Her Discussions by Dr Faye - What Every Woman Should Know About Their Fertility

Episode Date: October 19, 2026

How are we supposed to make informed decisions about our fertility when there's so much conflicting information?In this episode, I'm joined by Dr Pavan Minhas, a consultant obstetrician and gynaecologist, to unpack some of the biggest misconceptions surrounding fertility, from the biological clock and fertility testing, to male infertility and the advice we're seeing all over social media.Together, we explore what the science actually tells us and how we can make more informed decisions about our reproductive health, without unnecessary fear.We also talk about:🧬 Why men contribute to up to 50% of infertility cases💊 Does being on the pill for 10 years affect your fertility?⏰ What actually happens to your fertility after 35🥚 Why AMH testing can’t tell you how likely you are to get pregnant📱 Which viral fertility hacks actually have scientific evidence?Resources & links mentioned:-Dr Pavan’s Instagram: https://www.instagram.com/doctorpavan/?hl=en-Faye’s fertility clinic video: https://www.youtube.com/watch?v=lt0xEoT3QPc&t=997s-Study on fertility awareness among university students: https://pubmed.ncbi.nlm.nih.gov/21281094/💌 Subscribe to our newsletter: https://bit.ly/herdiscussions🔔 Join the HERd* broadcast channel here: https://www.instagram.com/channel/AbY4liwxlLnewx4H/?igsh=MWhuaXFweGtucTB3cA==📱 Find us on socials:Instagram & Tiktok - @drfayebatePodcast Instagram & Tiktok: @herdiscussionspod📩 Want to reach out? Email: [e-mail]🛑 Disclaimers: Opinions are my own. This content is for educational / entertainment purposes and not medical or financial advice.NOTE: The average age of women freezing their eggs in the UK is about 35 (HFEA, 2023). It is important to discuss what’s included in the cost with your provider, if you are looking at freezing your eggs.AMH - The figures mentioned are a hypothetical example. AMH falls with age, but the rate varies between individuals and can’t be predicted from one test. Speak to a doctor about your results.

Unlock unlimited free grocery delivery with PC Express Pass. Shop online and get the same low No Frills prices delivered. Get your first year of PC Express Pass for just $2.50 a month. Learn more at no frills.ca. Hold music. Not what you want to hear when a pipe dispersed in your basement is flooding. That's why Intact Insurance answers 2 million claim calls per year within 20 seconds. So instead of hearing this lovely track, you'll hear this in seconds.

Hello, Intact Insurance. If you're in your 20s or 30s and don't know when fertility starts to decline, you're in the right place. Women are expected to make huge decisions about contraception and pregnancy with surprisingly little and often conflicting information. Male fertility accounts for up to 50% of cases of infertility in couples. So today I'm sitting down with Dr. Pavann Minnis, consultant obstetrician and gynaecologist to answer the questions women are left Googling. from PMOS and endometriosis to contraception and fertility. By the end of this episode, you'll never need to watch another fertility video again. Dr. Pavon, we are going to come on to admiosis, endometriosis, facility, all that wonderful stuff. But first, for all the guests,

I love to hear a little bit about their background, how they ended up where they are, because a lot of our audience are ambitious young women. So hearing about your career journey is very interesting. You're a consultant in obstetrics and gynaecology. you started a seven-year training program. But what's interesting about your journey is, I believe it took you 12 years. And for those of you who aren't familiar with the medical training pathway, that's 12 years after five years of medical school and two years training after medical school. So seven quick maths, seven, 19 years.

Yeah, and then I had another year after my F2 where I didn't actually get my training number in Obs and Guine. So I spent that year just trying to like improve my CV and doing locums and things like that. So that's an extra year. It's taken forever. And what would you say to any young woman listening right now, whether she wants to pursue Obes and Guiney or another career pathway that maybe takes a long time? What would be your advice if they feel daunted by that timeline? You know, it is really daunting.

Even when I thought about a seven-year training program, that was really daunting for me. I remember thinking, oh, I'm going to be 34 by the time I finish my Obs and Guiney training and become a consultant. And I just turned 40 a few days ago. So actually, I was 39 when I finished my training. So it has taken a lot longer. But I think that if you have a passion for something, then the years do genuinely fly by. And my path was my path by choice in many ways. For me, having my children during my training was really important.

Working less than full time and having that time with my children was really, really, important and then at some stage towards the end of my training I was at a point where either I do two years full time and get it done or that's going to take me four years to do and at that stage I was like I can't I can't spend another four years doing this I just need to get it done get it finished so I think that things change over time so I wouldn't focus too much on the time frame unless it is going to massively impact your life plans and where you see yourself and how you want to live your life but things do generally tend to work out if you've got the passion and the determination to get through those years. And a bit of a selfish question from me because I'm at a bit of a crossroads in my career path.

How did you find having kids whilst doing obs and guine training? Because obsengany is notoriously known as one of the hardest specialties in medicine, highest burnout rate of any of the specialties. and one of those specialties where you can't do it half-hearted, there's a lot of manual dexterity required, a lot of muscle memory and the surgical procedures. How did you find taking it a step back and coming back? Because that's a decision I'm, you know, I'm weighing up.

We'll talk about fertility rates later on and I don't want to fearmonger anyone, but it is a consideration for women. If I was to start training in two years' time, I would be 30 and I wouldn't finish my training until 37. I would much rather start trying for a fact. a lot earlier than 37. It's been a juggle.

It's been a struggle at times and it's been really, really demanding. I'm not going to sugarcoat it because there's no point. I started my training after a few months I found out I was pregnant with my eldest. And I was really embarrassed. I was really, really embarrassed about telling my head of school, telling my educational supervisor, would they think that I'm not committed to the specialty? How would I look to everyone? But actually, they were so supportive.

and I touched on this earlier, like my deanry where I trained, they were so, so supportive throughout my training. And, you know, I spoke to people. When I was struggling, I spoke to people. I let them know that I'm struggling right now. Mainly my family, my husband was such a massive support for me and my parents as well and my in-laws. Like, it really does take a village.

And I'm lucky. I know I'm completely lucky and it's a privilege that I've had those people around to help me get to where I am now. You know, doing exams as well, when you have children, the number of hours that you put in around, you know, school drop off and pick up and then the weekends having someone look after the children so that I could study, it has been really, really difficult, but it's possible because if I can do it, anyone can do it, it's definitely possible. You just have to be well organised. You have to really plan your time well.

But I think that as with most things, you can kind of make it work one way or the other. and I had the same fear actually and that's why I had my children soon after I met my partner we got married and I was like I really want to have a baby as soon as possible because there was something in the back of my mind which was bothering me about fertility

and I was thinking oh you know I don't want to find myself in a position where I'm struggling to get pregnant I really want to get on and do it now and then everything else will fall into place and somehow it has we'll come on to fertility shortly but there's a study in one of the Scandinavian countries.

I can't remember if it was Finland or Norway where fertility rates are quite low. But they put a lot of investment into maternal leave, a lot of support for parents, but they haven't been able to get the fertility rate up. And they did this study on college students asking them when they thought their fertility would decline. I'll cite the study in the description because I can't quite remember. But the age that they thought fertility declined was alarmingly high. It was like 40. So, you know, there's this argument, I think, when it comes to birth rate,

obviously birth rate is declining. I think that is an argument that we're not educating women on the realities. A lot of the information women are told about fertility comes from an angle of fear, not empowerment and education. The biological clock does exist. It's not something to be afraid of. It's something we should be teaching in schools. I 100% agree with this.

I couldn't agree more. And, you know, sometimes I put posts up and I talk about fertility statistics. and there'll be people who comment to say, I'm so sorry, but this is like really fear-mongering. This is really scary to hear for me. I'm, you know, 37 and I'm just thinking about having a baby now. Now you've made me really worried. That's not the intention. The intention is to educate and to give people the knowledge to empower them to make decisions.

And yes, for some people, it will be too late in terms of receiving that information. Ideally, you'd receive that, you know, when you're at school and you're learning about all the other bodily functions. you'd learn about it then, or at least in your 20s. But the reality is that conversation is not happening. And then we're telling women that, you know, we're independent women, we're career-driven, we want to achieve all these great things in our lives in terms of our careers, which is absolutely correct. But we're then not having that conversation about fertility and allowing women to really make truly

informed decisions. And then it becomes very scary because then we're telling them actually, after the age of 35, we know that air quality and quantity declines. It doesn't just fall off a cliff. It declines slowly. But at a faster rate than it did before you were 35. And so why shouldn't we share that information? Because actually, I think a lot of women and young people want to know that information

because then they can see how that fits in their life plans. And I think that is, it's so important. And I don't think we should shy away from the conversation. It's a really hard conversation to have. It's really hard for me when I post this stuff on social media. There'll be lots of people who find it very helpful, but there'll be a lot of people who also find it overwhelming to hear. I guess that's the flip side of putting those sorts of posts out there

because you can't then create a 10-minute video on socials, on something like Instagram about what that means and how to plan, etc. It's a snippet, but it's a snippet often with references that you can then use to educate yourself a little bit more, ask the right questions to the right people. Yeah, social media, there's never enough nuance is there. You can't fit nuance in a 60 second clip. But I'm really glad you're saying that as a woman who is, you know, become a consultant in an extremely difficult specialty.

Because often, sometimes when I talk about facility, I'm accused of supporting trad wife culture or pushing this, almost like right wing, a traditional agenda, which just isn't the case. And I think that you're sitting here as a woman who has taken that information to integrate it into her career goals rather than tell her she can't pursue her career goals. Exactly. It should never be a trade-off. But, you know, when you're making your career decisions, you're making them based on having researched, having knowledge, educating yourself. So, you know, I knew I wanted to be a doctor because I found out what being a doctor involved.

I enjoyed sciences at school. I knew it was a career that I wanted to pursue. So I made that decision knowing, you know, and seeking advice from people. So that was a very intentional decision that I made. So why isn't having a family, if you wish to have one, if you wish to have children, you know, not everyone wants to have children and that's great for them.

But some people do want to, for some people it's really important. So why shouldn't they make that same informed decisions as they do with other elements of their life? It should be exactly the same, in my opinion, anyway. 100%. We're going to come on to the section called Buy or Bye Bye. Unfortunately, guys, I left my Buy or Bye cards at home today. So I will be reading them off from my iPad for the first time.

Basically, the only rule is we love nuance. you can give as much nuance as you would like to. And I'm going to say something and I would like to know whether you would buy this thing or say bye-bye. Okay. To it. At home fertility kits. Buy, depending on what kind of kit we're talking about. So if we're talking about ovulation predictor kits, then absolutely buy.

Because, again, it's knowledge is power. So getting to know your menstrual cycle, having an awareness as to when you're likely to be ovulating, tracking your cycles for two or three months. can be really, really helpful. I don't recommend that people track their cycles every single month and time intercourse every single month because I think it just then becomes a bit of a chore and it can become quite stressful if you're timing intercourse according to your ovulation window each and every month. My recommendation is intercourse throughout the cycle, but I think knowing your cycle, knowing when you're ovulating is really, really helpful. So by, by, ovulation predictor kits.

You don't recommend tracking your cycle every cycle. Is that just for couples trying to conceive or for women generally? Yeah, so mainly couples trying to conceive. I think using an app to track your cycles is really, really helpful or just popping it in your diary on your phone. Again, it doesn't need to be anything fancy.

I think tracking your cycles is really, really helpful because you're just getting to know your body better and then it helps you to recognize when things aren't normal for you. So I think tracking your cycles in general, really good idea. Ovulation predictor kits also very helpful. But if you think about it, you'll be ovulating around 14 days before you have your period. So if you have a 28-day cycle, it's around the middle of your cycle. So if you have fairly regular cycles, then you kind of roughly know when you're ovulating anyway.

But there are kits that are available. They are helpful for some people. So, you know, use them if you want to. Now, hormonal fertility kits or checking your AMH levels using at-home kits, I guess you have to understand what information you're getting from those kits and also really think about why you're seeking that information at that point in your life. So actually, if you're worried about your fertility for a particular reason, then first of all, speak to your doctor.

because you may have a valid reason that needs to be explored a little bit further rather than just having a hormone profile, because as doctors, it always comes back to history, examination, and then the investigation. So we're always skipping those steps and just going straight to investigation, which bothers me a little bit. And also, AMH, there's this common misconception that AMH is telling you about your likelihood of getting pregnant and your chances of getting pregnant naturally. And by naturally, I mean, just without any fertility treatment.

but that's not what AMH tells us. AMH tells us about egg reserve. It doesn't tell us about quality of eggs. That primarily is determined by our age. And also, it doesn't tell us about your chances of getting pregnant naturally each month. It's giving information from a fertility perspective in terms of if you're going to have IVF treatment,

your AMH will guide a fertility specialist like me as to how much of the stimulation medication I should put you on or what protocol of medication I could put you on, what your response is likely to be, how many eggs I'm likely to be able to collect and what that might translate into in terms of embryos. But on a monthly basis, when you're trying to conceive, you're only trying to release one egg and that one egg is hopefully going to meet one sperm that's going to fertilise, that will, you know, grow, divide, create an embryo which then implants inside the womb.

So it's not helpful if you just want to know about your likelihood of, getting pregnant naturally. If you want to plan for the future and you're thinking that actually I want to know what my egg reserve is looking like now because I want to bank those eggs to use in the future if I've got lower reserve now, for example, then that could be helpful. But I think you have to think about why you're doing it. And also, if you've been trying to conceive for a year for most people or if you're known to have any fertility issues like PMOS now, endometriosis,

or if you're 36 or over, then after six months you should see your doctor rather than waiting for a year because we can start investigations at that point to look at other things that could be impacting fertility, such as tubal disease or sperm-related factors. So yes and no. Yeah, that's a brilliantly nuanced answer, I think. To give you a little bit of context of some of my experiences with fertility testing, when I was in my first year as a doctor, I worked under a consultant who was going through. IVF and had a really brilliant relationship with her. And watching her go through that was really,

really, really challenging. And we had some really, we had some brilliant conversations about it where she said, Faye, don't put your career first if this is, if having kids is something that you want. Yeah. And for context, she was 37. She went through many, many, many, many rounds. So that opened my eyes. I think when, when I was at that age, I thought facility is a far, far far off problem. And it was the first time it had been brought to my attention as not that far off an issue. So I wanted to do a YouTube video exploring facility testing and the pros and cons. So I did facility testing. Yeah. And my AMH came back low. Now, obviously AMH has limitations. As you said, it's not an indicator of whether you are likely to get pregnant that month at that time. But what the

benefit was for me and my now fiancé, not my fiance then, was it triggered some really important conversations for us to have. So I think, yeah, I completely agree with you. AMH has its limitations and going straight in for investigations. The other thing I would say about, I did an at-home fertility test. I did, I did two. I went to a fertility clinic and I did not at-home test. My results from the fertility clinic came back first. So a consultant explained my results to me. And then I got my report on my phone afterwards. Now, in some ways, I wish I'd got the report on my phone first. I wish I'd got, because I wanted to see how I felt. And I wanted to have a better understanding of what women go through when they do an at home facility test. And it's not explained to them by a person.

So when I had those results explained to me, there was a nurse, the consulting. I was very well-supported. I'll link the video down below for anyone who wants to watch, but the consultant asked me to turn off the cameras before she told me the results. But it was done in a really, you know, someone who's trained to deliver those results. I can recognise that at-home fertility testing may feel less daunting because you don't have to go into a fertility clinic. You can do it from the comfort of your own home. But I do worry that those results, maybe aren't delivered in the most compassionate way. Yeah, and I mean, if you get a letter, or if it comes up on an app and you get some numbers and then you're looking at the normal range and it just says low, or if there's then a letter that's supplied, which kind of explains things a bit further, you're in a state often.

You're in a state of shock looking at that number. So when you're reading that, it's really hard to interpret that information. So when you're sitting with someone who is a specialist, who can really explain what that means and put that in context for you, and ask you questions, like Faye, okay, this is where it sits at the moment, but what are your plans? When, you know, what's important to you? Is having children really, really important to you? And also, financially, how are things financially for you? Are you in a position to consider egg freezing or, you know, freezing embryos? Are you in a relationship? There's so many questions.

It's not as simple as just having a number. And I think that's what I worry about most. I know there's some really great at-home fertility kits that are available in tests, and there's some people doing some really incredible work, and I really don't want to knock that. Because actually, I don't think that we should withhold these things from people either. No. Because actually, if you want to go and test at home, why shouldn't you be able to? As a woman, you can make that decision yourself as to whether you want to go and test

and use the at-home kits, and, you know, you could then follow that up with your doctor or be referred, whatever it might be and whatever it might look like. But I'm very pro-choice. So I think that you have to make that individual decision yourself, but it's really important to understand why you're testing and what those results might mean for you. Lots of friends ask me this very same question. Like, should I get it done or shouldn't I?

I'm like, look, why do you want to get it done? And what would you do with the results if your AMH came as low? Because also what we don't know is how slow or fast that AMH is going to decline. over the next few years, yes, it will go down. But is it going to jump from, I don't know, seven, you know, pick a malls per litre to one, you know, in the next two years? Probably not. It's a difficult kind of decision to make, I think. And I think sometimes people are just just doing the kits because they're there rather than thinking about why.

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So instead of hearing this lovely track, you'll hear this in seconds. Hello, intact insurance. Yeah, yeah, yeah, the kits aren't inherently bad, but understanding what you're going into is what's really important. next is castor oil packs so oh how do I feel so I did a bit of research about this because I hadn't heard too much about it to be honest so I find that so interesting when trends pop up on on social media women's health trends on social media and I pride myself on you know having a pretty good understanding of most most things and it pops off and I'm like that's I have no understanding of

that whatsoever and the thing is I've been kind of off socials a little bit recently because I've got so many things going on in my personal life. So I'm like, oh, what is this? Look, the thought process is that the castor oil is going to penetrate and it's going to ease off. It's like an antioxidant. It's going to detoxify by placing castrol on your abdomen and then wrapping it, wrapping a cloth or something around.

Yeah. And I think the reality is there's not evidence that really supports its use and shows that, you know, this categorically will improve, painful periods or improved fertility or any of these things. Is it likely to do any harm though? Probably not. So, you know, it's been used for centuries in, you know, some ancient rituals and if you think about, you know, Ayovetic medicine and it's been used for a long, long time without causing any harm. And for some people, it gives them peace of mind. It makes them feel happy. It makes them feel better. They feel like their symptoms

are better. They feel like it's doing something to improve their fertility. So I don't necessarily have a problem with it if you want to do it. But I would say bye-bye to buying these expensive kits and packs. I think you can easily do all of this at home, do a bit of research and use them at home if you want to. But it's not something that I'm going to recommend to my patients. Yeah. We'll come on to handling heavy painful periods a little bit later on.

But also I wonder, I think they're warm as well. I think maybe some of them, they warm them up. And then I think, well, then it's, you know, those could be some dilation of the blood vessels. That might be helping a little bit. Yeah, maybe. I mean, I just, I really don't know. But then I watched, I did watch some videos on TikTok. And there are people who swear by it and who really feel that it helps.

I think you've always got to look at who's giving the information. So if it's someone that's saying use these packs and actually it's an like affiliated link or, you know, it's their own product that they're selling. Just think about what you're buying into. I think going into it, knowing that actually there's not really a strong evidence base to support this, but actually I'm at a point now where I will try anything. And actually, this seems like it might be quite soothing to me. And I just want to give it a go. Then why not?

It's your choice. Yeah, it might feel like a bit of self-care. Yeah, that's it. Vitamin D. Bye, bye, bye, bye, bye, bye, bye, bye. Like, bye, bye, bye, bye, bye, not bye-bye, bye, bye. Not bye-bye, bye, bye. Yeah.

There's not many supplements. that you need to take, but vitamin D is the one that you do need to take. So vitamin D between October and March, there's not enough sunlight for us to make enough vitamin D because it's made through sun exposure to skin essentially. Low vitamin D levels can impact your bone health, your, you know, teeth health, muscle health. And also when you're pregnant, your baby is growing and we know that having low vitamin D levels can impact growth in the first year of life, can increase the chance of rickets and things like that in babies and newborns. So having good vitamin D levels is really very important for everyone.

But when you're pregnant and breastfeeding, then just take it throughout. And also folic acid. Phalic acid. Yeah. Just the two. It doesn't need to be anything fancy either. There are so many different supplements available, so many different types of vitamin D and doses, but essentially just 10 micrograms.

It doesn't need to be anything fancy. You can just buy it from your local supermarket, buy it online, buy it from Holland and Barrett, or wherever you wish to buy it from, basically. But it doesn't need to be expensive. It doesn't mean that it's any better than the less expensive. And folic acid, the same thing. Some people choose to take branded supplements that contain everything, because it's just easy for them just to take one tablet a day

and it contains everything that they need in pregnancy or when they're trying to conceive. But you really don't need to spend the money. I literally went to the supermarket, bought folic acid, bought vitamin D, and took them when I was trying to get pregnant. Jobs a good thing. Egg freezing in your twenties.

Buy if you're in a position too because, let's be honest, it's not cheap. Yeah. You know? Yeah. It's expensive. And not just the expense, it can take such a massive toll.

I mean, what do you think? Yeah, no way. The emotional, it's actually like a full-time job. Egg freezing is a full-time job. The way that you have to go in, you know, you're getting scans three times a week, you're injecting yourself every day. There was, I had to do my trigger injection after it,

I went to the cinema to go watch the second wicked film and I had to do my trigger injection in the back, in the bathroom of the cinema. Like you... Timing. timing and at the, you know, at the end, I was really searching my body for places that weren't bruised to inject myself. It was, because it gets really painful. And also I'm quite a, you know, I'm not, I'm not a needle phobe. I'm not a needle phob. I'm medically educated. And I'm doing it

not to, I'm not doing it for IVF purposes. I'm doing it. So there's not the emotional burden of wanting a baby at the end of it. And I found it extremely challenging. The last day when I, I think I injected myself five times on the last day. And by the last injection, I was looking at my fiance and I was like, like, almost tears my eyes. Like, I can't, I can't do this anymore. And I was going to do a second cycle of embryo freezing. And I've been putting it off because it was, it was intense. And I, I have the utmost admiration for women who do IVF. And they do five, five cycles. I'm thinking, God, that is the emotional, like, just toll on those women, you know? It is massive.

And I think that often people don't talk about their journey. So don't forget, these are often women who are still working and literally, like, popping in on their lunch break to go and have a scan to track their follicles, injecting themselves wherever they can privately. It's a lot. The emotional burden. and for lots of people they are having fertility treatment because they do want to have a baby

and they're struggling to conceive and so that toll, the pressure, the pressure of this has to be the one that works and then if it doesn't work, then it's a second cycle. This cycle has to be the one that works. At what cost do women keep going? And often it can be at the cost of their emotional well-being, their relationships, their career,

their family life, you know, their finances. It's massive. It has such a massive burden. But I think that if you're in a position to, 20s and early 30s is the best time to freeze eggs if you are going to freeze them. That's not to say that you can't freeze them afterwards. And if we look from the HFEA statistics that are out there, most women are actually freezing their eggs at around the age of 38. So we recommend freezing before the age of 35, and that's based on those two factors I spoke about earlier. So egg quality and egg quantity is, you know, optimal before the age of 35 and then it starts to decline.

So really, if you're thinking about freezing your eggs, you want to freeze them when they've got the highest potential of then creating embryos in the future and resorting in a pregnancy and a live birth. So doing that before you're 35 is ideal. But the reality is many women are doing it a little bit later because, again, lots of people didn't even know, don't even know that egg freezing is something that they can have done. You know, it's not available on the NHS for most people unless, of course, you've got certain medical conditions, mainly cancers and you're going to have treatment for that.

Then you may be able to freeze eggs or whatever. embryos depending upon your circumstances but the average cost i don't know how much you paid and you don't have to disclose that but the average cost is around seven to eight thousand pounds of freezing your eggs and then using them in the future so it's it's massive yeah yeah um i should i should disclose the clinic paid so this where a lot of controversy came in when i was sharing my journey is i got my egg freezing for free yeah and i think that's a really important clarification to to add the clinic didn't ask me to present them in any way shape or form and I wouldn't have agreed to that.

Like I can be completely honest about my experience and like challenges that I had and hopefully but we did, we had a full, we had a videographer he filmed my entire procedure he filmed me being put under being sedated, everything and hopefully

we should have that video coming out soon, fingers crossed so I'll put the link in the description if it's out. I can't wait to watch. But so, I'm just curious so did you contact the clinic or the clinic contacted you? So when we were doing, basically there are two videos,

we contacted the clinic to do just the facility testing. So I was going to do facility testing at a fertility clinic and compare it to doing at-home testing. Yeah. So that was one video. And then we walk into my facility testing and she did videographerferfer's there like this. And she goes, videographer, can you please leave?

Okay. So that's when things sort of snowballed into the next. stage of things. Right. So I think honestly, I think she felt a little bit guilty that she was like, I am the one delivering this news that your AMH is very low for your age. Yeah, we would like to offer you at egg freezing. No obligation for you to post anything. No obligation for you to share your experience in any way, shape or form. But that's something we would like to do for you. And to be honest, it was something I was considering anyway. But I was like, do you know what? Let's do. it and then I can film the whole

process and show the ups and the downs of it all. Yeah and I mean it's a really unique position to be in but the education that's going to come off the back of this and how many women you're going to young girls you're going to help it's going to be massive because

you like you say you had no obligation and you know it you only went for the first element of things which was having your you know fertility emoted and so you know you had idea and the difference in in the results receiving them through an app or going for a consultation but then seeing the next stage of things and that decision making process in all of that is yeah that's pretty special it's um my my aim is always from my experience with my consultant

and with the conversation she had with me is to bring that awareness to other people where it's not whether a woman in his 20s chooses to freeze her eggs or chooses to not freeze her eggs to open up that conversation and make it not scary. Have these conversations in a far enough away from your mid-30s, you know, ideally, far enough away that it's not scary. So you're not having these conversations at 34. You know, the classic, I don't know if you've seen the scene from friends where it's Rachel Green's, it's her 30th birthday.

And she's like, so if I want to have two kids by the time I'm 35, then I want to be with my partner for a year before. we're married and I want to be married for a year before we have kids and da-da-da-da-da. And she's like, okay, well, then I have to have met my partner at 30. And her cake is... Yeah, and the math ain't math. Yeah, yeah, it's like the biological clock maths. And what my aim with all the videos is always to...

All the conversations around fertility is for women to not be doing biological clock maths at 2am, to be having these conversations really early. And I think in your 20s, knowing what... you want. Like I'm a career-driven woman, you know, I know where I want to be in five years. I know what I want my savings to look like. I know what I want, you know, where I want to be living, and I think sometimes when women talk about fertility or think about fertility too early, it can be seen as a bit, especially to men, you know, especially bringing up those conversations with partners. It's a bit like, oh, whoa. And I want women to feel empowered to be like, well, this is actually

what way. I actually do have a biological clock. So I would like to be having these conversations. And guess what men do as well? It's just slightly later, you know, their sperm quality also declines around the age of 45, so they have a bit longer than we do. But their sperm aren't invincible. Yes, they're producing them all the time. That's great. But their quality does also decline.

And actually, if having a child is really, or having your own biological child is really, really important to you, then why shouldn't you have those open conversations at the start? You'll often talk about, you know, where you see yourself in 10 years' time in terms of career and, you know, where you're going to be living and working and all of these other things. So why should that be such a scary conversation to have? Like, no, we have enough burden to carry as women. We want to share that information. And if you're the right person, then come and join this journey. And if you're not, then that's okay. Yeah. Bye-bye. Bye-bye. Bye-bye. Absolutely. Final vial bye-bye is red light therapy for fertility. see. So that's another one. I hadn't heard too much about it. So I've done a little bit of research on it. So again, there's not, there's not, you know, strong evidence that using red light therapy is going to improve your egg quality, for example. There's some case series that it can increase live birth rates, but these are really, really small studies. And I wouldn't say that people should be spending a lot of money to go and get this done.

I think the case series are for women with unexplained fertility who have had red light therapy. If I'm right, I'll need to check. So I would say bye, bye, bye for this one until we have more evidence. And I think whenever you say there's not much evidence for something, or this is my experience, whenever I say that there's not strong evidence to support something on social media, that gets interpreted as it doesn't work.

that's not what you're saying, it's not what I'm saying when I say that on social media. I'm saying there's not strong evidence, an absence of evidence is not evidence in itself, but if we're weighing up how much you should be spending something, where you should be putting your energy towards. And also, you know, it's some things may not have much evidence, but if you think about it logically, they're unlikely to do harm.

So like that castoral thing that we're speaking about, you know, who knows in 20 years time we might have evidence and it may be harmful. So that's why I can't say, yes, you should use it. But you have to make your own decisions in life as well, right? Some things we're going to do, which aren't in our best interest, but we do that all the time. You know, when you're walking down the street, every decision you're making in life is not, you know, thoroughly thought out. You do some things because you want to do them. And I think with the thing with the red light therapy is, I guess it's sort of the waveform that's used and what is the right way form and also what you don't want to be doing is using red light therapy which could

be harmful to the oocytes because they're really fragile. Egg development, you know, it's a really fine-tuned process. So I think the aim is that it acts on the mitochondria to increase the ATP, give more energy for cells to repair themselves and for follicular growth and usite development. but we can't say that translates to increase egg quality. If you are doing this at home using your LED masks or things like that, for example, are you actually potentially causing harm because it's not the right waveform of red light therapy that you're using?

So could it be detrimental? Until you have the studies to prove or disprove that, you can't really say. So I'm a bit skeptical of if people are doing it at home, I wouldn't. If you're going to clinics and they can, you know, show you some evidence or prove to you that it's not harmful, then fine. Unlock unlimited free grocery delivery with PC Express Pass. Shop online and get the same low, no frills prices delivered. Get your first year of PC Express Pass for just $2.50 a month. Learn more at nofrills.ca.

Hold music. Not what you want to hear when a pipe just puts. and your basement is flooding. That's why intact insurance answers 2 million claim calls per year within 20 seconds. So instead of hearing this lovely track, you'll hear this in seconds. Hello, intact insurance. Yeah. We will come on to PMOS and endometriosis.

Very important, especially in the fertility conversation. But a couple more questions about fertility that came up a lot from the community. One was, so many of us are on contraception for a decade or more before we even think about fertility. Does long-term contraceptive use affect how? easily someone conceives once they come off it? So the short answer is no. So the evidence shows that taking contraception, regardless of the duration of time that you're taking it for, it doesn't impact your fertility. And for most people, their fertility returns back to what's normal for them.

You know, within three months. Of course, for some people, it can take a bit longer. But for most people, within two or three months, your cycle should come back to normal and your fertility should return to normal. But I guess the other side of things to think about is if you've been taking contraception for a very long period of time, for example, you took it between the ages of 25 and 37 and then you come off it. Your fertility now at 37 is going to look different to your fertility at 25 when you started the contraception because of that natural decline in quality and quantity. So some of it, you have to put it into context of yourself and think about your biological clock as well. But the contraceptives in themselves don't have a long-term impact on fertility.

You're not using up your eggs faster or it's not detrimental. And studies have shown that actually when you come off contraception, your chances of conceiving within a year are the same as those who weren't, using any contraception prior to trying to conceive for a year. So it sits at the same rate. The caveat to that is if you're using the depot, so the progesterone injection, that can impact your return of fertility. And it can take up to 12 months, sometimes, you know, a bit longer.

But 12 months for your fertility to return back to normal. For most people, it's around the study show around 5 and a half months from their last injection or six months from their last injection, but up to a year. Coming on to PMS and endometriosis, for a lot of women, they come in with symptoms maybe they're, I don't know, they could be 14, 16, whatever, coming with symptoms of maybe painful periods, irregular periods, even acne. They're put on the pill, potentially without referral to a specialist or without a diagnosis of PMS or endometriosis, but they have those possible symptoms. They're put on the pill.

They stay on the pill to manage their symptoms maybe for 15, even 20 years. Yeah. They come off that pill and then they struggle to get pregnant. For them, they likely may attribute the pill is the reason for their, for their, for struggling to get pregnant. Yeah. When actually it was the PMOS because you're not ovulating, therefore, you know, if you have very infrequent or very irregular periods, then the likelihood of you ovulating on a regular basis is very, very low.

So actually your chances of getting pregnant are low because of that. So actually if you have PMS and you're not pregnant after six months of trying, then that's the stage at which you should be speaking to a doctor. And we can definitely do investigations. We can, you know, check to see if you are ovulating, take a thorough history, examine, do scans, and then put a plan together, which might involve some. something like ovulation induction to help you get pregnant.

And so for a lot of women with PMOS, what I hear, PMOS and endometriosis, what I hear a lot of the time is the pill is used as a, what's the masks? Yeah, well, I guess it does mask some of the symptoms, but I think a lot of women with PMS and endometriosis feel that the pill doesn't have a point in terms in their treatment. And I can understand where that comes from, but I can understand how it can feel like that in a world where women's health feels neglected. Yeah.

And maybe they don't get seen by a specialist. But could you explain why the pill can be beneficial for women with PMS and endometriosis, but also what they could do alongside that in terms of maybe getting specialist support? Firstly, you know, they are often grouped together, PMS and endometriosis. We say all the time adenomyosis as well. and they're very separate conditions and some women may have, you know, both of those or all three of those conditions, but they are very different. Now, I think that hormonal treatment or management, because it's not really treatment, you're not really treating the underlying cause.

You are trying to keep it at bay essentially by using hormonal management. But I feel that with PMOS, it really depends on what your primary concern is. So if it's that you're having a lot of, you know, your periods are really infrequent or you're not having any periods, you know, you're having one period a year or two periods a year, that's not healthy. We want you to be bleeding more than that. Ideally, you know, three or four times a year at least because we want to reduce the chance of changes to the lining of the womb to the endometri. which could result in pre-cancerous changes and endometrial cancer in the long term. So being put on the pill to induce withdrawal bleeds is helpful from that perspective. If you're managing things like acne, then again, taking hormonal treatment can help to manage acne

because you can have pills that work against the testosterone that you have higher levels of, essentially, which is driving the acne. So I think that there is a place, but I can definitely see why it feels very much like women are being fobbed off with the pill. Because let's be honest, lots of women are being fobbed off with the pill. They're not getting answers because people don't understand these conditions well enough and even healthcare professionals. There's some great GPs out there who have a real passion for women's health. But there's lots of people and lots of GPs included who feel very overwhelmed by women's health who find it very, very complex. often you go to medical school

you have a few weeks of obs and guiney training. I had three. Well, there you are. Across five years. Three weeks of women's health. That was it. Learn it all in three weeks. That's obstetrics and gynecology,

which by the way are often like considered to be two completely different specialties. So it's like you're learning fast. And then when you're going through your placements, they'll often have maybe six months in obsengine as a placement. And that's where they're learning everything that they need to learn to then go and take that back with them. them to general practice. So it can often feel very overwhelming for GPs as well. But then I think that there has to be a commitment to learning for all of us as healthcare professionals. We have a

duty of keeping up to date with what guidelines are, what the evidence is, how we're managing our patients. That should be our end of the bargain to the patients that we're taking care of because we can't just say, I don't know, because I didn't, I didn't have a placement that was long enough, you have to take the oneness upon yourself to go and learn. Because if you know that you're coming into contact with women and girls who are going to be struggling with period problems, with fertility, with, you know, various different PMDD, then you have to go and learn. And if you, if you can't, you're not able to, then I think that there needs to be really transparent conversations in general practices. And there needs to be people who are dedicated to,

seeing those patients, and maybe others who won't see those patients. And I know that we're not in a position to really offer that, because let's be honest, you know, GPs are very, very stretched. I completely appreciate that. But women can't just keep being fobbed off. The education and the learning and the commitment has to be there to women's healthcare. Two things can be true at once. I've had a couple of comments recently about GP accusing me of GP bashing. And, you know, I always want to be so, so, so clear. There are absolutely phenomenal GPs and, you know, doctors who drive women's

health forward and are actively fighting against injustices that have, you know, previously occurred. But two things could be true at once. We can be living, the NHS can be stretched beyond its means and GPs can be fighting a losing

battle trying to get through, trying to sort people's symptoms out in 10 minutes. But women can also be, you know, there is also an justice that is happening in women's health. Those two things could be true at once. You can hold them both. You should be able to hold them both at the same time. And we also need to acknowledge that in stretched healthcare systems, it's certain groups suffer more than others because we rely on biases and we rely on the evidence available. When the biases exist against women,

against racial biases, against socio-economic biases, and then there's a lack of evidence as well in women's health, there are certain groups that will suffer more and that does need to be called out. Yeah. And I think, you know, how will things ever change if we're not having honest conversations? We can't, we can't want to change things but not be willing to listen or to hear the hard truths. You know, not all gynecologists are brilliant gynecologists. Not all obstetricians are brilliant obstetricians. Not all people are good people. You know, this is true of everything and everyone. But I think that's really sad as well. Actually, it really does make me sad because as women, we're not asking for much. I really don't feel like we're asking for much. You're

going into a consultation with whoever you're going into a consultation with asking for someone to listen. And sometimes I have patients who come in and they're really upset. And I can tell that they're upset as soon as they walk into the door, through the door and take a seat. And I'm like, how are you? And you can just hear it in their voice. They are not happy. And so then if I'm like, well, I haven't done anything. Why are you unhappy sitting in my consultation room? And if I have my backup, how are we ever going to have a meaningful conversation? Like, you have to appreciate the hardships that women go through on a daily basis in all elements of their life.

And health is a massive one. You know, we just have to grit our teeth and get on with it and just bear it and crack on because life's happening. and we haven't got the time to moan about our periods or go and see a doctor or, you know, we just do what we're supposed to do, but at some point it's too much. And at that point, people seek help. And if people are seeking help,

it's because it really is too much and we need to listen. And if we're not listening, we're not doing a good job. Yeah. You don't know that woman who's sat across from you whether she's been going to a GP for multiple years and has finally got a specialist referral You know, you don't know what it's taking us to get to that point

how many people she's explained her story to. Yeah. So I think it's really, yeah, it's brilliant to have professionals like you who are willing to meet a woman where she's at and recognise you don't understand what's brought her in with those emotions. Yeah. That's really important. And that does come at a cost though because then my consultations always run late.

But, you know, what can you do? Because I'm not, you know, my fertility couples. I'm given 20 minutes to have a consultation with a couple. That's taking a male history, a female history, you know, potentially examining, going through examination findings, discussing those findings and putting a management plan together in 20 minutes. I can't do it. Yeah.

Because I know that these couples have wasted such a long time to come and see me. So I can't just, you know, shove them out of the room after 20 minutes. I need to spend time and that will come at a cost of other people waiting a bit longer, but hopefully when you do eventually see someone like me, it'll be worth the weight. Yeah. Yeah, you can't rush people's emotions, can you? Yeah. I've got a couple more community questions on endometriosis, PMS and admiosis.

So grouped together again, as it was one big homogenous lump. As you mentioned, it's not a homogenous lump. Someone's asked for someone who might be struggling to get a diagnosis of PMO. admiosis or endometriosis right now, what happens if their ultrasound comes back normal? Yeah, I've spoken about this before on my socials, actually. A normal scan doesn't mean that the symptoms are in your head. It just means that we haven't picked anything obvious up on ultrasound scan. Ultrasound scanning is not easy to do either.

I scan patients. Will I miss endometriosis? Absolutely. I'm sure I have. I worked with a consultant who was absolutely phenomenal in, endometriosis ultrasound scanning and he would you know just he'd really see those deposits of endo that other people might miss and those those subtle signs and it's a skill not everyone has it not everyone is able to pick up conditions like endometriosis even with PMSS you don't actually

need to have polycystic ovaries on scan to have a diagnosis of PMOS so we can just throw that one right out the window a normal scan doesn't mean that you don't have PMOS. It's taking a history. It's understanding, you know, your symptoms, the regularity of your menstrual cycles and using what we call the Rotterdam criteria to diagnose. And polycystic ovaries on scan is just one of those elements. There's three different criteria. And if you have any two of those three, then it could potentially be PMOS. So that one, let's put that one to bed. You absolutely don't have to have polycystic ovaries on scan. Now, with adenomyosis, again, it's picking up those sort of subtle signs on scans. They're looking at the thickness of the myometrium,

the muscle layer, comparing the front wall and back wall, the shape of the womb, looking at the muscle itself and looking to see if there's any areas which are suspicious for endometriosis, looking at the transition between the lining of the womb, the endometrium and the muscle layer to see if that transitional layers lost. So you can see it's quite technical and it can be missed. I think with adeno personally I find it a bit easier to diagnose adenomyosis. And sometimes I even have incidental findings of adenomyosis and I'll ask patients, well, are your periods painful or heavy and they'll say no.

But then I also wonder, is that because you've always had heavy and painful periods? And that's your baseline. That's your normal. So you don't really appreciate it as being heavy or painful. But I think the important thing to answer the question is, no, a normal scan doesn't rule it out. Your symptoms are real. Your experiences are real. Speak to your doctor.

Go through what you're experiencing. And there are other tests that are available as well. that might mean an MRI scan of your pelvis if it's indicated. It might be, you know, being referred to a gynecologist and having a laparoscopy, a keyhole surgery to have a look inside the pelvis to see if there is any obvious endometriosis. But sometimes you don't see those deep deposits. The pelvis can look clear, but actually there could still be deep seated, deep infiltrating endometriosis, which isn't really obvious.

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Hello, intact insurance. Yeah, again, lumping them all together, but we know that these conditions, tend to have a diagnostic delay with the diagnostic delay for endometriosis increasing from eight years to nine years over the last recently so we don't seem to be getting better. Again, at the risk of GP bashing, which I don't want to do, if a woman is struggling to be referred to a specialist, is that any advice that you'd give her going into her next appointment? I would say get a second opinion and really advocate for your.

yourself and then just ask the question. So if you don't think it's endometriosis, what do you think it is? Because I'm not happy with these symptoms. I can't continue living my life this way. It's affecting my quality of life. So what do you think is causing my symptoms? And often when you ask that question, if someone says, well, I don't know. Well, if you don't know, then refer me on to someone who might know or might be able to do the next stage of investigations. But isn't that shocking? How much are we talking about endometriosis, adenomyosis, PMDD, all these conditions. How much are we speaking about them now? And yet the diagnostic delay is getting longer. It's just so unacceptable. And that nine years doesn't even account for women from ethnic minority groups. That's in, you know,

11 years plus often. Yeah. So it's really sad. I just can't believe that we are where we are. Yeah. And you hit a really good point that when it comes to ethnic minorities, that's a whole other kettle of fish when it comes to women's health as well. We know the maternal mortality rate for women of ethnic minorities is different as well.

Do you have any specific advice for those groups of women when it comes to advocating for themselves. Yeah, so I think that sometimes that element of that delay isn't all just, you know, going to see your GP for nine years and not getting a diagnosis. There's also that time period before even seeking medical advice because you don't know that this is not normal. So I would encourage everybody to have those conversations with your children early on at home. It needs to be in the curriculum. You know, that's where the education needs to start. But we also need to have those conversations at home. We need to stop being scared to talk about periods. There's nothing dirty or wrong with periods. Talk about them. I talk to my boys about periods. It's a very normal conversation.

We use the words at home, vagina, vulva. Like, you know, it's a very normal. It makes my husband feel uncomfortable. It does make him feel uncomfortable. But I'm like, I think we were at my mom and dad's house actually. And is it? Where do babies come from? And my mom was like, Because she knew that my boys would probably just say the vagina. Like literally they are, they will say, you know, they're a bit older now. So they are also aware of where they're having conversations. But I think education is key for black and brown women and South Asian women I can speak about personally because that's my experience. I was devastated when I had my first period.

Really, really upset because I saw it as such a, I saw it as like a. a dirty thing. I saw it as, you know, I don't know, I just felt really sad. I cry. I cried so much. And I think lots of people do feel that way as well. They do, you know, feel upset. But I felt really, really sad. And, you know, it's not because my parents didn't want to have the conversation about periods. My mom definitely had a brief conversation with me about periods. I definitely didn't speak to my dad about periods. But that's just because culturally, it wasn't done. It wasn't a natural conversation to have. And that really needs to change to have those conversations earlier because by talking about what's

normal, you can then help your children to understand what isn't normal. You can help them to seek help earlier, get diagnoses where they need to be made and have better qualities of life. I think that's a brilliant, brilliant message for everyone. The boys need to hear more about more about periods, more about vaginas, more about vulvas. Love that. Oh, this is a really important question that I would love your opinion on. And it's a bit of a sensitive one. But I think it's an important one to discuss. So Anne Hathway announced that she was pregnant with her third child at age 43. Her age alone made so many headlines. What do you think is the impact that has on a young person's understanding of fertility? And I say this is a sensitive question because I believe that

every individual has the right to privacy when it comes to how, these pregnancies came about. Yeah. But my concern is when celebrities are having kids above the age of 40, we saw it with Amal Clooney. Yeah. There can be a distortion that happens in public perception. Yeah. When it's not clear whether those pregnancies occurred naturally or by assisted means. Yeah. And I don't think that they have a responsibility to all of us to declare how they became pregnant and what their fertility journey look like in achieving that pregnancy. I think that we have a responsibility as a society to educate better so that people can put that into context.

So that, again, it comes back to having those conversations about fertility so that women in there, you know, from school age onwards are aware of their, you know, of the natural decline in fertility that happens, the biological clock. And also, you know, having conversations about how pregnancy can be achieved and how it does look different for different people. You know, should we be speaking about IVF in school-age children? I don't know. It might be a bit early. But, you know, some level of education does need to happen, doesn't it?

Because I think that people will think that, you know, Anne Hathaway had a baby at 43, so it's definitely possible. Of course it's possible. If you're ovulating, if you're menstruating, of course you can get pregnant. It can happen. It might be harder to get pregnant when you're over the age of 40. doesn't mean it's impossible. You know, some people freeze their eggs.

And when you freeze them, they're frozen at the age that they were frozen. So if you freeze your eggs when you're 25 and choose to use them when you're 43, those eggs are still the age of you when you were 25. The quality is reflected as a 25-year-old as opposed to a 43-year-old. I can understand how it can send mixed messages because on one hand we're saying fertility declines. On the other hand, we're seeing high-profile women. having babies later on and then not necessarily sharing how they achieve that pregnancy. But I think why should they, why should they share that? That's down to them and we need to do

better as a society on educating. Yeah, giving people the context 100%. A big topic is male facility. So could you tell us before one more question. What impacts male fertility and what are you seeing in your practice right now? So statistically, we say that male fertility, or male subfertility accounts for up to 50% of cases of infertility in couples. So it's a contributing factor in at least half. In reality, and I was having this conversation with someone yesterday, I think it's more than that. You know, if I see seven couples in a fertility clinic, I don't.

I see a lot more. But if I saw seven couples in a fertility clinic, I'd be lucky if I even saw one normal semen analysis. Really? It is such a rarity. Honestly, I cannot tell... Interesting. I'm shocked myself.

I think I need to probably audit what I'm seeing myself probably a bit more definitively. And is that got worse or would you say that's been fairly consistent since you've been practicing? So because in fertility specifically, I've, you know, been doing fertility specifically for the past maybe four years or so. So it's not like a long period of time. me to see how it's changed. But I think that there's so many factors, you know, there's diets, exercise, BMI, male, you know, it's not just women who need to stay healthy and fit. Men also need to stay healthy and fit because it is then, you know, seen in their sperm

parameters, low numbers, you know, low normal morphology, low motility. smoking is a no-no excessive alcohol in fact you know ideally not drinking at all yeah for women we say that why are we not saying that for men why do we say for women when you're trying to conceive you no amount of alcohol should be consumed it's not safe really then for men we're saying limit your alcohol intake it should be the same message you know um drugs cannabis all the drugs stop supplements, you know, protein supplements. They're not regulated. We don't know what's in them really.

There's been some studies. I think I was reading the University of Birmingham. They looked at various protein supplements and there's higher levels of like estrogens. There's some estrogens in some of them that can affect the sperm production pathway. So I think men need to really open up their eyes a lot more to the significant impact that their lifestyle and how they choose to lead their lives has on a couple's fertility for sure.

That's really interesting. Finally, Dr. Parvind, you have been absolutely incredible. This has been a wonderful episode. We finish every episode by asking a question to all our guests, and that is, what do you wish every woman knew by the time she was 25? Big question, hey. Big question. Big question.

What do I wish every woman knew at the age of 25? I wish every woman knew that it's okay to advocate for yourself. That's not just at the age of 25. It's at every stage of your life. No, that it's okay to advocate for yourself. Know that it's okay to say, I don't agree with you about your health particularly because there's so many unknowns in women's health still.

And I think that if you're experiencing something that's not normal for you, then that's good enough to seek advice and help and for someone to listen and to take you seriously. I also want everyone to know that they should make conscious decisions about their fertility where they can and be fertility aware because we can't turn the clock back. So if you're 25 now, know that, yes, in 10 years time, your fertility will naturally start to decline. It will still be possible to get pregnant after that. But think about what that means for you because that's a 10 year window for you to make conscious. decisions if it's within your means to do that.

That is a really important lesson to finish on. So thank you so, so, so, so so much. Unlock unlimited free grocery delivery with PC Express Pass. Shop online and get the same low No Frills prices delivered. Get your first year of PC Express Pass for just $2.50 a month. Learn more at nofrills.ca. Hold music. Not what you want to hear when a pipe just burst in your basement is flooding. That's why Intact Insurance answers 2 million claim calls per year within 20 seconds.

So instead of hearing this lovely track, you'll hear this in seconds. Hello, Intact Insurance. Thank you.