage, minor cellular damage,

not necessarily to eggs, but to other cells in the body, liver, et cetera, leaky gut. We could go down the rabbit hole of alcohol, but if you can avoid drinking, how much are you drinking per week? I don't feel like it's a lot, but then when I start adding it up, it gets to be more than I would like. I'm going to play like the health guy dad role and just say alcohol is converted into acetyl aldehyde, which is a poison and your liver can handle it and

you're young and your liver can deal with it. And people are going to say, well, I know so many people that were conceived on alcohol or that people didn't know they were pregnant until two weeks into it. And they were drinking like a fish on spring break. Listen, probably all true. But if you want to bias toward maximal health, alcohol is a toxin and there's no question about it. Anyway, if you've had a few drinks going into this egg thing, they'll look at the eggs. I doubt it's going to be a problem, but just know that. So stay away from alcohol. We've done good on this actual, because we started, when did we start? We started Tuesday, last Tuesday, a week ago. You're both on stim right now? Yes. You're taking pregnal and gonal. Right now we're on folistim and menopur. So folistim is FSH. Okay. Yeah. And menopur is probably an LH thing. Nowadays they'll also prescribe,

it's very expensive, but especially for older women of which neither of you are, growth hormone, gonadotropin.in. They will sometimes recommend, and this is expensive and the data are not clear on this, but PRP injections, platelet-rich plasma injections. Now that's an injection into the ovary. They draw your blood, they spin it down. This is really big in the kind of like knee rehabilitation. Some people think it's good for your brain.

I'm gonna be really honest. If anyone tells you that there are stem cells in PRP, back away slowly and say, Andrew Huberman said that you're lying. There might be one stem cell in PRP. In fact, it's illegal for clinics to say there are stem cells in PRP because there's so few of them. And the FDA has banned stem cell therapies outside of the research setting in the US. People will go down to Columbia to get it. But PRP you can get because it's FDA approved. Platelet-rich plasma. So they're spinning down the platelets in blood. Your blood has a bunch of stuff, but platelets can be enriched,

but they'll inject it directly into the ovary in women. And there's some interesting data from laboratories in Greece showing that you can increase the number of eggs. I think they had a 50 or 52-year-old woman get pregnant after PRP injections. A lot of this is kind of anecdata. It's pretty expensive. It ranges from 1,000 to 3,000 per injection. Again, huge variation. Typically the PRP clinics will say, oh, we only do it once a month as a way to drive a lot of people to it. And as people have more and more trouble conceiving, they become more and more desperate and they're willing to throw more and more dollars at it. I know that piece of it is so rough. You know, I don't want to demonize PRP. I think if you have the means to throw the kitchen sink at this process, PRP is probably

going to help. There's evidence that NMN, the David Sinclair, what you're trying to get is more NAD. The NAD is a substance in cellar component that goes down as we age. This is what he's trying to reverse. He's trying to reverse aging that way. NMN is available as a supplement. Some people will take NR instead of NMN. There's a whole industry there. There's a ton of battling. If you want to make a lot of enemies, just go on Twitter and talk about NMN is available as a supplement. Some people will take NR instead of NMN. There's a whole industry there.

There's a ton of battling. If you want to make a lot of enemies, just go on Twitter and talk about NMN or NR and people just start fighting. The people that work on this stuff are really aggro and very smart. So they're aggro and smart and it's controversial. So you get a lot of, it's like a barbed wire topic. But nonetheless, people will take NMN. There's some good sources of it out there.

I don't want to plug any sources because that's not what we're about here. But some people will do that as a way to bolster things. Some people will go high on the antioxidants. They'll take things like glucothione, ubiquinol. Here's what I recommend people do. Talk to the doctor and say, give me the lowest cost, the moderate cost, and give me the Lamborghini version as well. And tell me what those cost, and then compare that to what you're able to do. Because the ideal situation is you're doing this only once or twice and then it's a done deal and you'll eventually get your hamburgers. Okay. So what are some things that have been really shown to improve egg quality? However, one of the more impressive ones there is L-carnitine or acetyl L-carnitine. Very interesting and what I would consider strong data for sperm quality and

motility and for egg quality. Really? Okay. Especially in women that have dealt with PCOS, polycystic ovarian syndrome, especially in smokers. Okay. Smoking nicotine or vaping is terrible for egg quality and sperm quality, like big thumbs down. So L-carnitine can be taken in oral form. It's over the counter in this country, except in the injectable form, which actually more is assimilated from injectable form. You can get a prescription. Don't go buying it rogue on the internet. Injectable form. You want a clean form from a compounding pharmacy prescribed by a doctor. Two mils or a thousand milligrams a day of the injectable. It's easy. Also, listen, if you're going to go down this path, get over your needle aversion. You'll learn to love it. No, she hates it. I have been giving her all of her injections.

I can't even give it to myself. I have a couple of friends whose wives, sorry guys to tell this story, who were going through IVF and they had me inject their wives. There's like three friends now. Wow. Because I've worked with a lot of syringes, right?

Yeah, of course. And I'm not afraid of them at all. And so you're giving the syringes into their butt and they're giving syringes into their stomach. And so I always joke, I helped get your wife pregnant. I like to be able to make, it's not a kind joke,

but the injections are frequent. It's every day, multiple injections, some into the belly. If you're very, very lean, can get uncomfortable. If you're not lean, congratulations, because it's a lot less uncomfortable. Into the muscle can hurt. You got those big, long needles. But here's the deal with

use a sharp needle and just go in fast. You don't feel a damn thing if you go in fast. But I realize that people have aversions. Okay. Glucathine, ubiquinol. I see some people out there prescribing berberine or metformin. I think that's a bad idea. I don't know who is saying this. What is that supposed to do? It's a tree bark derivative, but it can really mess with blood sugar. In fact, metformin and berberine are known to blunt blood glucose. They do have a little bit of mild antioxidant properties that berberine does, at least. I would stay away from that unless your doctor is really bullish on this. But the big things are NMN, ubiquinol, glucothione. There's a lot of interest in

acai as an antioxidant to help with egg quality. Now, listen, if someone's in their 20s or 30s, chances are things are going to be tuned up nicely and you won't need a lot of this stuff. It's when you start getting into your early, mid and later 40s that this stuff becomes challenging. We'll give you a little backstory already. So Liz has 20 follicles. Saw follicles. Great number of follicles. And I don't. I have nine follicles.

Do you know the distribution? Five and four. Well, at least it's fairly symmetric. So that's good. Does that make a difference? You at least have the idea that one ovary isn't dramatically healthier than the other. Okay. We've been doing the shots and doing the thing.

And then our last appointment, which was two days ago, they were like, okay, so five are growing nicely, four like aren't basically. So five is looking like what it's going to be. And I was like, oh my God, this is a disaster. And then I went back today, they increased the menopure and now those others are growing more. So now there's a little more hope for that. But anyway, so we're in it. These numbers that we've been avoiding our whole lives, we now know. Would you agree? Isn't it just better to know? I don't know. Well, let me put it this way. Let's say you didn't want to know and you waited three years or four years

and you had two follicles per side. Exactly. And you would say, goodness gracious, what if we had gone into that? No, I do think that. I wish I had known at 27 what the number was. I've been on birth control since I was 18. So this has had most likely an effect. Are they keeping you on birth control during this? I'm off of it currently, but I was on it up until. And that was my decision and it was a bad decision. You think so?

Yeah. And I'm going to probably do this again and I'm going to stay off of it for like six months. Birth control also has all these amazing benefits. No unwanted pregnancy can equilibrate cycles. And then of course the different forms of birth control people can discuss and think about. I'm trying to think if there's anything else for egg quality. You want to make sure you have enough calories, right? I mean, we know for instance that if women don't eat enough, they stop menstruating. Athletes, typically, anorexics, regular cycles are good. Some people are more nutrient sensitive based on cycle regularity.

Some people are not. Then there's the whole kind of neuroendocrine part, like being happy, getting enough sleep. Yeah, yeah. No way. We did that a little bit. Yeah. I was in a conversation with somebody about this recently about, you know, how important it is to be in a good mental space in order to conceive and all this.

And then, of course, you hear about tons of people who get pregnant right as they're breaking up or in a terrible relationship. And so I confess at this point in my life, I'm very encouraging of healthy relationship. It's certainly what I strive for to varying degrees of success. And by the way, that would all be my fault. That's nice of you. I'm sure. It takes two. It takes two. Does it? That's what they say. It takes two. It takes two to make it work. One person can screw it up. I like that. I don't think I buy into that, but okay. Really? Yeah. All right. Anyway, I think that in general, it's good to get rest and that's going to go with positive

state of mind. If you want to know how to get great sleep, we've done multiple podcasts on that. You can just, I'm not going to plug our podcast, but I guess I will. If you remember lab.com, go to perfect your sleep. We have a sleep kit if you don't want to listen to a podcast or master your sleep. We have whole episodes on this kind of anything that Matt Walker puts out there is great on sleep. We also had you on armchair, and we talked pretty extensively about sleep. Getting sunlight, all that good stuff. Getting good sleep, limiting your stress. I think in terms of nutrition, I would stay with what works for you. You know,

some people are vegan and it works for them. Fewer are like pure carnivore and it works for them or keto and it works for them. Some people are omnivores and it works for them. So, you know, you go with what works for you and you want to make sure you have enough calories going in. But at the end of the day, they're going to extract eggs and those eggs get frozen. And then at some point they will get unfrozen. They'll get cryoresurrected. Isn't that a cool word? They'll cryoresurrect them like Han Solo. Although I guess some of them will be, some of them will be little girls. We don't know yet, right? Till the sperm comes along. And then they're going to take sperm and they're going to thaw the sperm. So let's talk about sperm collection and embryo freezing, et cetera. So you're going to take sperm from a sperm bank, or I think now men can donate to a sperm bank until age 42. I think that's what it is. There's some evidence that older sperm creates a higher incidence of autism and autism spectrum disorders.

disorders. However, even though it is statistically significant, it is still a very low or very small increase. So you take a 48-year-old sperm and you take a 30-year-old sperm, the probability of getting an autistic child from an older sperm is higher, but it's still quite low overall. And is there any correlation at all to ovarian health to autism? Not that I'm aware of, but there are mutations that both parents could have, one or both parents, in things like NeuroLigen3, which is associated with something called Timothy syndrome. Excuse me.

Timothy syndrome is an L-type calcium channel, different mutation. It's a form of autism. You know, and as soon as I say autism spectrum disorders, I'm going to just get dogpiled because by putting the word disorder there, people say, wait, you know, on the spectrum or neuro, neuro, exactly. So listen, I'm just using the nomenclature as it exists in the medical literature. I am not to say whether or not

something is disorder and asset, neurotypical, et cetera. But if you look in the DSM, there's bipolar disorder. Okay. So we're saying everything's allowed while we're on our hormones. No one can cancel us. That must be nice. Well, I say this not to be politically correct. I'm not as concerned about being politically correct. I just, in covering so many mental health issues on the podcast, and also in talking about parenthood, there are mutations, for instance, in like NeuroLigen3. It's an adhesion molecule involved in brain wiring. I have a friend who has a mutation in neuroligin-3. They talk about whether or not one of their atypical children might relate to this. You'd want to know if you can. Now, here's the beauty

of in vitro fertilization. You can screen embryos. In fact, my postdoctoral advisor used to say, why doesn't everyone do IVF? And I said, well, because some people want to have intercourse to conceive. And he was like, well, why couldn't they just like put the dish on the nightstand and then just like have sex next to it? I'm like, I want to know. You can select out BRCA2 mutation, breast cancer mutation. You can select for sex. Remember when we talk about biological sex, we can reliably talk about XY, XXY, all that. And there's a whole interesting literature about when a baby is born, how that's actually determined by the genitalia versus the karyotype, X, Y. Super interesting literature. Maybe another episode. They're going to take some sperm,

they're going to run a sperm competition, or they're going to push what looks like the best sperm over to the egg and fertilize. And then at some point, that will turn into what's called a blastocyst, which is a ball of cells. It becomes an embryo. And those embryos are then frozen. Typically that process takes about a week. Not every fertilized egg will turn into an embryo. And then they'll take those embryos and they'll do some genetic testing. Typically the first thing they'll do is chromosomal testing. Now let's say you decide to fertilize the day you retrieve eggs and freeze a few embryos. That's actually the better scenario. So I don't know, and this is highly personal because people often don't want to reveal if

they're doing this with a partner or they're doing this with a sperm. Neither of us are doing it with a partner. Okay. So at some point you will determine the best source of sperm for your eggs and you'll fertilize those. Now there is some evidence that doing it while the eggs are fresh before frozen and fertilizing them could be better. There's a lot of success fertilizing cryoresurrected eggs, right? On solo eggs. Yeah, exactly. So then, you know, those embryos are maintained and there's a cost to maintaining them anywhere from, you know, $300 a month to $800 a year.

You hear all sorts of stuff. You can select twins. You can select boys. You can select girls. I mean, depending on how many there are. So you may end up wanting to do two rounds. You may want to end up doing three rounds. Some people feel lousy on stim. Some people feel great. I've seen it all different ways. Can we talk about that? Of course. How we're feeling? Yeah. Because even like the diet stuff, is there like a super food that super jacks up your eggs that we don't know about? Well, you want to make sure you're getting enough protein. I know the

plant people are going to kill me for saying this, but typically animal sources are going to be the best sources of whole protein. Eggs, it could be cashews, Greek yogurt, beef, chicken, tuna, you know, salmon. People who try and get protein from things like peanut butter and beans, typically you end up having to ingest a lot. Those are mostly carbohydrates and fat. So yeah, some protein in it, but calorie for calorie is not a protein rich food. You need plenty of fat. So olive oils, maybe even a little butter, a little bit of cholesterol isn't a terrible thing.

A little bit, a little bit of cheese, fruits, vegetables. You don't want highly processed foods. Why not? What does it do? Highly processed foods have a number of issues with them in small amounts or in moderation. Are Pringles going to kill you? No. But there's a bunch of other things in there that can disrupt the gut microbiome. You want your gut microbiome healthy? Do you need to take probiotics? No. Just eat a few low sugar fermented foods or drink some kefir or some

kombucha. Okay. Got it. Once a day. Actually, there are a lot of reasons to want to do that. Okay. And have a healthy gut microbiome. Incidentally, there's a gut microbiome, there's a nasal microbiome, and there's a vaginal microbiome. There's also a urethral microbiome in males. Wow. So yeah, any mucosal line tissue. Yeah. These tissues that are mucosal line, I'm pointing my mouth for those of you listening,

are amazing. If you think about it, if you cut your skin, if you're like me, you heal really slowly. If you bite the inside of your mouth, think about it, heals up almost perfectly. And it does that in an environment with a lot of bacteria. The gut microbiome is an incredible thing. It's important for brain function, immune function. So like kimchi, natto, for those of you that like Japanese varieties, sauerkraut. If you're going to buy this stuff in the store, it has to be in the refrigerated section. Can't be the non-refrigerated versions that there's no microbiota surviving in there. Greek yogurt, again, low sugar Greek yogurt. These kinds of things are good. Some people need more carbohydrates than others. If you're exercising really heavily, some people,

certain phases of their cycle want more carbohydrate than others. I get a little reluctant to give prescriptives on nutrition because nutrition is so personal. And some people really do thrive, it seems, on a vegan diet. Some on a vegetarian diet, like lacto-ovo or pescatarian diet. Some people do really well on red meat. Other people do really well on a combination. So some of it's probably genetic. Some of it's lifestyle. If you're Dax and you're lifting heavy iron three days a week and you're riding motorcycles and all this stuff, you probably want to eat more animal protein. You're just going to be craving that, you know? And we talked about last time, I mean, he's doing a number of other things that probably make him crave protein. You know, somebody who's doing less of that kind of protein breakdown type activities and muscle

breakdown activities might need a little less. In general with your vaginal microbiome, how do you maximize that? How do you make sure that's like always tip top? Great. Well, I don't have one. So when you say your vaginal microbiome. Mine. The vaginal microbiome. Okay. So this is interesting because there are two general schools of thought. Here's what we know about the microbiome generally. Let's just talk about the entire microbiome, all mucosal tissues. If you own a pet, if you don't wash your hands quite as much as other people, if you swim in the ocean every once in a while, if you own a pet, if you don't wash your hands quite as much as other people, if you swim in

the ocean every once in a while, if you garden, your gut microbiome is healthier. Every time you meet someone and shake their hand, you're exchanging microbiota that then you wipe on your face or get into your body. People who try and maintain a hypersterile environment generally have a deficient microbiome. You need the bacteria from the environment. Now, does that mean that you should be getting dirt and other substances in your vagina? No. But overcleaning can be a problem. The microbiome, whether or not it's vaginal or nasal or urethral, has its mucosal lining and it has layers of tissues. These are very soft tissues. Obviously, they have a lot of free nerve endings, unlike the skin on your arm, which are the nerve cells don't come all the way to the surface. They're sitting below the surface in areas like the vagina and in the urethra, the penis nerve endings go right up

next to the surface. Also in your mouth, you've ever eaten something that are drank something that's too hot and you burned your mouth and you can't taste things. Well, you burned back some of those neurons. You actually destroyed them transiently. They come back. So on top of that, however, there's a mucosal lining. And that mucosal lining, a mucus sounds gross, but it's actually a very important substance within the body.

And there are cells that secrete mucus at the proper amount. Some people require a bit more mucus in their gut microbiome than others. So there are all these indirect measures that people use, right? They'll say, oh, you know, it's consistency or odor. And you know, it's interesting.

Women are so much better at understanding their bodies, especially their genitalia than men. Men understand like one or two major functions of their genitalia, you know? The sex portion of their body. It's like, you know, it's like every guy grows up doing the ruler test. Like every guy.

Every guy measures from the top and the bottom. And then because these measurements are typically done behind closed doors and it's on the honor system. Sure. Yeah. So they know a few things, right? But women are very, because they have cycles, they're basically running a monthly experiment, which at one part of the month, their vaginal mucosal lining is one way.

And then later it's another way. Yeah. They know how it relates to their emotional state. They know how it it's another way. They know how it relates to their emotional state. They know how it relates to their sleep. They know how it relates to their partner. Some women will even say, you know, oh, like I knew that was a good relationship because my vagina was happy even though we weren't together. I mean, I think everyone would agree there's a strong emotional component to the vaginal lubrication process, right? Yes, sure.

It's not only emotional, but there's a component there. It's also related to hormone cycles, right? And this is one of the chief symptoms of menopause is vaginal dryness, which is why they prescribe estrogen. Since this is about menopause, just say that we've had several people on the podcast to talk about this. So I can confidently say the data on estrogen therapy for menopause say that if the estrogen therapy is begun before or in the early phases of menopause, outcomes are far better than if it's done after someone's been in menopause for a long time. Oh, so you should start-

But if you've been in menopause for a long time, you should still talk to your doctor about possible therapies, but they're generally estrogen therapies, right? Does cortisol affect lubrication? It probably does. Probably. I don't know specifically.

Yeah. What you find when you start looking at the hormones is that it's like a spider web. If you pull on any hormone, another hormone changes. You take melatonin, another hormone changes. It's just the way the body works. Right. It's trying to find a balance.

Yeah. It's all ratios. In fact, this is a fun one. If you look at the same measurement value, so it's typically nanograms per deciliter. Did you know that women have more testosterone than they do estrogen? Really? It's just that- Overall, all the time? Yeah. Or at certain moments? Yeah. If you look at nanograms per deciliter, they have more testosterone than they do estrogen? Really? It's just that- Overall, all the time?

Yeah. Or at certain moments? Yeah. If you look at nanograms per deciliter, they have more testosterone than they do estrogen. But they just have more estrogen than men have? And less testosterone overall than men have. Wow. Wow.

No way. Stay tuned for more, if you dare. Race to 35 is brought to you by Indeed. Do you have ambitious hiring goals for the last quarter of 2022? With a powerful hiring partner, big goals are no big deal. You just need Indeed. Indeed is the hiring platform where you can attract, interview, and hire all in one place so you're not wasting hours on multiple job

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Head to parallel.co. That's P-E-R-E-L-E-L dot C-O. It's dot C-O, not dot com. And if you don't love it, you can cancel anytime and there's a 30-day money-back guarantee. We're not taught this because it's just too convenient to just say, oh, women have all the estrogen, men have all the testosterone, but that's wrong. That's just wrong. Men have estrogen. It's important for brain function and for libido. Men who suppress their estrogen have serious libido issues. Women sometimes who have

testosterone issues can have low libido. We're not talking about libido and sex this time. But we want to because we've talked about this because we have no libido. Why? It's counterintuitive. Probably because of the estrogen suppression. Interesting. What is the estrogen suppressive drug? Menopur, Falastem, and then tonight I'm also getting put on Ganorelin. Yes, Ganorelin.

And what's Ganorelin? Hold on a second. So it's the estrogen suppression is, right? It's the nice thing about being in my career. You have a lot of these people on dial. Oh, I love it. No way. You're texting like another neuroscience?

Repro doc. Oh, this is great. Anytime someone has a concussion or an aneurysm or something, I get the call because I'm sort of a referral service. Yes. They don't want my surgical skills. You're lucky I don't have your phone number. I'd be texting you every day.

I have this issue. Here we go. So FAMAR is the estrogen suppression. Oh, I'm not on day. Um, I have this issue. Here we go. So Fomar is the estrogen suppression. Oh, I'm not on that. My menopause was doubled and I was like, why? And they're like, oh, your estrogen was high. And then what I noticed is that my libido was fine at the beginning. And then it like dropped during this phase. Yeah. Again, I'm not a physician. I don't prescribe anything. I'm a professor. So I'm just going to profess things. You have a very specific purpose in doing what you're doing right now. I'm not saying that having sex or masturbation, etc.

wouldn't necessarily facilitate it or not facilitate it. I don't know the literature on that. I certainly haven't heard a fertility doc say that somebody shouldn't have sex while they're doing this. We were told that we're not allowed. Because I think because we're hyper-feral, they're like, we're afraid you're going to have like triplets. Oh, because you're not on birth control. The quickest way to put the kibosh on this whole process is to get pregnant. Right. Exactly.

So there are some things that women and men can take for libido outside of this whole thing. I'll just mention them because it comes up. Sorry. No pun intended. Sorry. We love it. Sorry. That was for you, Dax.

That was for you, Dax. Was that okay? He's so sad he's not here right now. Plus, he would have dove right in onto your testicles getting smaller. If Dax were here, we'd be talking about testosterone, exandrolone. Exactly. So it's probably good that we hold out for him. And they're open about this, so I can say.

But one of their children was conceived in a hot tub. And so I think he must take a lot of pride in that because his testicles were obviously hot and it still worked. Oh, but this is great. This is great that you brought this up. It's also great they conceived in a hot tub. Yeah. Okay, first of all, I want to say, were they actually submerged in a hot tub? That's different than being in the hot tub.

That's a great question. Remember, 60-day sperm cycle. We're going to get really nuts and bolts-y because... Nuts. Sorry. Can't help it. Remember, 60-day sperm cycle. We're going to get really nuts and bolts-y because... It's nuts. Because... Sorry, I'm... Can't help it. Because we can and because it's truly educational.

The sperm that allowed fertilization of that child, whichever one it was, that sperm was born 60 days prior to getting in that hot tub. Right. Right? Believe it or not, even though the testicles are of varying size, but they have some volume to them, the sperm are born in one place and then they kind of mature at a different place, kind of like the eggs in the follicles, right? You can check out the anatomy. There's the vas deferensis, the vasectomy. It's the little tubes that connect to the, right? And

there's the seminiferous tubules. And then there's what we think of as ejaculate, which has both sperm in it and semen includes sperm and other seminal fluid that is not sperm. Right. Okay. So they conceived in a hot tub, but those sperm most likely were not raised in a hot tub. Got it. So what were you doing 60 days prior to that, Dax? That's what I want to know.

He'll probably be like, I was conceiving in other kids. Yeah, exactly. Knowing him, he's probably capable of it. If anyone could, you could do it, Dax. That's right. So let's think about libido just for a second. So there are a couple of things that are obviously great sleep, being happy. Sunshine, believe it or not, in the afternoon on a lot of the skin has been shown in a study

published in Cell Reports Medicine, Cell Press Journal, excellent journal. It has done an Israeli study showing that men and women who get sun exposure on their skin have increases in libido, increases in feelings of passion and attraction to their partners if they're not partnered with other people. Why? Because skin isn't just an organ to protect your organs. It's a endocrine, a hormone organ. And so there's this pathway. There are these cells called carotinocytes and those cells make something called P53 and it can relate to the testosterone and estrogen pathway. And if anyone thinks that libido is just testosterone, it's the ratio of testosterone and estrogen, and also things like prolactin, et cetera. So get sun, get some sunlight on your skin. Don't burn, don't be an idiot, but get some sunlight. I think they did 20 minutes

with as little clothing as possible while still being appropriate. So for some people that might be naked in your backyard, for some people that might be just shirt off, for some people it might be bathing suit, for some people it might be bikini. A lot of people say, well, what is this? The whole thing about people are into sunning their anus. Do you know about this? Oh, sorry. Yeah. There's a whole thing on Instagram of people like putting their feet in the air and sunning their buttholes. I recently saw this. It's been a thing, a conversation. It's actually not the anus because technically like rectum is in it. You're in it. It's the rectum.

But it turns out there's no evidence that that is beneficial for testosterone, estrogen, and libido. However, getting a lot of sun on the skin is provided you don't burn and don't do it too long. Okay. So that's a natural thing. And then all the other stuff, the foundational stuff, get enough sleep, be happy, eat enough food, exercise. Be happy. So easy. Right. But then there are a few supplements, a supplement called Tongat Ali. It also goes by the name Long Jack and it also goes by the name something eufolia. I can't pronounce it.

Tongat Ali has some effects on the estrogen, luteinizing hormone and testosterone pathways that have been shown to increase libido at a dosage of about 400 milligrams per day. Typically taken early in the day. It's a capsule or powder form and early in the day because it can kind of wake you up a little bit. Women and men sometimes will experience a libido increase.

And maca, the maca root. Now, women who are trying to conceive or have hormone issues should not take maca because it can tap into the estrogen pathway. Got it. There's also something from Ayurvedic medicine, which is very interesting, called shilajit. S-H-I-L-A-J-I-T. Shilajit. It's a tar that you melt in water and you drink it. Has been shown to increase FSH.

So if you're going through these things, I don't think you want to start messing around with that. But Shilajit will increase libido a bit. Tonga Ali will increase libido a bit. Maca will increase libido a bit. And women especially seem to respond to maca quite a lot. If you're trying to modulate your hormones for sake of pregnancy or egg collection, et cetera, be careful with this stuff because they're acting as pseudo hormones. There are interesting data that for people who are taking

SSRIs, Prozac, Zoloft and related things, which are controversial, but nonetheless are used for OCD and for other anxiety related disorders can overcome some, not all, but some of the SSRI inducedinduced reductions in libido. Right. Cool. Oh, that's good to know. Yeah. So there's a lot out there. We've done an episode on testosterone and estrogen optimization. We will do another. Yeah, we'll listen to it. The sources of these are very important. I will say, if you're going to look at sources, maca, there are tons of good sources, the powder forms. Tonga Ali, there are two sources I can mention. I do have a relationship to one, but I'll mention two so that you can pick and know that our podcast is partnered with Momentus.

And so you can go there and find Tonga Ali, but Solarae also sells Momentus. Why would you want to go to one of those two brands or maybe another is that there are a lot of bogus versions of these out there. And anytime you're taking supplements to tamper with hormones, you are going to find a lot of supplement companies are going to throw in a little testosterone. The testing of these supplements is not very controlled. So the two brands are tested. Again, I'm not plugging brands. You do not have to do this. And a lot of people don't want to increase their libido. And there are other things. I'm very anti-young males watching porn excessively. And I'm very anti-young males masturbating excessively. Why? Because there's

all sorts of sexual dysfunction that's now turning up in males that have trained their brain. And here I'm talking about males, but it could also be females to get aroused by watching other people have sex only. They're third person in the process. But there is evidence, however, that having a healthy relationship to your body, and I'm not going to tell people whether or not to masturbate or not, that's certainly not my role, but there aren't a lot of data on that. And yet there's a lot of lore. Like some people will say, well, like use it or lose it. You know, women will say, use it or lose it. Nowadays, women's sexual health is a lot more talked about maybe even than men's sexual health. You know, I remember growing up, no one talked about vibrators and

no one talked about sex positivity. And I'm going to do a whole series on sexual health. And I think it really just boils down to this, whatever your religious leanings, whatever your beliefs, whatever your relationship status, you need to define certain things that are good for your mental and physical health. And I'm going to say it again, mental health, right? Because you're going to do things and feel guilty and ashamed. That's not mentally healthy. But in terms of physical health, let's think about sperm quality. If you're trying to conceive, what do they tell you? Don't ejaculate for the two or three days before you bring in your sample, but definitely make sure that you ejaculate before you start that abstinence period. Why?

Because some clearing out of the pathways, because you have some sperm that die, right? 60-day generation cycle. So you want to get rid of the dead sperm, then you want three days to kind of replenish the ejaculate. Yeah, that's what it is. There's some cautious nods in here. The thing about a conversation around sexual health and reproduction and egg retrieval, etc. We all are here because whether in vivo, IUI or IVF, some sperm and some egg got together in a body or in a dish.

It happened. Yeah. That's how we're here. And so the mechanics of it are pretty interesting, I think. Can we just close the loop on libido? Because why don't we have libido? Is it because estrogen is really... They're blunting. They're blunting estrogen and estrogen makes you more horny. Is that like this? Blunting estrogen. A lot of the way hormones work is what they call the delta, the change. Remember, estrogen primes progesterone. And what does Mother Nature want?

Mother Nature wants that egg fertilized, right? It's a limited number of them. It's very wasteful in Mother Nature's eyes to shed a uterine lining, right? It's very wasteful also to conceive every possible pregnancy, right? Once you're down that path, it's nine months, typically, sometimes earlier, but typically nine months. And just think about the life change. Think about the brain changes that we know occur with pregnancy. And

the most metabolically demanding thing that any human being can experience is not pregnancy. The greatest metabolic demands, you know what you need to eat the most? Lactation. When you are lactating, it is immensely metabolically demanding. Yeah. Pregnancy, less so. My friend, we were talking about the egg freezing podcast, and she was like, when I stopped breastfeeding, she's been so depressed. It can change your hormones in a way that's like really wild too. Interestingly, I've seen someone go through high stim and be very emotional. Kind of negative.

And I've seen somebody go through high stim and feel great. That's sort of where Liz has been in and out. Because I felt fine. And then I felt like really sad. Day two was like very bad for me. And then day three and four were okay. And then yesterday was kind of bad again. And so it's been like up and down. Every stimulation protocol is slightly different depending on the clinic and the person. And so the whole system, the accelerators to the floor, they're trying to create a hyperfollicular phase. So that's going to be estrogen primes progesterone.

So maybe they're ramping up your estrogen, LH, FSH, and they might be clamping estrogen, they might not be. So if estrogen is tonically high, remember, that's like birth control. And then they're going to release that and then it'll prime progesterone. It's an increase in estrogen that then primes the increase in progesterone.

So it's kind of goes up, up, up, up, up, up, then dips and then progesterone, boom, goes up. There are other factors in this. And if anyone wants to see the charts of this, they're really beautiful. You just can Google menstrual cycle and just go to images on Google. People always get upset when I say Google it. Is there really another surgery? There's like DuckDuckGo. Bing?

Exactly. Like what guys? Is there one called Bing? I'm from the Bay Area. It's Google. We're Googling. I think everyone's Googling. It's a Kleenex. Come on. Exactly. It's a band-aid.Go. Bing? Exactly. Like what? Is there one called Bing? I'm from the Bay Area. It's Google. We're Googling. It's a Kleenex. Come on.

Exactly. It's a Band-Aid. Exactly. Right? Anyway. So, you know, there's also interesting pheromone effects from having a partner there. Like I'm not asking about your current relationship status, but we know a number of things. For instance, the smell of women's tears lowers testosterone.

No. Absolutely. What? Paper published 2010 in Science Magazine, one of the three apex journals, Science, Cell, Nature, from Noam Sobel's lab at the Weissman Institute in Israel. That's, wow. Yes. I put it on Twitter.

Oh my goodness. The heat I took. People were like, oh, well, that's because you're not supposed to have sex with someone if they're crying. And I was like, you know, actually, I've seen people cry after sex. In a good way. Yeah. Yeah. I've seen it. Yeah. Right. Thank you for saying that. It's crazy that the psychological interpretations that people put on these findings, let's just look at it as a snapshot of human biology. That's humans, by the way. There are other things like

the smell of your partner's clothing can shift your ovulation cycles. And whether or not it's pheromonal or purely smell isn't clear. You know, I get dogpiled. Is it really pheromones? It has a different definition than hormones. You know, you get these really geeky scientists, you know, I guess I'm one of them that get upset when you say something like human pheromones. Okay. It might be a smell, not a pheromone. I've learned to just sort of inoculate these conversations, but I also say them because I do like to acknowledge that biology isn't simple. So if you cry a lot, does that mean you reduced your partner's testosterone? No, like he may love being a

caretaker and if he can soothe you, great. Exactly. Everyone's different. He or she. So we've got the process, we've got libido. Now let's talk about freezing embryos. Some, if a woman goes in after 42 or 43, they're not going to take your eggs. They're only going to freeze embryos. Let's imagine this hypothetical. You meet what could be the most amazing partner and you're 42. What do you do? Like second date conversation is not, hey, you want to free some embryos? I mean, it's kind of like hot date conversation, but what do you do? You could get a sperm donor, but now you're fertilizing with someone else's sperm and you could fertilize. And when you go together, there's a form and you sign a bunch of different agreements.

Sometimes it's even with a notary. Let's say you and whoever you want to fertilize your eggs go in there and you say, okay, what happens if we break up? Yeah. You make an agreement and you both have to agree. Wow. Do you get the fertilized embryos or can he have them if he wants? What if one of you dies? Yes.

So my best friend went through this process with her fiance and now they're married, but they were engaged at that time. And yeah, she was like, oh, we had a big debate over that. If I die, does he get to keep them and decide? And I was like, well, I want to keep them as your best friend in case I want like another one of you just like floating around. But that's a weird thing to think about. Do you know anyone who's had their partner pass. Do you know anyone who's had their partner pass? Do you know anyone in this case? No, but they can extract sperm from a cadaver testes. No. Yes. You're allowed to do that to a dead person? Do you have to like declare it

before? I'm sure there's something that goes into the legal part. And I don't think they can be dead for like 10 years. Here's what's interesting about donating sperm. What happens is the egg extraction stuff is very controlled and you're trying to get it into the right, what's called culture media. Media is just the fluid that it sits in with a bunch of nutrients and all the goodies that normally would keep it alive in vivo in the body. With sperm, it's pretty funny because the process is,

I may know someone who's done this. You go in and in the old days, they would give you pornography. A magazine, yeah. Yeah. Nowadays, it's like they don't do that. They just put you in a room and they days they would give you pornography. A magazine, yeah. Yeah. Nowadays, it's like they don't do that. They just put you in a room and they remind you to lock the door. And they give you your phone. And then you put the cup through the little window, like you had

given a urine sample or something. And then they take it and they wash it because there's other bacteria and stuff in there and other things. They're going to wash it and then they're going to freeze it. And before they do that, they're going to look under the microscope and get some rough estimate of the count and the morphology, et cetera. One thing I'll just say to guys, if you don't want to do it at the clinic, they can also just give you the cup. You can do it at home. Really?

That stuff can survive at room temperature for a very long time. That's what I was going to ask. I thought it died like quick. As long as it's kept warm enough, but not too warm. It's about four hours. Oh, wow. But you don't want to take your time. Right. like quick as long as it's kept warm enough but not too warm it's about four hours oh but you don't want to take your time right right but i've seen this process happen where someone gives a sperm sample they come in you know they're talking you're talking to the receptionist like hey i

brought brought my sperm sample they're like oh they take it out in front of everybody oh my god name they're like oh yeah no totally they're right and then they put it on the counter sometimes and they're just talking to you and you're kind of pointing at like, um, do you want to get that? Why do I say this again? Are we trying to create entertainment here? No. What we're trying to do is illustrate that the stability of sperm at room temperature is incredible. And the stability of sperm in the body is incredible. This is why kids, folks, you can't just get pregnant on the day that you ovulate. Sperm can survive in the vagina for a long time. 72 hours?

Is that what I've heard? Yeah. And it sort of depends on the conditions and the health of the sperm and the vaginal conditions. Is the vagina a positive environment for the sperm to survive? Oh, yeah. Because it feels like it's warm, but not warm, too warm. Oh, yeah. Everything about this was optimized.

I'm not saying sex is only for pregnancy, but let's, I have a good friend who's a cardiologist and he, and one time we were talking about the withdrawal method, also called pulling out. And he said, you know, you have to be very careful with the withdrawal method. And I said, yes, I realized that. And he said, and I said, why is it because of the sort of pre-ejaculate? And he goes, well, yeah, but you know, the main reason is it doesn't work very well because it was designed not to work. The whole process is about getting pregnant. And so of course there are people that can avoid pregnancy for long periods of time. People have varying levels of control around that and, you know, it can be better at it or not. That's a knife edge approach, right? Whereas

like condom contraception and, you know and obviously multiple layers of contraception is gonna be best if your goal is to not get pregnant, obviously. So they're gonna take the sperm, they're then gonna wash it, and then they're either gonna freeze it or they're gonna fertilize those eggs. If they fertilize those eggs,

then they can screen them for all the chromosomal abnormalities that do increase in frequency as people get older. Now, that said, there are many women who are in their 40s who have high follicle count, but that still could have chromosomal abnormalities in the resulting embryos. There are many women who have low follicle count

who create incredibly healthy embryos with very few or no chromosomal abnormalities. This is an interesting importance. So for women that are afraid to get their follicle count, just understand that at the end of the day, what do you want? Healthy embryo. How many follicles you have

is related to the probability of getting that, but not in any direct way. So there are a number of other factors, like they're going to measure your AMH levels. AMH is a sort of broad measure of how well the whole overall cycle is primed for fertilization. Got it.

It has some other functions as well. You know, they're going to take a number of these different measures. So it's a collection of different things. One reason I was excited to come on this podcast to talk about this when you wrote to me, Monica, was that there's a lot of stigma around all this. There's a lot of uncomfortable conversation that happens. And I can tell you as somebody in his, you know, I'll be 47 next month, I've had partners of varying age. And it's one of these things where I have friends who've had a ton of trouble conceiving. I have friends that are like, no trouble conceiving.

You want to know where you're at with this stuff. Yeah, it's true. And I think it would be great to remove some of the stigma around just going in. And for males, get your testosterone checked. By the way, also get your estrogen checked. For women, get your follicle count done. Just get it done.

Also, you can keep it private. You don't have to go on a podcast and talk about it if you want, right? You can. You're very bold. And I actually do want to give you both credit. I just want to give you a nod because it takes a certain kind of bravery to get out there and say like, hey, I'm doing this and it's challenging. It's like suppressing libido. And then there's these associations with like low follicle count. And I wouldn't even call that low, but sort of moderate follicle count. And so I'm saying at the end of the day, you want to know how many healthy embryos you get. So I have a question for each of you. Yes.

Are you going to fertilize any of these eggs or are you just going to freeze these eggs? I'm just freezing. Just freeze them down. Are you going to do a couple rounds? I think so. Great. I'm definitely at least going to do two. I'm going to get off the birth control for some period.

My doctor said four months minimal. Yep. I'll do it again. We'll see what I get combined. I don't have anyone to, as Dax would say, spray my eggs. Is that what he says? Yep. Of course he does.

Spray my eggs and I'm not ready to have a donor do it yet. Even though I hear what you're saying, it's best time. Well, you've got time, right? Yeah. You've got time. This podcast is called Race to 35 because I turned 35 at the end of this month and Liz just turned 35. Okay, so you are in a position to fertilize really healthy young eggs. Yeah.

I'm also doing it the Monica way. Yeah, I just started seeing someone, but I would be very weird to ask if he wants to spray my eggs. May I ask how old he is? He is 32. So if he wants to go donate sperm and just freeze them, those sperm are probably going to be better

at 32 than they will at 45. And he would freeze them inside my things? If he wanted. He would just freeze it. They just put some samples on ice. So you don't have to be like, will you spray my eggs? You can be like,

you should just do it. Just to have them. It could be a fun date. Actually, here's the cool thing about the cup method at home. You can actually partake in that. Oh, that's fun. Right?

It's not him in some room like looking at his phone. I love what you're saying. And I went on a date with a guy who founded one of the few kind of startups that encourages and offers sperm freezing. And he told me men have a biological clock too. And we really kind of focus so much on women's biological clock. And again, to your point, women are focused on our bodies, how all of it is operating. I think a lot of men don't even think that it really matters. But he said, in cases of fertility, one third is the woman, one third is both partners, but one third is the man.

And so, but don't you think it would like stress out because we don't talk about men's biological clock. A woman suggesting that is seen as so maybe crazy, right? When it's actually not. I'm not on dating apps, but I think there should be a box that you click on the dating app. In all seriousness, I think if someone told me they really wanted my sperm, we're going to put it on ice and no one's going to use it unless you authorize it. I think that touches on a primal cord. Yeah, absolutely. Absolutely. If someone was like wanted my eggs, I probably wouldn't give, but I'd be, you know, depend, but I would be flattered. I mean, there's nothing, there's nothing hot about having a newborn and changing diapers and all that, but fertilization, let's face it, right? Yeah, it's hot. It was designed, I mean, again, I don't believe in

intelligent design. I'm just saying, and I always say, I wasn't consulted at the design phase, so I don't know any of this. If anyone tells you they were consulted at the design phase, turn and run. But, you know, Mother Nature arranged all this in a very interesting way that links psychology and biology. It's not maybe second date conversation, but here are a couple of things, and this might be a good segue for us to talk about men and sperm health and some things too, aside from being careful about heat. Is younger sperm better than older sperm? Not necessarily, maybe by sheer volume, number of sperm. Now here's the thing. So typical number of sperm, the numbers

vary tremendously might be like, you know, a hundred million per mil, milliliter, but can be as low as 10 million per milliliter. And then let's be honest here. The number of milliliters per ejaculate is going to vary tremendously from person to person and from ejaculate to ejaculate. Is the amount that comes out, is it correlated with how much pleasure you're having? Oh. Oh, that's a great- Haven't run that experiment precisely. I think it will correlate with how long it's been

since your previous ejaculation. That's why guys like edge. What? You know, edging. Oh, yeah, yeah, yeah. Where they're like getting on the brink and then stopping so that by the time they do ejaculate, it's like huge. There are even supplements that people will take with lecithin and some things like that

to increase ejaculation. It's different now, I think, because I grew up before internet. And so pornography was consumed by video VHS or by magazine. I'll be really honest, I wasn't a big consumer of pornography. I just wasn't. I feel very really honest. I wasn't a big consumer of pornography. I just wasn't, right? I feel very lucky actually that I didn't have an addiction or a kind of fixation on it, but I knew people that did. But nowadays, because of the ready availability of pornography

and the expectation on like, you know, sort of ejaculate volume and sexual behaviors, it's tricky. I mean, there's also, there's a shift towards more extreme and violent and there are experts on this. I'm not an expert,

but there are academic experts on this that understand the research. It's a whole landscape. But yeah, I think that that's an obsession for certain people. I mean, the edging thing is kind of interesting because that also speaks to ejaculate control, which is, you know, in neuroscience terms, we call it top-down control, which is the ability to use your brain to suppress reflexes. And there's all sorts of things from Tantra and things about exhaling very long to relax the nervous system in order to avoid any kind of stress response. So keep in mind that in men and women, the sexual arousal phase, so lubrication of the vagina or erection of the penis is actually governed by being primarily parasympathetic, more relaxed. But ejaculation in males and orgasm in both males and females is a sympathetic driven

response, not sympathy as in emotions, but it's the stress component of the nervous system. And then there's a strong relaxation that follows probably to encourage partners to stay put and pair bond and share, you know, pillow talk and smells. And, you know, I mean, like if you love the smell of your partner's armpits, and I know many that do, they just love the smell of their partner's skin or their hair. Yeah, that stuff is wired in typically in the post-coital bliss phase, right? Or, you know, and this mate recognition, these things are important. Well, when you came on our show, I'll never forget this. Dax and I have talked about it multiple times. You came in and then, you know, we all shook hands and stuff. And then in the podcast, you said, we've probably all smelled our hands since we touched.

That's right. We're exchanging chemicals. Another paper from Noam Sobel's group at the Weizmann Institute has shown that when we meet people, we tend to touch them. This is pre-COVID, but especially now we touch them, we shake hands typically. And then we tend to wipe those chemicals on our face, typically on our eyes. We're exchanging molecules all the time. On purpose. Yeah, probably in a sort of subconscious signaling of, you know, people's immune status and people's

hormone status. And we're not aware of it. You know, I didn't come here, shake your hand outside and then go, oh, you know, she's doing a cycle of IVF or a cycle of egg retrieval, as it's called. But sperm health. So guys don't get kicked in the testicles. If you skateboard or BMX or rollerblade, don't fall on a handrail. I knew guys growing up that did that. Just know the risks. Don't be the idiot that jumps over the pole like the pole hop and then lands on the thing or climbs the cyclone fence. Damage, physical damage. Okay. Those things aside, sperm health is going to be facilitated again by all the things, sleep, exercise, low stress, et cetera. Sleep especially for in terms of testosterone and sperm production. We talked about some things related to sperm, L-carnitine again, the two

grams per day, taking it orally by capsule, you're going to need to take quite a lot, two to four grams per day, injectable again, only through prescription for a doctor, maybe two grams per day. Those are doing injections. Maybe the Shilajit data are interesting to you. Here's the thing. A lot of guys, especially in their 40s, but now even in their 30s, are doing testosterone replacement therapy, TRT. We talked about this a little bit last time. And even some women are doing TRT. Testosterone replacement therapy is injections of either small or larger amounts of testosterone. Sometimes it's a pellet that you implant under the skin. Sometimes it's a pellet that you implant under the skin. Sometimes it's a cream that they'll put on their scrotum, by the way.

That's actually quite concerning because then if their partner touches it, she's getting that stuff. It goes transdermal. Be careful. There's been cases of women getting facial hair growth or children getting facial hair growth from touching their dads who are taking the andro cream. Yep. Be careful. There also been cases of young boys getting breast bud development from touching their moms who are taking evening primrose oil, which is highly estrogenic. Oh yeah. Oh yeah. So, you know, taking testosterone exogenously from outside the body. Yes. It'll help them gain muscle, lose fat. Their libido will go up, but it will plummet their sperm production and testosterone production because the body and brain has ways of monitoring how much testosterone is circulating. And if there's a lot

of it, it's not going to signal LH to go make more. So what happens? Guys who want to maintain fertility on TRT will take HCG, human chorionic anadrobin, also called pregnyl, every other day or so, or maybe twice a week, they'll inject pregnyl to stimulate the testes to continue to produce testosterone. They'll sometimes even take FSH. Wow. Yeah. So last time I was on here, I talked about TRT. I did an experiment with TRT and then decided to move off it. It was an experiment for a book that I'm working on. I thought I should experience that. And sure, you see your sperm counts reduced. I can attest to this that you can... Sorry. It's everywhere. Sorry. No, we can't avoid it. I can assess this, that taking pregnenol HCG

will offset some of that reduction in sperm count. And then if you take FSH, it will really bolster that sperm count, even if you're taking testosterone. However, keep in mind, guys, because here we're talking to guys, if you're going to get on TRT, there are a couple of things you probably want to do first.

First of all, if your testosterone is already high enough, don't get on TRT. Don't be a moron because you might want to have kids later. If you are going to have a vasectomy, a lot of guys are now doing that young because they just don't want to have to wear condoms. Yeah, this is becoming much more common because they are reversible, but not always, and not always perfectly reversible. Or they're getting on TRT, they actually require you to give a sperm sample and they freeze it down. So if you're thinking about doing this for medical reasons or other reasons, and it can help with depression and things like that,

they should freeze down a bunch of sperm. It helps with depression? Testosterone. To increase testosterone? Yeah, it really can. It makes effort feel good. It's related to the dopamine system. You don't want to take too much of it.

And again, to optimize testosterone, it should be sunlight, nutrition, sleep, training, supplementation, and then and only then if you need it, testosterone replacement therapy, training, supplementation, and then, and only then if you need it, testosterone replacement therapy or testosterone augmentation therapy. Because a lot of guys, their ranges are healthy, but they want that boost. And some people do really well on it and feel great. Dax and I talked about this. Some people will get tons of acne and feel lousy. We're talking here about steroids, right? It's a steroid hormone, but mind you,

estrogen is a steroid hormone too. You're on steroids right now. Doesn't mean you're on anabolic steroids, but you're on steroid hormones. Cortisol is a corticosterone, right? And so if your testosterone level is lower as a woman, does that mean that maybe you get more stressed? Is that connected? Yeah. It's associated generally with resiliency. So if guys are going to use testosterone, just know that you can disrupt your sperm. Every guy who takes testosterone has a reduction in testicular size to some degree or another, some less, some more. And of course, guys are starting out with different sized testicles. Some of that can be offset.

Maybe all of it can be offset, close to all of it, by things like HCG. Again, these are prescription drugs. So be cautious. So let's just take the example of this young gentleman that you're dating now. It's early days, but let's say 32. Let's say I'm going to assume because he's in his 30s, he's not taking testosterone. Although nowadays there are a lot of guys in their 20s and 30s, and I'm guessing that his circulating testosterone is just fine. I have to imagine he's fit and takes good care of himself. I'm going to guess that if we did a blood draw, he'd have a healthy levels

of testosterone. Now would be a great time for him to put some sperm on ice because when he's 45, if he wants to have a couple more kids or, you know, maybe, or donate sperm or have a family, then he's got the sperm there. So how do you ask a guy to give his sperm in a way that will make him feel good about himself and not fear you and like get nervous and neurotic? I mean, I don't think I'm going to do it. If it were you, let's say if it were you. I'm just curious. Yeah. How should women bring it up? When I was younger, I definitely wanted to avoid having children because I didn't have the means to take care of a family at that age. I just didn't. I was in graduate school, only junior professor. I watched

friends of mine who started labs and have kids just struggle so much more and sleepless nights and they didn't have time for workouts. I just was like, I want to be an old dad. I'm like, I'm going to be an old dad. I know I'll officially qualify as old. I'm 47. I mean, it's, it's the older dad. So from my psychology, if a woman says, I really want your sperm, there are fewer things that actually, actually put the emphasis on your, let's, let's run this all different ways. If it's, I want your sperm, that's a little weird. If it's, I want your sperm, that's kind of interesting one. If it's, I want your sperm, that's interesting. And then if it's, I want your sperm, that, sorry, I don't know why I laughed on that one. That's a very, each one of those things means something different.

Yeah. And this is going to be highly individual, but some guys might hear that and think, wow, that's scary. This person is over their skis. But it depends on the phase of the relationship. Also depends on the moment when you say that. Yeah. When is it best? When is it post? No, that's the worst time, don't you think? What are we talking about? Post-coital? That's what you're about to ask, right?

Well, post-coital, if someone says, thank you for your sperm. Yeah, exactly. Oh my God. So grateful for your sperm. Oh God. Yeah. I mean, here, I don't want to go political just because I don't want to deal. But we're also dealing with a landscape in which unwanted pregnancy and what one can do about that varies tremendously by location. Yes. I think even the plan B, the morning after pill, that whole thing. I mean, contraception is going to become the topic. Yes, exactly. And so withdrawal method, condoms, combination, you know, hormonal birth control, etc.

Vasectomy. I think a lot of guys are getting vasectomies now. No, they are. I interviewed a bunch of them. And I think men should be buying Plan B in the way that they buy condoms and just have it in their homes because also they're not being tracked as much. There's a lot of data and privacy things. There's a lot of things that men can do right now that actually would help their female partners a lot.

Yeah. Yeah. I think it depends on the nature of the relationship. I mean, to me, what bigger project can you have with somebody than to want to start a family together? It's very primal. You want someone's DNA. Are you more attracted to someone whose DNA you're better matched with? Like the pheromone thing, again, there's the vagina happiness, but there's also like something else. And people say, oh, if the fireworks and it's all I said, that means they're like bad for you. Like, where do you fall on that?

So there's a, there are data that show that animals and people will select the partner whose smell represents the most different immune status so that together you have the largest immune. Wow. Histocommatibility complex is an MHC. That said, there are a lot of reasons why people pair up. Will he be a good provider? Will she be a good provider? Are you attracted to them physically? You know, there is this idea that when things take off, you know, hot and fast, that it's a problem. But having been in a number of different relationships in my life and, you know, some are like zero to 60 in a minute and some are zero to 60 across years. Some some are zero to 60 across years.

Some are zero to 100 across years. It's so variable and it's so time of life. Again, I'll just, because it's safe to just use myself as an example. I always knew I wanted kids someday, but the whole mindset around wanting children didn't really kick in until fairly recently. I'll be honest. Another reason why I was like, wow, I can't believe this email came in for this podcast because I mean, I didn't think that I had a biological clock, but I've been spending

a lot of time around people who have kids recently and it hit like a tidal wave. Wow. It's like, I don't think about it in terms of any one thing, pregnancy or conception or, you know, I just, I think about like kids. Like I want a family, I want a litter, I want a whole litter, you know? And it's weird to just feel that way because it's just something that you don't say lightly. Totally. Us too. We've had this exact same discussion. Some girls are five years old and they're like, I'm meant to be a mom. They're playing dolls. Like it's in them. It is like really in them.

And I've never, ever had that. It's career and this and my own privacy, like my own solitude and stuff. And now I'm like, I think I'm there. I know women that lactate when they hold babies. Yeah. Even if they're not pregnant. Exactly. They don't do it immediately. Yeah.

I know someone who did not want kids, but then had a kid and just loves being a mom. I have a close family member who adopted. Yeah. And it really flipped on the just love of children and a maternal instinct. This whole conversation really hits home because my family's at the UN now. There've been so many marriages and divorces and remarriages to people. It's like, you look at, you look at my family, Thanksgiving is pretty interesting because it's like, and some of these people used to not be able to be in the same room and now everyone

gets along pretty well. Thank goodness for therapy. But it's just incredible. So many countries and configurations represent. And you see all of it. We are wired for family of some sort. Now that could be a person and their partner and a dog. It could be their person and their dog. Like that's a form of non-sexual family, right? I think that there are biological timers.

And I think men have them too. And I think that it probably also relates to life position and status. You know, I want to be able to take care of the people in my life. And so when I couldn't, I had less of an orientation towards kids. In fact, I was always like, Oh goodness, like whatever happens or not going to have a kid. And that's a terrible message to send someone because it makes it sound like I wouldn't want a kid with you. But actually what you're saying is I'm not in a position to take care of that kid. And then later when you have a position to take care of the kid, there's this whole set of adjustments that goes with learning how to even have a conversation

about that. And you know, some people conception is incredibly arousing for them, the idea of conceiving. And so sex for them becomes about that and that excitement. And look, there's so many factors to this. I don't think we can pinpoint to study, but I think that we should just acknowledge the variability and not just between people, but across the lifespan. And I bet you that this egg extraction process is going to have a profound impact on the way that you think about relationship and relationship trajectory. How could it not? Exactly. You're placing your DNA there for the specific purpose of replicating that DNA with somebody else. Yeah.

While you're on the hormones, like what is a brain on hormones? Is it a brain that is, like we were talking about this. First, we were like, what is real? What is real? Like, what can we trust? Can we trust any of the thoughts in our head? Yes. And is it a little bit like being drunk, right?

Where people will say there's a kernel of truth, right? What you say when you're drunk, which again might or may not be true But I do think it'll be a little bit of a truth serum And with hormones, is it the same because i'm having a lot of thoughts about a lot of things And again, i've had more of an emotional roller coaster than monica It's been really fascinating because i've had a lot of very clarifying thoughts about relationships, about even this person I'm dating, but like, can I trust my thoughts on the hormones? Let me start in the psychological side and then I'll migrate over to the biology.

So the great Carl Jung, right? One of Freud's disciples and who had their own independent theories, of course, had a wonderful saying that I subscribe to at least, which is that we all have all things inside of us. Meaning every one of us can be a sociopath. Stanford Prisoner Experiment spoke to that. Nazi Germany spoke to that. Are all of us Mother Teresa's? Maybe, maybe not. Do we have the circuitry? We do. Some people actually try out a bunch of different versions of themselves. Some people have hormonal fluctuations that give them access to what it is to be hyper irritable, hyper aroused, libido suppressed, experiencing all those things. So is it the hormones? Well, there are a lot of different kinds of hormones, but steroid hormones, estrogen, testosterone, they cross the blood brain barrier.

So they come from the ovaries in y'all and the testes in males, and they cross the blood brain barrier and they have two major effects. They have the immediate effects because they can park on the outside of cells and receptors and do things like change the texture of skin for estrogen, right? Change the amount of hair growth. Beard growth is from a hormone called dihydrotestosterone, converted from testosterone. So it's the same thing that causes balding. So it has different effects on the face and on the head. So you see guys with a back of the head balding spot, a lot of DHT, dihydrocystostomereceptors there. Guys who have the more widow's peak thing, I always wanted that.

You ever had Ed Harris on this podcast? No, I love him though. Exactly, who doesn't love that guy? When I was growing up, I saw that guy in a couple of movies and I was like, when I grow up, I want to be bald like him. But bald like him, meaning like the widow's peak, it's a certain pattern of dihydrocystostomereceptors.

Interesting. So it crosses the blood-brain barrier, has these immediate effects, okay? Estrogen therapy will have an immediate effect. But then the amazing thing about steroid hormones is they're what's called lipid soluble. They can cross the membranes of cells, which the membranes of every cell

are made up by this double fatty layer. It's like two little fats, phospholipid layer. And they can actually enter the nucleus of cells and change the DNA of cells. They can change your DNA. And this is interesting because puberty is a good example of when steroids released from the ovaries in girls and from the testes in males

cross the blood-brain barrier and change the brain from one that thinks about butterflies and unicorns. You know, little kids are kind of similar, right? And suddenly it's like attractions and acne, moods. And so is hormone brain a real thing? Absolutely. And there are short-term effects and then there are permanent effects. But after puberty, the permanent effects of hormones are not going to be that robust except under conditions where hormones are very low or

very high for long periods of time. So people who take testosterone for a while, male or female, will start to feel better and more energetic, less stressed. But it's going to have other effects as well. You get more oily skin. That's why guys get acne. Women too. Women who take any testosterone,

and sometimes women will take a very low dose of testosterone to increase libido and vigor, but they sometimes will get a little bit of facial hair growth. Right now, of course, the big controversy in the trans kids movement

is a very hot topic nowadays on social media, but there are a lot of clinics popping up around the country, like how early to do that. There's a huge, hugely controversial topic, but it relates to, do you do this before puberty, during puberty or after puberty? I don't have data on that, but this is going to be one of the major questions of our time because of a nine-year-old who hasn't hit puberty says they want to transition. What do you do? Do you let them do it then? do you do it later? Is it earlier better? There's some experts on this that would be amazing to talk to. So hormones shift the way that you view the world. When testosterone is elevated over baseline, typically effort feels

good. You feel like you can lean into things a bit more. When cortisol is high, you feel stressed, but you also are more resilient. You can ward off infection. I'm not talking about males versus females, but when there's an increase in estrogen, do people feel a little bit more emotional? Yeah, of course, but that's true of men and women. And is it connected to dopamine and serotonin? It is. So the hypothalamus is this structure right above the roof of the mouth that is about the size of a large gobstopper candy. And it houses neurons, nerve cells for temperature regulation, for libido, for aggression. Those neurons both produce and are highly sensitive to hormones. Got it. So testosterone and dopamine tend to kind of go hand in hand. When one goes up,

the other goes up. When testosterone and dopamine go down, prolactin goes up. Prolactin is a hormone that is associated with milk letdown and nursing and lactation. It also lays body fat down in both males and females. So dads, you know, you've heard of the dad bod. Dads who conceive, you know, you have a new child, oftentimes they'll put on a little bit of weight. And that's probably prolactin related, the smell of their child's skin. Libido in the early days of after a kid is born, if the couple are spending a lot of time together and around the kid, oftentimes the libidos of both will be diminished. That's normal. Not always, but a lot of times. Why? Well, their focus really needs to be on raising that kid, not on creating more kids, especially at that moment. There's all sorts of hormone effects depending on the hormone. So

yeah, I think is there hormone brain? I mean, I think that's kind of a broad sweep. I think some of us manage stress better. Some of us are more in tune with these things too. And I think what's beautiful is when, I can say this, is when a partner says, I'm heading into this phase of my cycle, or a guy will say, I'm stressed or I'm sleep deprived. I'm a little bit edgier. Know thyself, right? The Oracle had it right. And being able to communicate that well can be helpful. It's a terrible faux pas to say, oh, that's just your hormone speaking, right? But let's just acknowledge that hormones are like stress, are like sleep. They strongly modulate our brain and our psychology. By the way, we should mention after the retrieval is when they say it can have

the most emotional side effects because there's a drop in hormones. I don't know if you've heard about this. Oh yeah. It's like a postpartum depression of sorts. So that's what made me nervous too. I was like, oh my God, I'm already a little cuckoo. Be careful not to anticipate it so much that you ensure that it happens. Right. So if it happens, it happens and be aware of it. But also that's a time to get a little bit more sunshine to make sure you're socially connected, to make sure that you're nourishing properly. There's this kind of runaway train around depressive states and sleep deprived

states that feeds on itself and sometimes not in the positive way. Yes. You end up isolating. Cause yeah, as soon as yesterday I was feeling a little loopy and then I can't do my own shots. So Monica has to do them. So I go to Monica's and then within the first five minutes, I mean, we had an accident. My, my tripod fell on us. And then by the time I minutes, I mean, we had an accident. My tripod fell on us. And then by the time I left, I was fine. I'm not just lying in bed watching Sex and the City reruns and just whatever. Social connections. Yeah. Eating food I'm not supposed to eat because it's processed. And there's all that stuff too, where I feel like you're failing at it or I didn't sleep well. So it's the self-fulfilling

thing where you feel like you're going to then ruin what you're doing. You're not going to ruin these eggs by one night of poor night's sleep or by one stressful episode. I mean, again, think about some of the conditions under which people conceive. Famine is one thing, but again, I know people who like two days before they broke up discovered they were pregnant. Does that seem to be a relationship between like breakup sex and getting pregnant? I mean, I have a friend. Well, aggression. Oh, that's interesting. I have a friend who they had a baby, they were married, separated, divorced, had sex once. Oops. Didn't get back together. They just had sex. And then they had a second baby from that one time.

Did they stay together? No, but they kept the second baby. So yeah, maybe there is something. There might be something. Based on my story. I realized we should touch on different ways to deal with embryos. So they can be implanted back into what they call the host mom. So back into you, you can carry them or- Or a surrogate. Yeah, or you can put them into a surrogate and there are going to be epigenetic effects, like in utero effects. What does that surrogate eat? How healthy is your gut microbiome? Are they abstaining from alcohol? What are their genetics, right? There's a lot of stuff that crosses the blood placental barrier.

Some people opt to not carry it because they don't want to carry it. Maybe for work, it's not convenient. Maybe they don't want that done to their body. Maybe they take a certain class of antidepressant or other drug that they really don't want to go off because they're going to be unhealthy. A lot of reasons one could do that.

There's also the situation where people can't conceive. And so what happens is eggs age. I should mention this because this points to some new technology. As eggs age, if you fertilize them, the chromosomal abnormalities almost always, not always, but almost always are due to things that are happening outside the nucleus of the cell. The nucleus cell contains most of the DNA of a cell, all the genetic information for replicating and creating a human or any other cell. Sperm obviously makes it into the egg and then the DNA combine and then they recombine it, et cetera, get multiple cells. The process of the fertilized egg becoming an embryo involves cleaving of that egg. It actually has to pull apart. And a lot of that has to do with these spindles, which are really, really cool. They're like these prongs of biological material that essentially rip the thing apart. And then you end up with two nuclei, nuclei being the plural nucleus. And as eggs age, it appears that the mitochondrial DNA and the spindles are what create some of the chromosomal abnormalities because the spindles aren't pulling things apart properly. Okay. Cause the chromosomes have to

mix. You get some chromosomes from dad and some chromosomes from mom. One of the reasons why the efforts to improve egg health as women age includes things like glucothione, ubiquinol, NMN, things of that sort, is because those are antioxidants and other things that impact mitochondrial health. And so you're trying to improve the health of the mitochondria. I should also mention there is some interesting data on acupuncture for pregnancy and egg health and sperm health. If you Google fertility and like green lamps, you're going to get something, someone selling something. So you need to be aware of that. But there's red light

therapy. There's all sorts of interesting things. So whether or not they work or not, whether or not there's peer reviewed studies varies, but there are some interesting data about acupuncture and pregnancy. Our friend is here. Of course he went long. He's teaching us so much. We're talking about hot tubs. He has too much information.

So much. I told him you conceived in a hot tub and that made you a super man because most times the hot tub's bad for sperm. Sperm doesn't like to be in a hot tub. But it's a 60-day sperm cycle, Dax, so whatever sperm created that child

was... Bold as hell. Was born before you went in the hot tub. You know, we don't want to get into the mechanics of this, but conceived in a hot tub can mean many different things. In the hot tub. Were you guys like outside of the hot tub or in the water? Okay, listen, I want to first say that it's a terrible idea to have sex in a hot tub. It seems romantic.

You're like, well, this is going to be so great. And you think, oh, there's liquid in there. Nah, it's an answer somebody has tried it's an anti-lubricant so we had long sworn off any kind of hot tub sex pool sex ocean sex but it's just a shower uh shower you can probably get away with if you're aiming the water correctly but the point is we had had had just a horrendous week of fighting to the point where I was like, well, I'm going to bail out of this vacation early. Let's pack up. Oh, what? Breakup.

So what happened? What happened? Breakup. No, we had mentioned breakup sex, like often leading to pregnancy. And then we were like, we got to do a study on like, what is the chemical getting released specifically in that? I always think of you guys as never fighting, never having any arguments. This is bizarre. This is bursting my bubble.

Eight and a half years ago with a one year old. So, yeah, we had to figure out how to get through that. But at any rate, and we're not makeup sex people. But in this event, we happened to make up. We were in the hot tub. And the next thing you know, there was penetration, there was ejaculation, and then there was Delta. There she is. Is Delta the name of the child?

Yes, and she's the best kid that I've ever met. She's so wonderful. So there you go. It works. She's incorporated the essence of aloha in her. Oh, yeah, it was in Hawaii. It was in Hawaii. Got it.

It's totally okay that you guys fight and it's actually a good thing to say. Yes, we were doing quite a bit of disagreeing at that point with the one-year-old. We were like, who's in charge here? We're both in charge. Oh my goodness. We're going to wrap it up

and then... Text me when you're through. I love you, Uberman. I'm so glad you came in to do it up. Okay. Text me when you're through. I love you, Uberman. I'm so glad you came in to do the ladies' podcast. Love you too, man. I hope to see you soon. Ladies, just check out the girth of those quads. Oh, man.

Hey. I'm surprised the couch hasn't given way. Dax, we need to get together and train and sauna and cold and talk lots of things. I could use your guidance on a number of key life things. I love that. Really quick before I hang up, we're on the Missouri River, which as of this morning was 61 degrees. So we cold plunge in the Missouri River. I don't know that I've had a better cold plunge experience in my life. Amazing. Well, don't raise your testosterone too much because, you know,

you've already successfully reproduced. He has a vasectomy. He's all good. Honestly, I think with Dax, it wouldn't matter. Everyone, all right. His sperm are like the evil Knievel. They can jump the vasectomy. What a compliment. My anus, like in the back. Unnecessary roughness.

Bye guys. All right, bye. Let's take this baby home. So let's say either by donor sperm or by donor egg, what's going on there? So let's say we've got partners who are in their mid forties and they want to conceive and they're having trouble getting healthy embryos. There is something that is not legal in the U S but that's starting abroad. And that is legal in the UK, which is called three parent IVF, where they take the DNA from mom, they take the sperm from dad and they take the nucleus from mom's egg and they take it out and they put it into the cytoplasm, which is the egg from a younger woman that has a young spindle and mitochondria. Not legal in the US, has been approved in the UK for mitochondrial dysfunctions. And I'm not promoting this, but there are clinics that do this in

Eastern Europe. Actually, the Ukraine was a site of a lot of this. In Mexico, not a lot of data about the health of the offspring, but this is happening. So it's kind of interesting to just talk about it. But then of course there's, if a woman and a man can't conceive and it has to do with the egg quality, they can take the egg, let's just say a healthy egg and fertilize with the man's sperm and then the woman can carry it in her own belly. So there's all sorts of ways through this. And you know, we talked about optimizing egg health. We talked about optimizing sperm health, some of the hazards to egg and sperm health. We talked about some of the age-related

factors, getting your follicle count. Guys, I don't know, get your sperm count done. It's easy. And there are companies, again, I don't have any association to any of them, but they're like now at-home testing kits. And then there are sperm tests that are sperm volume, motility, and morphology. And then there's sperm tests that are far more expensive. Like how many DNA fragments are there? More sophisticated tests that again, scale with expense. Understand that if you're going down this path, better to just educate yourself early. I would love for people to start talking about it more. I'm so happy you guys are doing this series and not just women, but men should listen to this. I can tell you as a young guy who never really thought about anything except not having an unwanted pregnancy when I was younger. Trust me, there comes a day where you're like, your whole world becomes about

this stuff. You think, wow, I want a family, how to do this and bless you if you fall in love with somebody who has frozen their eggs. Congratulations if the guy you're with and can give you the healthy sperm, right? With you, right? That you want, but just better to understand how it all works. And then, you know, I know people that have put immense amounts of money and energy toward this whole process. It is expensive. Clinics vary tremendously in cost. And I will tell you this, nobody gives you your money back if it doesn't work. And the reason I say this is because I don't think there are a lot of crooks out there, but keep in mind that when people are desperate for something like children, you just have to understand that they will have no problem bringing you in,

getting you all excited, billing you, and then blaming your biology at the end. They're not gonna yell at you or ridicule you. But then you're gonna say, well, it was this, it was that. I think there's an emotional stance that one needs in order to go through this. Today, we talked mainly about the biology and a little bit about the psychology,

but I think that it's a big journey. It is. Right. And I think that the process is one that you can learn a lot about the biology so that when they say, hey, you should do PRP and you say, well, that's a thousand to $3,000 a pot. What are the real data on that? And then they'll tell you, well, I've just had good success with it. Or they say acai or they say L-carnitine, you know, they're varying levels of evidence that go with each of these things. And so you just have to decide based on your own budget. I do think it's great that people are freezing their eggs in the anticipation that maybe someday they want to make some little ones. Yeah. Awesome. Oh my gosh. Thank you so much for the time and all the info. It is

really nice to hear a male perspective on this. We have a range of men and women coming on this show. And it's really nice to hear from a man. Boys, you're going to want kids at some point, perhaps. Maybe not. But don't rule it out just because you're 20 years old. The day might come. Or you're broke right now. Or financially, you're not stable enough, but you're going to want to be and be ready for it. Again, we're all here because the sperm met an egg successfully, either in a dish or in vivo.

And the only species I know that violates that is the, I think the California condor, the females can self-fertilize. Oh, really? Oh, yeah. Two females can fertilize an egg or they can fertilize their own eggs. Asexual reproduction in the condor. I think it's the California condor. So unless you're a California condor. Condor listening.

All our California condor listeners. That's our major demo. Big following on Instagram. Okay. Well, thank you so much, Andrew Huberman. We appreciate you. Check out Huberman Lab Podcast.

It's awesome. It's so good. I don't know anyone in my life who doesn't listen and love it. So thank you for that. And thanks for coming.

Thanks. I had a great time talking biology with y'all. Thank you. Bye. Bye for now. Wow. I feel like we just went to college. Like a way better version of college that I got.

No diss to any of my professors, but I did not learn about this in school. All of this was new information. That was really helpful. I hope that science lesson is informative for people. It definitely was for us. So, okay, I want to say in the home stretch, and I don't know if that's true, but I think that'll make you feel better. Okay, I like that as a concept.

So we will be back next week for more shots more stories and we thank you all for listening Bye.