Life Uncut - How do you like your eggs? Frozen or fertilised? TALKING FERTILITY

Episode Date: November 16, 2020

We are so excited about today’s episode Lifers!!We have the ridiculously qualified and ridiculously lovely Dr Cheryl Phua in to chat all things fertility!!Cheryl works at Genea - a world leading fertility clinic, and specialises in infertility and reproductive endocrinology (CREI), including female and male factor infertility, reproductive endocrinology, adolescent gynaecology, andrology and menopause management and is very active in the research department (whilst we were interviewing Cheryl she was also on call to deliver babies, so there’s not much this woman can’t do in the world of fertility!) There is something for every age and stage of life in this episode as we talk IVF, egg freezing, costs, contraception, infertility, endometriosis, PCOS (polycystic ovary syndrome) and more. We learnt so much and we really think you will too. We want you to know that you are not alone no matter where you are in your journey and that help is not inaccessible!! If you know someone who may benefit from this episode (let’s be real, we feel like all women can) send it their way and share us in your stories!! We love seeing that and this is an important one!A big thank you to today’s sponsor @geneafertility - leading the way in fertility advances for 30 years!They are helping us to get the fertility word out! If you need any help in any of the above or anything that we spoke out throughout the episode you can find out more by going to https://www.genea.com.au/fertility-collective/making-babiesWe hope you get as much out of this as we did!Ps. Please take two quick seconds to vote for us in the podcast awards because we would love to win (obvs) we will love you for it and it will make all those midnight records in our pyjamas on no sleep worth it! Just CLICK HERE type in  Life Uncut as your vote then go to your email to confirm it! That’s it!!Hit 5 stars, subscribe and share the love, because, well, we love love xSee omnystudio.com/listener for privacy information.

Hey guys and welcome back to another episode of Life Uncut. I'm Brittany and I'm Laura and welcome back. Welcome back. How many times can we say welcome in the first couple of second no but guys we did actually miss the ask uncut last thursday but that was because we had some exciting news we've been doing a few episodes with kiss fm on radio so we actually had to do a live ask uncut i know we did you dirty i'm sorry about that but also if you haven't heard we did chuck up a very quick bonus episode of the little cuttings which were from our radio stint with kiss fm so if you haven't had a chance to go and listen to that yet it's just a little sweetener it won't take you long and that was us live on radio it was very weird it was very fun um it was really

awesome to be able to go and do what we do on the podcast on radio however I'm here for this guys I'm I love podcasting we're not going anywhere don't worry it makes it slightly harder I don't know how you felt Laura but it's like sometimes Laura and I were sitting here and we sometimes we're in like a bit hyperactive and we say too much and we go too far and we think it's hilarious but then we're like don't worry we'll just cut that I can't believe you said that we'll cut that And there's a whole nother aspect when you're live on radio, because you've got to be conscious that whatever you say, it's out there. Oh, and also like when we record this, like you guys are so aware, we tell you every week,

like when it's just Britt and I sitting in this bedroom, like we just shoot the shit. It's so fine. Fully with full knowledge that like I will edit it and I will save us from our own embarrassment. There is no savior when it's live on air. No, sorry. So there's us completely unfiltered. But yeah, we had such a good time. we did it with Mitch Turi who's usually on Mitch to Midnight on Kiss FM so we just got to kind of

hijack his show for an hour. We have a really really exciting episode coming up today so we are going to keep our intro short I will tell you quickly what it's about before we jump into it we have gotten so many questions over the past year about fertility about baby making about contraceptions about egg freezing everything you can think of and it's actually something I have been super interested about and I've been trying to research it myself over the past year and that is fertility and egg freezing so we decided to get a specialist in she's an amazing woman I'm going to introduce her later but it's really exciting it's a really big episode and I reckon it's one of our favorite episodes we've done absolutely I mean we did the contraception

episode so long ago and then we talked on that episode if you haven't listened to it yet go back talking contraception we talked about egg freezing very like very superficial and very surface level and we wanted to do this episode but do it justice and get someone on who is so incredibly experienced to be able to answer all of the nitty-gritty questions that we've had and also like you know it's almost like this thing like oh like I'll just freeze my eggs in the future it's something that like every woman says at some point if they think oh I'll just like worry about that later down the track but no one really knows what that involves and so we do have like the most special of specialists coming on to explain all of the ins and outs and all this so

I'm really really proud of this episode it's going to be great which is why we decided we would keep this intro nice and short and sharp but we do have an accidentally unfiltered for you only the one which comes from Brittany here we go hit me okay it doesn't come from me it's not mine but I did find it I just want to preempt that happened to a friend you're like this was not me I did not get a guy's dick stuck in a door I promise I actually really need to reiterate this definitely was not me. Okay. So I have a casual hookup friend who comes over for a little bit of cheeky afternoon fun here and there. So he came over last week. It was a great afternoon. Then I had a crazy weekend and didn't get a chance to clean my room properly aside from a quick change

of sheets. Fast forward to Sunday evening. I'm on a really, really great first date. We've been out all day and it's now turning into dinner. I told him I just needed to run home to get changed quickly out of my active wear before going to dinner and then he was welcome to come home if he liked we were sitting in my room chatting and i grabbed my clothes to go and get changed in the bathroom i'm so i'm so worried already how filthy was this girl's bedroom when i noticed that not only were there still two wine glasses next to my bed but my friend with benefit had left the condom wrapper and the condom sitting there as well for how many days how do you sleep with a Use condom next to your bed.

How many days? Like, I understand a house being messy, girlfriend, but not knowing that there's a condom next to your bed. That stuff smells. Smells like chlorine. But also, it would have been bad enough with the two wine glasses next to the bed. Like, that is a telltale sign.

You're not, like, you're not double parked. You're not doing that on your own. Like, that is a big enough red flag. If I had gone to someone's house on a date and they had two glasses next to their bed of red wine and this is 5 p.m. in the afternoon, I'd be like, what did you do all weekend? Do you know what, though? the question would be were the two glasses on the same side or were they on separate sides

because if they're on separate sides and then I think that's a telltale sign that you're in bed drinking wine with someone but if then they're on the same side you could just be an alcoholic who always sleeps on the left-hand side of the bed Laura's got five wine glasses on a bedside table and like there's a few empty glasses like next to my bed right now or water mind you but there hasn't been five people sleeping in my bed that has actually happened to me before with the wine glasses i live alone and it has happened before where i i wasn't on a date i just had a girlfriend over with wine glasses didn't clean them didn't put them away then i brought a date over and i could see him looking at the wine glasses looking at me being like a bit uncomfortable and i just

had to be like look dude like it wasn't a guy he's like it's okay if it was and i was like well i know it's okay if it was but it also it also wasn't but you're like but even if it was i'm gonna say that it wasn't all of this is uncomfortable now i'm not actually gonna tell you the truth okay so have you ever found something in someone your dating's room that really fucking didn't belong there like underwear a bra a singlet something that you were like let's talk about how this item of clothing or this thing arrived here yeah i found my sociopath ex had a whole wardrobe of his partner's clothing and he's like oh oh i was like what is this whole wardrobe of clothing that i have found he's like oh she just left them there i need to send them back to her brit the more that

you tell me about this story the more outrageous it gets if anyone hasn't listened to episode number three we refer to it all the time but it's um so I dated a sociopath and that's where Brit tells the full story about how she dated a guy with a double life for two years just for anybody who's new to the podcast who hasn't heard it I still so vividly remember and I kick myself for this now because I ended up staying with the guy for almost two years of course you did well no because I you know I this is the one I always talk about as well the red flag guy you know my my very failed relationship um I remember like I'd been at his house all week and then I was at his house like on the weekend and just randomly there was like another chick's underwear in his

clothing pile and I was like who the fuck are these and he lived with two other guys and he's like oh oh like it must have been like dashes undies whatever anyway so this all unfolded and It must have been my flat mace undies. They're like white lace frill. No, I think he was trying to blame it on Dash as in like it was someone he had picked up. And at the time, it's just so crazy how you make excuses in your own mind for someone else's behavior because you don't want to believe what's right in front of you. So I was like, yeah, like this doesn't seem right. But like, I can't figure out when you would have brought a girl home.

So like it must have been, must have been. Now that I'm older and wiser, I know better. And I know that they were not friends underwear. I love that that took you five years to get to that conclusion. Oh, at least I'm getting over it now, guys. Anyway, anyway, that is enough of us from intro. We know that this is short and sharp and usually we just yabber on for so long. But honestly, this is such a great interview that we really are excited to get into.

And Britt, tell us about Cheryl. Look, the reason I'm so excited about this episode is because there really is something for everyone in this episode. It doesn't matter what stage of life you're at. it doesn't matter what age you are whether you're just coming into your early 20s whether you're 30 whether you're 40 whether you were divorced married we talk about endometriosis we talk about polycystic ovary syndrome we talk about the effects of contraception IVF and egg freezing the whole journey there's literally something that is for everyone and that's what really excites me

about this yeah and I think like even on that I was really surprised by the way that the conversation went and like how important it is you know we we talk about this a lot about how like you can live your own life and you don't have to set like you don't have to do things by society's standards and you don't have to stick to a time frame and we we are absolute advocates for that but there is one thing that we cannot escape and that is that as women we do have a biological clock and this episode was never to scare people into like taking action this is not about scaring you into going and freezing your eggs or worrying about oh my god am i ever going to have a baby What if I don't know if I want to have one yet? None of that is what this conversation is about.

What this conversation is about is arming you with the information so that you know what to do and you can make those decisions in five years time, in 10 years time, whenever it is that you feel like it's right for you, but at least you know what your options are. And I think that there's so much power in knowledge and there's so much power in being able to make those decisions early for yourself so they're not taken away from you. So our fertility specialist today is Dr. Cheryl Foie and Dr. Cheryl Foie we found through a clinic that has so much respect in the industry and it's called Jenea. They have clinics all around Australia and they really are the leading specialists in their field. Before I jump in to Cheryl's very very long list of accolades

I just want to say that what an amazing woman. She came to us to interview in person and the whole time she was on call to go and deliver babies like she really does just go above and beyond we were like we need to get this done really fast but anyway no one gave birth in the hour that we had her it was fine i was like laura you're in safe hands if you go early so bear with me because this woman needs a hot second for us to tell you why she's so good at her job so cheryl has a master of reproductive medicine with a subspecialty of fertility and reproductive endocrinology following her completion of subspecialty training in infertility and reproductive endocrinology also known as CREI she studied further in female and male factor

infertility further reproductive endocrinology adolescent gynecology andrology and menopause management so there's literally no one more equipped to answer these questions what we're saying is we pull out the big guns for you guys nothing but the best for our life uncut family oh we went straight to the top and I learned so much I thought I knew a lot about this sort of stuff just from reading here and there, but I had no idea. So I'm so excited to introduce you guys to Dr. Cheryl Foy from Jenea Fertility Clinic. And I really, really hope you get something from this interview. Cheryl, I am actually so excited about this episode today because a lot of these questions, sure, we've been getting a lot come from listeners for a long time. It's one of the

most commonly asked things is about, holy shit, I'm in my thirties and I don't have kids. What does this mean what do I do but on a personal level for me I have had these questions for a long time I'm 33 all the audience know I've been single for a very long time I've had a bit of a rough trot kids have been on my radar but but at the moment I can't see how that would happen with someone because I'm the most single person you've ever met so I am so excited to have you and quiz you so thank you so much for coming today oh thanks ladies thank you so much for having me I hope I can try and answer some of your questions but I think it's a really good topic to chat about because your listeners like you know everybody's at a different time point of their

life it's just good to have information about these things because I think it's still quite a subject that most people don't speak about yeah 100% and when we we actually did an episode quite a while ago around contraception and that was kind of where this conversation around egg freezing and fertility and IVF came up as a point of real sort of investigation conversation because people were like oh yeah we've all heard about egg freezing but what does that even mean and what does that even entail and at what age so we're going to unpack all of that which I'm really excited about as well especially for Britt. We'll look after you Britt don't worry we'll try we'll try our best. But just firstly if you can walk me through a little bit about tell me about yourself

about what you studied and about why this was a focus of interest for you. So I studied medicine in Sydney Uni and then did training in Sydney and then completed my training actually in obstetrics and gynecology and then decided that I really really enjoyed the sort of fertility aspect to it so did further subspecialty training and sort of got these extra letters after my name as most doctors sort of tried to attain so they're called CREI it just means that we did extra exams why I really don't know so basically it's extra three years of fertility training so I actually did an undergraduate degree before going into medicine and that was in biomedical engineering and so because of that I like the mesh of the technology and medicine and I sort of liked that it was

women's health focused and things and I actually now work at the public hospital RPA as well as partner with janea because i believe that sort of science and technology in the ivf setting is really important i actually when i was writing this and looking up the questions and thinking of the best things to ask you i said to laura holy shit i was like have you seen how much i said this doctor's legit have you seen how much she studied i was like she's reproductive endocrinology she's gynecology andrology menopause management i was like i don't even know what half of these words are but she knows it i was like don't worry we get the real experts on this podcast guys at janea what do you guys find is the most common reason people come to see you so what's the most

common i guess issue that people have with their fertility there's a whole range of things but it's quite interesting to say sort of depending on sort of your patient population where you see patients and sort of what um sort of i guess it's a bit also more about what patients seek out in their own doctor because i think in terms of fertility and talking about anything from even before patients are sort of females couples are trying to fall pregnant they see you from way in the beginning of their journey all the way through to the end where they have been tried for 10 years,

can't fall pregnant and now they're sort of at the end of their 10 trying to find help and things. So from that perspective, we see all types of patients coming through. More and more now, because I do work in the city, I do get a lot of women coming to see me

who are trying to preserve their fertility and take charge and control of their own sort of fertility options because they may have focused on their work, on studies, finding a house maybe in Sydney's real estate market um and sort of left things a bit late and sort of they realize now and they're sort of more and more in the media egg freezing sort of fertility preservation even if it is with a

partner etc all these other options are actually quite legitimate so quite easy to discuss with my patients and i think that the most important thing is knowledge base and empowering them to take charge of their own fertility well we put some questions out actually to our community to ask like what are the most common questions that people have and like the number one by far question that we got hit with was at what age are we supposed to start caring about this like as women at what age do you really need to think about well fertility is something that I should be conscious of I think it's really interesting because this is what I say to my patients in rooms I just said this yesterday when I was sort of consulting all I remember from high school was

not to fall pregnant yes contraception was number one don't fall pregnant you know it's the worst thing that could happen to you maybe and like you know go to school etc but no one tells you that there's a finite, especially as a female, no one tells you there's a finite time for fertility. And I think that's really important to sort of conceptualize. As women, we're born with as many eggs as we have in our ovaries. And unfortunately, the number and the quality go down as we age. So 35 to 37 is when it starts to go down. And after that, it's a bit of an exponential decline in quality. And the things like troubles falling pregnant, increased miscarriage rates, and difficulties sort of with success even from IVF it can't really overcome the age-related decline

and so that's why it's really important to sort of be aware that female age is actually the strongest indicator. So 35 is pretty much the magic number for you guys is it is that the number that you say I know it's different for everyone but is that the number that generally the population need to start to think well I probably need to take steps now to look at. I think that that's definitely the time where you should start to chat either with your girlfriends your family your GP But even running up to that, there are many, many other reasons why your fertility might be impacted. Nowadays, and one of my sort of area of interest

is what's called fertility preservation. And that in itself is for women. Younger women are nowadays being diagnosed with things like cancers, leukemias, or even breast cancers at a younger and younger age now because technology has moved sort of quite speedily along. And these women, if they're going to have treatment, for example, like chemotherapy, or if they've got an ovarian tumor, a tumor on their ovary and it's got to be removed,

then that fertility will be reduced and so these women might have to access treatment or see a fertility specialist a little bit earlier in order to make sure that they've sort of got their bases covered moving forward if that's if you know having a family something they want and this isn't necessarily that like the rate of these sorts of diseases or complications are increasing it's that the technology has gotten better and we're able to identify it earlier correct and we're also able to offer you something that's got a higher chance of helping you achieve a family in the future the technology's just got to that stage where it's actually a lot more reliable and it's just a lot more um she's a lot better now we talk about it a lot on this podcast we talk about timelines and

we talk about you know like as a woman you know you can live your own life and you can like make all these decisions for yourself and people are pushing back marriage later they're choosing occupations they're choosing to have kids out of wedlock or you know the timeline is out the window but there is something that we can't get away from and that biology absolutely can't change it and we can't we can't you know it's an uncomfortable conversation for a lot of people to have and especially so yeah and especially because there's a lot of social stigma around when are you getting married when are you having kids but this we thought was going to be such a wonderfully empowering conversation because there is so much ownership and so much choice in being able to come

forward and go okay I'm going to take control of my fertility now and I'm going to at least know what my options are I agree and I think a lot of women that come to see me a lot of them don't even go on to do any other treatment or pursue anything else but they just needed a chat to discuss what it was what sort of life would be what it means to have an you know their blood tests or the ultrasound results showing this that or the other they just wanted to talk to someone in order to put their mind at ease that yes at this stage in my life i am empowering myself with as much as i can to move forward to optimize the chance that i will be able to have a family if i so choose to in the future and that's why janae also came up with horizon which is a dedicated bespoke egg

freezing clinic only so who looks after women who are freezing their eggs because they choose to every time i ask my patients i've had one uh lady who's 38 come into me the other day and she goes yeah i have two cats so i was just thought my life was over i have two cats you know that's it that's me done and i didn't have to think about it and then her i think her family been pushing her to freeze her eggs for a while she's like no no no i've got the cats i'm happy but then she meets someone and then it tweaks something and she's like no i may want kids i don't really know i've got to see whether or not you know that's going to work out for me etc and so she's sort of exploring options now is she ready to start a family with you know joe blogs is she not is she

going to freeze some eggs so that at least she knows that if she waits a year or two to suss him up cv's ideal to you know contribute some proportion of his dna to her offspring then you know is it is it the right sort of person for her then she's still got sort of eggs that are frozen at a younger age because what happens with egg freezing is that technology is that it's snap frozen in time which means that success rates from pregnancies is based on the age of the egg so did you bring your freezing kit here now because i feel like we could duck into the bedroom and freeze to make britney's like i do not want to waste another day 33 let's get this on the way you've got a kitchen i've got a freezer i've got some ice in there i don't know what you

need um no i love this it's about it's literally about sure maybe women aren't ready now but it's about giving you the option down the track to be ready maybe she's not your 38 year old client maybe she's not ready right now but when she's 40 her eggs I imagine they decrease the quality decreases exponentially at that age very much so but I guess for me a question that I have is okay so I'm single I'm 33 I'm not trying to have a baby so I have some friends for example that have been trying to have children for a little while and it hasn't been happening so then they have taken the step to go and check their fertility I've always been in my mind I'm like okay I'm sure i'm fine when the time comes it'll happen i feel like i don't know what my fertility is going to

be like i don't know how healthy my egg's going to be i don't know if i can even have kids so for me what would i do what's the first step to go and check how healthy my reproductive system is what are my fertility tests that the average joe boy would go and do it's interesting you mentioned that so everybody thinks and everybody's got a friend that got married and then like you know on their honeymoon had in the course one time and they got pregnant the first goal was so easy but when you actually look at the studies it actually suggests that even if you're in your 20s or early 30s there's about 20 to 25 percent chance of pregnancy per month so it's a one in four chance per month and it takes generally couples with no other issues up to a year to

conceive their first child so it's actually not sort of as quick as most people sort of put it out today probably forgot about the other times they were trying to be honest i reckon but from that perspective what happens is we know that as we get older the chance of falling pregnant by herself if everything else was normal goes down so that by the time you're about 40 that's about five to ten percent per month that's to do with egg quality x a whole gamut of other reasons potentially what you can do to think about options moving forward is to consider things like the blood test that you can do and one of them is called an amh level to look at what's called your egg count or ovarian reserve and then an ultrasound to check the follicle size and again

that looks to see whether or not there's a normal amount turning over, et cetera. But you have to bear in mind that there's a lot of things that could impact these results. So being on the pill for a long period of time, for example, can artificially suppress it by about 30%. So that's not to say that it's gotten rid of your eggs,

not at all, but when you stop it, it just goes back up again. So it's important to know these things because back in the day, the only way we could test for people's sort of egg count number or variant reserve was a good old ultrasound internally. So a little sonographer, like you know,

but stands there and measures and counts every little follicle. Now there's a blood test called an AMH level or anti-mullerian hormone and that can also correlate with an egg count but that more and more so seems to be impacted by the pill use and a couple of other things. So this was a question we got quite a bit in regards to pill use and I think that there is a lot of misinformation around the pill and what the pill can do to fertility

and I mean the biggest question, the biggest concern that came were from people who have been on the pill for a really long time and they're worried that being on the pill could directly impact their fertility and their ability to be pregnant in the future. Is that the case or do you see it's kind of the other way around? It's probably the other way around. Most of the time the pill would not directly affect women's fertility moving forward in the future. What people go on the pill for though is usually the reason why women might then have troubles achieving a pregnancy in the future. Most commonly you go on it because you've got painful periods or irregular periods. Now painful periods

could be a sign of endometriosis, which is when you've got abnormal deposits of sort of tissue that normally lines the lining of your womb, surrounding the cling wrap that surrounds your organs in your belly. Or if you've got irregular periods, that could be normal when you're sort of,

you know, in your teenage years. Or if it continues on, it could be a sign of what's called polycystic ovarian syndrome, where you just have a lot, a lot of sort of high levels or an imbalance of your brain's natural hormones, which makes your cycle irregular.

And being on the pill would normalize that. usually clears up the acne as well as some people have excess hair and things and that seems to help that so it's almost like the pill masks what the issue is and you're not actually dealing with you're dealing with the symptoms you're masking the symptoms yeah you've probably treat the pill is a symptomatic sort of so it sort of treats the symptoms that women have but underlying it all what was the cause of that and that's usually the reason why people may have trouble falling pregnant and then it's like you hit you're 33 or you're 34 or whenever it is that you decide you want to have children and instead of it being this easy road to fertility and to

getting pregnant you're like oh holy shit here are all these things i didn't know that i could have dealt with when i was 18 and six months later i still haven't had a period so if you don't have a period presumably you're not releasing an egg and if an egg isn't being released then there's really no chance of pregnancy because how a pregnancy happens is that an egg and a sperm have to meet in the fallopian tube the egg and a sperm then travels back down the fallopian tube for about five days and lands in the lining of the womb so you imagine the womb is a little sort of nice little incubator for the embryo if the embryo is genetically normal and it's got the right energy it should send the correct signals to the womb and back and forth and then it should

implant but therein lies the issue even if you're young fit and healthy with no other issue medical problem or any other factor that's preventing pregnancy from happening it's still only a 25% chance so someone like me i've been on the pill since i was 16 ish um pretty much the whole time and i'm 33 now would you give would you say that i should probably look at going off it and giving my body a break correct and then test do all the tests one three months three to six months later for the pill effect to wash up and then you'll know where you stand and people sort of when my patients seem they're like oh my goodness my it counts one doesn't mean only one egg left it's like a golden egg if you don't have sex next month you're in big trouble it's sort of a marker

of you feel you're in a normal range it's like a graph with women's age on the sort of one axis and the number on the other axis it sort of looks at your egg count for your age so we know that they've looked at studies looking at sort of lots of women and you can have a low normal or high this does not reflect the quality nor does it tell you how likely you are to fall pregnant so you know in three months i'm going to be calling you up i'm like cheryl you want me to just write you the form right now you can just do it tomorrow i actually do so i i yeah i work in radiology so i'm constantly checking my follicles they're on ultrasound they're fine i'm always like i do but it's you're going to end up causing yourself problems are you sure i mean by constantly i mean like

every few years like i mean like every shift like on my break really like you still will tell this on my break it's not actually no it's one of those things that over the years like i'll go into my colleague and i'll be like hey can you just check the old follicle count and then they'll be like britney your ovaries are fine there's no cysts your follicle's fine like like you're fine but i've never done a blood test and i've never done anything further so i feel like i feel very inspired already i'm gonna go off the pill and wait three months and then i'm gonna get my blood test yeah and also don't forget for the couples that are listening in as well new south world's health is trying to sort of encourage couples to be more aware of fertility and its

impact because the problem is the definition of infertility is different depending on how old the female is so women greater than 35 years old it's six months of trying with regular unprotected intercourse and not achieving a pregnancy if you're less than 35 like yourself but it's 12 months so it can take quite a while because people say oh yeah I know it'll happen it'll happen by the time you sort of try to see your GP or somebody else it might time might have gotten away from you and I don't see this not uncommonly sort of at RPA and in my rooms in the city that people sort of come and say oh yeah you know we tried and then we sort of just time got away and before you know it but she's 41. We talk a lot about women's fertility and we talk a lot about

that being the issue why someone may be struggling to fall pregnant and but we don't talk a lot about men and we don't yes sort of like that's never really a focus how often do you see it when you have a couple that presents and it's actually the woman's egg counts fine she is all great ready to go and old mate's got some problems going on not up to 10 to 30 depending on the literature in which you read can be male factor and a lot of times it's a lot of little things that add up that then draw out the time to achieving a pregnancy so obviously if a man has no sperm there is a zero percent chance of falling pregnant but usually what happens is that he's got sperm that doesn't move as well that's not as much in the ejaculate as it should have

for example or he's got you know lumps and bumps where it shouldn't be and that's impacting the quality of the sperm there might be sexual dysfunction and erectile dysfunction as a cause of male infertility or genetic issues which means that he can't produce sperm etc. I had a friend who told me that his swimmers were going backwards he had a test done and they were swimming the wrong way is that a thing it was like yeah the movement can be abnormal so that when they look at a sort of a sperm test they look at sort of main things how much there is how they're moving and what they look like under the microscope his are just going to his were like i do not want to have a baby that was swimming in the opposite direction to the egg

it's like me in the dating world in the dating world you've got at least you're in the pool right i'm out there giving it a crack no but cheryl another question in relation to like the male infertility and the problems with sperm and things like that i guess as well female does things like um diet drinking alcohol um smoking all these lifestyle factors exercise how healthy you are does it all affect it does your fertility yes it does it can and it also impacts pregnancy once you do get pregnant as well so it can they've done studies to show that the mediterranean diet appears to be good for fertility and that's just like feta and olives isn't it it's like pasta lots of fresh veggies all these things the pasta but not too much etc but also smoking we know can

impact the quality of the sperm and high levels of alcohol intake as well can impact sort of time to falling pregnant if everything else was normal and sperm quality there's also some theories about egg quality but by and large it's female age still well there you go ladies and gentlemen if your husband or boyfriend is a little slob on the lounge drinking his alcohol you can give him this to listen to and he can get up and get moving or he can just go and do a sperm test to prove to him that is impacting the sperm count and that will help him maybe we wanted to get into talking about IVF and I thought we'd hit IVF and then we'd talk about sort of egg freezing it's two separate things so just to kind of get into for anyone who has heard of IVF doesn't actually know what it is

doesn't know what it entails talk me through what that is and what it means and what the process is if somebody's considering it before we go into that all right just let you know I forgot to mention when we were talking about testing for fertility the New South Wales government's actually trying to encourage more couples to test for their fertility and sort of to seek an opinion or seek help sooner rather than later so there's a 500 rebate now that's being given out to couples who are assessing their fertility or to people assessing their fertility so going back when people say you know when should i seek help when do i need to speak to someone anytime that suits you because everybody is at a different time point and a different point of their journey

i was going to say that that was a question we had in terms of everything ivf egg freezing consultations the whole process what sort of um health rebates and government support is that is is there like a you have to be with your health company for 12 months before you're allowed to go on that process so there's a medicare rebate for most things a proportion of the amount and then there's a health fund rebate if you're a bit covered and this is for each process so if you want to go and just have your fertility check there's a medicare rebate for that and then obviously there's different ones that apply for ivf and then there's also different ones that apply for egg freezing which we can kind of get into those as well yeah what is IVF and why would

somebody choose to do it so IVF is sort of what's called in vitro fertilization where we basically try to mimic the environment of your fallopian tube in the lab so it was sort of set up sort of 40 years ago initially for women who had lost both of their fallopian tubes and so therefore had no other option of getting pregnant because like you sort of like I mentioned it was the egg and the sperm having to meet in the tube, floating down the tube for five days and then landing into the lining of the womb. But if a woman, I suppose back in the 70s, if her tubes were removed for a reason, then there's no way that the sperm and egg could meet in order to form a baby. And so what they did was they over, we override the brain hormones and this involves injections, which most people

are sort of a little bit worried about. What the injections do is that we try to get as many eggs as possible that's safe to grow in a woman's ovaries that month by encouraging and overriding the brain hormones to select for just one of the strongest eggs to come through with ovulation. From then, what happens is that we'll monitor that that's happening with blood tests with hormone levels and ultrasounds internally to measure the fluid sex or the follicle sizes. Once they're big and juicy, then the patient, women will look for what's called an egg collection. And that's generally done in a day surgery. You've got the option of having it done under a local anesthetic or under a general with an anesthetic doctor present. Bear in mind, we can

never see the size. So a lot of women were sort of worried. They're like, oh, we had like, you know, 20 follicles. How come I only had five eggs? You need to remember that the egg is the size of a hair follicle. So what we're going on is actually surrogate markers, like the size of the fluid sacs and hormone levels to indicate to us whether or not there'll be eggs that we can retrieve. On the day of the egg collection, my patients come into the day surgery. So I'm there doing everything i put it's done all done through ultrasound guidance so an ultrasound goes in the vagina with a small needle attached and we drain all the fluid out it then goes into the test a test tube which is where the monica test tube baby comes from and the scientist is with

me there in the lab she's got a little incubator with a microscope attached and she basically pours out the fluid to look for the eggs for us i have so i'm i'm like you should you guys should see laura and i'm on the edge of our seats i am just i'm so enthralled in this and i have so many questions and i'm in my head i'm like where do i even begin so okay let's just so that's still the egg collection part but we can pause there and then we can revisit again yeah let's pause and then we'll just ask we'll go through that so when we go back to the hormones what is the time period we're talking about over from when you give the fertility specialist you'll find out very soon like we're obsessed with periods in the fertility world have you had them how often you get them how

long they last for what they look like are they heavy but moving forward so what happens is with the period we normally start with a period and most women are on what's called a short cycle where you start hormone injections on the second or third day of your period on average these injections go for about 10 to 14 days and that's the general amount of time it takes for the follicles to grow to a size that's that we think that should be eggs in most of them okay and is this just they take these injections home they put them in their tummy like it's like a diabetes kind of thing it's like a diabetes thing it's a it looks a bit like an epi pen and it's sort of very very fine needles even finer than what people take your blood test with because it's like very

small just to administer the drug and when somebody goes to have their eggs harvested is that even the right thing to say collected collected brutal so okay get some free range eggs harvested um when someone goes and gets their eggs collected yes what is the ideal number of eggs if you're like this is this is something that we would ideally want perfect case scenario this is the amount It's tricky because everybody's egg count or egg reserve is different. So depending on someone with a low or high egg reserve will be how much you would think your patient would get. And that's the individualized care that sort of we tend to provide

as fertility doctors. From that perspective, though, the study suggests that from an IVF population, 8 to 15 eggs seems to be a good window, a good number to get to optimize the chance of pregnancy. And if you get 8 to 15 eggs, how many then are implanted, fertilized eggs would be implanted into someone? because we're only at the test tube yeah you've just jumped ahead like 10 steps i was like that is a lot of babies no very for someone who is currently pregnant my biggest fear is finding

out there's two in there's 15 in there okay no so we're they're in the test tube and we're looking yeah so collect the eggs are in the test tube and then sort of partner goes off and collects a sperm sample in the lab usually a lot easier for men because all they need to do is ejaculate into a little container they don't have trouble with no needles into their testicles usually and no need to have any hormones generally speaking and then it's up to the domain of the scientists and that's why it's sort of important sort of to pick wisely and at janea we use sort of an incubator that's got a time-lapse imaging that's the only one in australia that we use it's called jerry what happens is the embryologist at janea will then take the sperm and the eggs and put them

together and incubate them in the lab for five days so they do multiple all together at once all the eggs will be put together with the sperm on just let them have a party depends if the sperm counts normal generally speaking that's the mode of fertilization and then from then it's grown in our incubator called to jerry and we grow them in their undisturbed in culture for five days so jerry six days depending five to six days jerry's a pimp jerry's having a mass orgy with all the eggs in the sperm he's the best party planner in sydney i wouldn't go into a bar i wouldn't trust a jerry but like maybe if it was like a brad or an austin or something like you would trust a brad over a jerry and austin i'd trust an austin but that's so american of me

i was like jerry seinfeld i don't know how i feel about this but anyway exactly put my kids in his petri dish hey okay so we've we've got jerry he's having his wild orgy party and what happens next so from then we normally sort of try to mimic the environment in which is the fallopian tube of the body so it's like we're trying to say that this is going to be taking looking after your embryos from its first inception. After that, usually five days later, you'll come back and they will pop the embryo,

one only, generally speaking, back into the lining of the womb. And that's done through the cervix, a little bit like a pap smear. After us, as a fertility doctor, I always tell my patients again, after poking your ovaries with a needle five days ago,

you then come back five days later, all else being okay. And we then look at the embryos then in the lab, see what we got. And we will put one back in through into the lining of the womb and then it's up to the embryo to find a comfy spot and it's a bit like a pap smear so it's like a speculum goes in a bit of uncomfortable at the time a little plastic catheter passes through the neck of the womb and right into the lining of the

womb in order for the embryo to be placed gently in there by the scientist and so once you've got let's just say four embryos yes how do you or is there a way that you pick who's the strongest who's the most healthiest who's got the most likelihood of actually taking so that's the benefit of having

a system like Jerry is that the embryologists are constantly watching it and the doctors can also go in look at your patient's individual incubator and actually play

because it's a video record it's time-lapse imaging so we've gone in and we've looked at the embryos and seen how they develop not just on the fifth day but I want to see

its journey and to see whether or not it's doing the right things it's achieving its right milestones at certain time points in its little development of a five day old

what's called a blastocyst or a five-day-old embryo. And from that perspective, what happens then, we can see, has it done the right things at each time point or has it just sort of

done some dodgy thing in the middle and got to the fifth day and still looked really nice. And combined with that, they've also got an app called Grow that allows our patients

to visualize their own embryos growing in their little incubator. So it takes, because it's being recorded with a time lapse, it takes pictures at certain point time frames and loads it up into a patient portal is what i'm told and the patients log into their own portal

and they're able to see themselves so they can visualize their own embryo and i've got couples do this all the time they just put bets on which one it is it's going to make it to the day five stage and say it was this number four the wildest 2020 moment that we're like i am in the future right now now we're betting on our embryos it was very sweet but yes it's people sort of because it gives them it makes them feel more involved in this early part because a lot of the times i think traditionally it used to just be like that's embryology to take it out look at it put it back in take it out look it back put it back into the incubator but now with this sort of new technology that janea's got we sort of can leave it in there and we don't have to worry so much but we still

got the option of visualizing it all the time so i have a couple of questions you said that they only put one egg fertilized egg back in yeah so if i was open to having multiple babies if i was if i wanted to have twins if i was open to having triplets could i have that as an option or is that not something that's not something in australia we've got about more than an 80 single embryo transfer rate one of the highest in the world because we know about the risks of twin pregnancies and multiple pregnancies and so by and large unless there's sort of other factors we tend to put the one embryo back so on that um when you say you know the risk factors with multiple pregnancies are the risk factors with multiple pregnancies that are ivf the same as the risk

factors with multiple pregnancies that are conceived naturally or is the ivf multiple pregnancies do they have higher risk factors similar but there's a higher chance of twinning in an IVF pregnancy already anyway so then if you think about putting two or three in that they tend to do overseas then there's a chance that those could split as well and there's a four percent chance that that one could split into identical twins already so you have like 27 babies and you're probably not what we're looking for here guys yeah so when you are just putting in this one embryo there's still a chance that that can split and have twins anyway yes yeah yikes these are just things i think these are things that you don't really know i think the general population

and the population like twins everybody loves twins are very cute everybody loves twins um sort of you know you've got people who've got twins in the room currently and they are very cute however we know that they are at increased risk in pregnancy for both mother and babies things like cerebral palsy you know problems with the growth and things so all those things need to be taken in consideration and it's a chat to have with the fertility specialist that you're seeing and that's why it's all again very important to have one that you sort of can gel with and things along this journey because it can sometimes be quite a long journey and it's quite emotionally mentally and financially and physically stressful at certain time points and different so people

will always say look so how do i pick a clinic for example it's very hard to know what an individual sort of um criteria is to pick a clinic or a man like yourself but you've got to make sure that it's somebody you feel comfortable with and i think the reason i picked janea because i worked at rpa and i part and chose to pick janea to partner with them for my fertility sort of the aspect of my fertility is because i will look after my patients throughout the whole journey and i do the i manage their cycles i see them in my rooms i do the egg collection and the transfer etc and i sort of you form a relationship and sort of you'll know their history and background a little bit more.

And so that way, I think they're supported a lot more throughout their journey. I also know that the lab is cutting edge in Australia. They do their own research. They build their own machines and use their own media. So that, again, ties into it for myself. I have a question just going back to something you said a little while ago.

And this is probably, as on like the more sort of controversial questioning, I guess, around IVF. It's like, what happens with the other, if you've harvested eight or 15 or whatever number of eggs and you've managed to fertilize a number of them but have only then inserted one yeah and that's taken and it's all happy days yeah what happens with the rest of them so generally speaking on average out of the number of eggs we collect not everything will make it to the day five stage or so what i normally code one four so say we get 10 eggs we normally would get two to three embryos on average at day five and if we put one back and

it works we've got two left if possible and if they're good enough quality they will put be put in the freezer for baby number two when the first cycle didn't work etc and they can be stored there for 10 years according to news like the tissue law so a fertile so you can't not just can freeze your unfertilized eggs you can freeze yes freeze and embryos were where it all started so that's because the embryos are like hundreds of cells and the egg is only sort of one full of water so embryos were where snap freezing first came up sort of started off and because they tolerated it really well so they survived being dunked into liquid nitrogen and taken out really really well eggs they had troubles with for a very very long time up until about five years ago where the

technology caught up and they were able to make about 80 to 90 percent of them now survive the freezing and thawing process because in the egg is full of water it's full of fluid and so ice crystal formation was a problem but now with snap freezing they've sort of overcome that so is it better to be freezing not not better depends on if your circumstances in life that's the problem like yeah it's better to is it better to try and freeze an embryo or an egg what has a higher success rate of if you've got sort of depends on where you are in life in terms of if you're in a relationship and you're wanting to use it in the future because if things change in relationship you're gonna need the other party's consent in which to use frozen embryos eggs if

you freeze are your own to take wherever you want to use however you want so when you freeze an embryo it's like joint custody wow okay so you have to and then if you decide i want to have this inserted into me you know four years down the track and you've broken up your partner has to give written consent or verbal consent or some sort of consent process yes which makes sense it makes total sense but i guess i just never really thought of it like that i mean like the fact that you know that there is this five-day-old embryo that's been snapped frozen in time for four years yes but to think that there is two biological parents that both have to consent to that becoming a child is pretty incredible like there's a lot I'm getting my

head around stuff as we speak but also like don't forget it's quite interesting because quite a lot of couples who come five years ago had IVF to have achieved their first pregnancy then might have achieved subsequent ones themselves but then still had this one or two in the freezer for example but if things haven't then worked out in their life as you know we know things can change at any time and then they're like oh I really really want a sibling or another child but now they're like five now for example if they were 32 when they did it then they might now be 38 39 their chance of success all things being equal would still be higher using the 32 year old embryos but they're stuck because if they can't use them that's a bit

of a tricky situation and so you say well I mean we have been speaking very broadly about you know when couples go through this when couples are ready how many women come in to see you that say I'm single I've decided I want to do this on my own let's do it probably like sort of 60 40 more 60 couples but more and more we're getting women that have sort of ticked off all the boxes in their life career or whatever education or uni they want to go to they've probably bought a house somewhere that they're very very so they like and they're comfortable with and they've realized they've got an extra room or something and they're now ready being responsible adults and responsible individuals

they're not ready to start a family but perhaps due to COVID restrictions or you know difficulties in finding a man or a suitable partner just living in Sydney

correct I'm surprised they found a house but anyway besides the point so because of all of that they actually are coming to see me because they've reached a time point

when they're like I need to figure out what I'm going to do options would be to freeze your eggs second option would be to think of if you wanted to use sperm

from a donor either somebody you knew or from a clinic recruiter donor i have a big question around around sperm and like where do you get like where do you get your supply it comes from the penis laura trust me i know i've been there twice um no but like if you're if you are someone who is single who's wanting to go through this journey by yourself then what are your options for getting a sperm donor not just asking a friend or getting you know someone who is in your immediate circle but like is there a book you can go to do you pick out like a menu like how do i thought before i got into this is it just

like a little thing we just go to like different tabs for like different parts like i'll have the crispy chicken and i will have that dark head man also yeah i'm sure there was a movie like years and years ago and and the like the woman and it was sitting there picking out like oh i want like a you know a eurasian man or i want like i want him to have brown hair and he she picked out the qualities and so i have it in my head that this is what it's still like i don't think it's quite like that unfortunately it's on a netflix show at the moment i've been watching this show have you seen the duchess she's this crazy woman you've seen it yeah she's this crazy woman and um she's like i'm gonna go have a baby and she goes into the clinic and she's literally flicking through

a book of like hot men and it has like a bio about them like i mean are you telling me cheryl that i don't get to go into a restaurant i'm sorry you don't get a restaurant you don't get to pick your height weight size of his biceps no sorry so wait you can't you can't even pick like You can pick certain things and there's certain things, but there isn't a catalog per se like you. Clinics work with different sort of sperm banks and different IVF clinics will have their own partner bank. At Jenea, what we use is we use New South Wales sperm.

So men who've volunteered to donate in New South Wales because it's not, you can't pay somebody to do it in New South Wales because it's against the law. So these are men who have just volunteered to give their sperm for the greater good. Correct. But you need to remember that there's an 8 to 12 month wait for that. Wow.

And it's funny because in New South Wales, the law states that anybody trying to donate sperm, eggs or embryos can only form five families, including their own. Is it so we can stop him breeding down the track? State to state is different. So New South Wales is the strictest and it's five families only.

From that perspective, that blows up the waiting time. In Canberra, there is no wait time because there is no limit. But also there's this massive case that came out in the States of a man who fathered like hundreds of children and then they were worried that the children were going to end up marrying each other and stuff because there was so many kids.

And you wouldn't know. You wouldn't know. No, you wouldn't. You'd be hooking up with a guy and you'd be like, God, we've got similar eyes because you're my brother. Sometimes I look at that and I'm like, God, we look the same. Should we check this? And then how would you know?

You wouldn't know. I'm pretty happy to live in ignorant bliss now, put it that way. Yeah, so okay, so that's in New South Wales. Interesting that Canberra, there's no limit in that way. And in Victoria, it's 10 families. Yikes. it's really interesting how different states have different rules but like sort of all throughout they all go into what's called a donor registry now so it's no longer de-identified per se in that

if if i'm a donor conceived child i can once i turn 18 access to see if i've got any half siblings or anything that were conceived from my same donor sperm for example and is there is there enough data on there to go and find the sibling like you can literally yeah because that was a question that came in actually was if i am one of these children can i go and find out access to donor registry and check with them so they i mean we could speak about this for hours we will have to move on to egg freezing in a minute but there's a few last quick questions i wanted to ask you on ivf basically what is the rate of miscarriage in ivf is it higher in ivf than if it was a natural pregnancy not usually no the rate of miscarriage should still be based on a female age and the

good thing about ivf is we can also opt to test the genetics of the embryo once they reach a certain stage and time point in their journey and that can sometimes reduce the risk of miscarriage two big last questions the first one is Cheryl is price we all want to know it in my head I think in a lot of people's head it's like it's 10 grand a pop 10 20 grand that's what we've always just thought in the public but from go to woe what what are we looking at for an IVF journey so take so the first step is to see a GP for a referral that may or may not cost you something out of pocket taking you right back to the start of the journey and then you generally have to see a fertility specialist

and there's two modes of care here that I'll speak about because I work in the public system at RPA which is a fertility clinic that's covered by Medicare

and you have to get your GP to refer you on there. They will make you a booking and then there's a wait time to see the fertility doctor

and then things happen from there. Privately, you can see a fertility specialist in their rooms and that's got a cost involved with that of which you get

a proportion back from Medicare. The IVF cycle itself is where the main bulk of the costing is at janea it's about depending on the level of coverage that your health fund can cover and depending on what tier you are it's about six to eight grand out of pocket per per site collection cycle including an embryo transfer and is that including the hormones and

that's everything okay it doesn't include the testing of the genetics of the embryo but that's an aside six to eight thousand dollars to be honest is actually a lot less than i thought it was absolutely and I think if you've been someone who's trying for a really long time I mean you know this is something that you want in your life you make more of a sacrifice than that for a car or for a luxury holiday or whatever you know I think that you know it's a reflection of priorities in life I think so I think it's very hard for people to sort of get their head around that as well but the good thing is that which would fresh off the press Janaya is also launching this thing called in this together where if you've done three egg collection cycles and you haven't got a baby

or you haven't gotten pregnant, please check the details on the website. They're launching it on Sunday. The number four and number five egg collection will be at no

out-of-pocket cost. This was going to... Asterix, asterix, asterix. Otherwise, it might kill me but you need to check the details but you need to have also used up your embryos

in the freezer, for example. But three egg collections and we're putting our money where our mouth is to say that we believe that if you haven't got a baby by then, that the next two

should be on no gap because we think that we should help you. Well, I think that that's one of the big like the big fears isn't it like you you go into this and you know we can say oh well six thousand to eight thousand sounds really reasonable but if you have to do this so many times because you aren't feeling that or finding that it's been successful for you then that's when the cost can well and truly outweigh what people can financially be able to afford to

have a baby or you know they're already 50 grand in debt before they've managed to have a baby which is you know a whole nother expense in and of itself so I think the last question I really wanted to ask around IVF is when when do people decide to stop like when is it okay enough's enough and I know that that's a very personal question and that's obviously going to be different for everybody in this journey but as a doctor do you sometimes have to say I don't think we're going to be able to achieve it and I'm recommending that this is time to stop yes yes I do and it generally comes like you mentioned it's a very individual journey everybody has different time points in which they sort of decide that this is it for me I've had a couple just do

it one time she was 40 and she said look we just wanted to do one like well fine you know it didn't work but we're happy we've given it a go and this is our journey stops here and i'm like look that's perfectly fine i'm here to support you if you've got any questions let me know but similarly other people in the same sort of situation can keep going and until there's sort of for example a lack of response to the hormones because you might not produce any more eggs past a certain level if your egg count's very very low or you get past a certain age then that's probably when most specialists would say advise women to stop and after about sort of 43 to 45 I think that's a very very small handful of women that get pregnant with their own eggs because of the quality and

number issue so there is an age limitation where you would say we can't like the eggs are not healthy enough or viable enough for us to be able to even harvest them to go through with the process in the first place or even if you do you can see how you respond in one cycle perhaps some people might do that but then with the caveat that you but there's a very high chance that this is not going to work just one more thing backtracking because we did make a joke about it but i actually don't think we got the answer and i do want to know oh yeah when you're actually if you're doing it on your own and you are looking for donor sperm yes we made the restaurant joke but what information are you actually given to choose your sperm like in realistically do you get to see

pictures or is it just this guy has brown hair and he's caucasian but what are the details that you get you get a medical history you get a full medical history some of the overseas banks are also now doing genetic screening for their donors beforehand you get sort of um statistics and things and some of them will come with like a photo of them when they were a child so you can be like well my kid looks a lot like that guy yeah yeah cute kid i'll take it and you get sort of um baseline characteristics and education family history when his parents passed away for example like things that might be pertinent pertinent for you and for your own child for example if there's a family history of breast cancer you know things like that but also I guess

conversations that you would probably want to have with your child you know that they're going to ask questions especially if they don't have any connection to where that sperm's come from just the questions that we all have about who we are and our identity and and like what what makes us us like I think that that's a really important thing to be able to touch base with with your own parents and to be able to to have that closure as a child and the women that my sorry my brain is ticking the women that come in that can't use their own eggs or anything what are their options are there people like that already have these embryos that are frozen and great that are like you know what i'm not going to use them i'm going to donate the whole embryo to someone

there are women like that and there are some clinics that support embryo donation definitely by and large or women are older so i do see some women 46 or 47 that run out of their own eggs they're in menopause for example that then access a donor egg bank so same thing as donor sperm except these are women generally overseas who've donated eggs to an egg bank who then sort of uses that as a platform to help other women achieve a pregnancy there really are just so many options out there for all these women that are having trouble like if you're out there listening now and you could be in any one of these categories it's nice to know there's an option and there's a clinic and there are people that will support you so i really love that and i think the important

thing is just to have the conversation it's just just to start it off you don't have to have it and then segue into anything straight away but you just have to sort of chat about it to your friends your family or even anybody really and sort of just get the ball rolling just see what your options are if it is something that you may or may not want to explore in the future just moving into egg freezing as well because I really think that that's something that you know I mean IVF is much further down the line and we have a lot of younger listeners who are very interested in like just their fertility in general and I mean we did this conversation came up as well we did a big episode which was around being single in your 30s and so many people were like

well you know what are our options and what do we do so just to unpack egg freezing and what it actually is talk me through how that process happens or is it very similar to the IVF collection it's quite similar to IVF but you're a woman after my own heart because if you ask my friends you will know that I'm on to them about checking for their fertility because it's something that we can't reverse I mentioned way back in the beginning of the podcast that as women our eggs get older and we get less quality and less numbers as we age we can't really reverse that but most of the women i see that come and see me in sort of my rooms about talk about to talk about egg freezing it's basically empowering themselves for their own fertility journey and most of them it's quite

interesting when you talk to them most of them like yeah yeah i'll come back and use it no problems you know it's so great blah blah but the reality is when you look at the big picture of how many people actually come back and use it only about five to ten percent of them do but yet when we go back and interview these women they're like look that was the best thing i ever did because then i didn't have to think about anything anymore i didn't have to settle for you know tom down the street you know because i felt that my biological clock was ticking i knew that i'd done the best i could at time point x in order to optimize my fertility so that if i did want a child in the future and i'm not quite sure whether i do or not then i've got the option moving forward yeah tom

down the street's probably a player so it's probably good that she didn't settle for him I think that that's that's really interesting when you said that because it's something that I think about I I'm often thinking now oh my god do I am I gonna run out of time and my eggs not gonna be healthy but I imagine how much real relief you would have had if you're 25 and you're like you know what I'm just gonna put them in there now and then I don't have to think about it for the next 10 years or even if you're 25 30 32 and you go and get tested and you're like actually I'm fine for another seven years like I'm I don't need to worry about this right this second and maybe in three years time I'll consider egg freezing and then who knows in that three

years you might have met the love of your life and it all happened naturally so I think just you know being empowered with knowledge it's exactly right that in itself puts people's minds at ease and you know whether you go down the the path of having egg freezing or whatever it is that you choose to do you have the choice yes I really think so and I think it's about knowledge and about knowing our own fertility and the fact that our eggs are finite I think that sort of needs to all like i mentioned again like all i remember was contraception all these other things sort of came and when you see celebrities hollywood celebrities getting pregnant in their 50s you think that ivf can overcome that but by and large potentially a

lot of them did use younger donor eggs so that's the other thing to be aware of the process of egg freezing sort of is very similar to the ivf process so same thing obsessed with periods which means that once you get a period we do some blood tests to make sure that everything's okay for you to start the same hormone injections as someone who's undergoing IVF would have. That's to override your brain signals to grow, again, the follicles or the fluid sacs in your ovaries.

We collect them, but instead of putting them together with sperm in the lab, we use what's called Gavi technology to automatically snap-freeze them in time. So from the eggs that we will retrieve, that afternoon, my scientists in the lab

will then sort of remove some of the cells on the outside to check if the eggs are suitable to be frozen. mature eggs will be suitable to be frozen from that perspective it then gets put into what's called gavi which is a generic sort of first where we automate the freezing process so it's taken out of the hands of sort of embryologists which says variability from person to person frozen in time and it's put in liquid nitrogen for however long you for 10 years maximum but however if they come

back and use it that was my question my next question so 10 years is like your max storage right and what are the costs like what's the storage share interesting people come and they talk to me and so always talk about cost because it's not medicare covered unless you're having treatment that can impact your fertility as a female for example removing an ovary for cancer chemotherapy etc so by and large women that come to see me for what's termed social egg freezing there is no medicare item number for this and so there's no medicare rebate and most most health funds won't cover it because there isn't a medicare rebate because of that sort of we've sort of dropped it down one of the most affordable egg freezing clinics in australia and it's about

four and a half grand for the first egg freezing cycle and it's a little bit less subsequent ones in a year people worry tend to worry a lot about the ongoing costs it's actually a bit like a gym membership it's about 44 a month at the moment just for the ongoing yeah so so i was very surprised myself that was actually not as sort of bad as i thought it would be that the actual outset is the cost of the cycle and the drugs that are most important that's the biggest um stressor usually for my patients but the ongoing cost is people just write it off 44 a month and in covid times just put that to the storage i guess instead of your gym membership if you don't want to get well also i think if you put that into perspective if you if you buy a coffee a day and you're an almond

milk drinker with an extra shot that's the same that's literally one week's worth of coffee is your month's storage for your eggs yeah i think i think once you put something into perspective all of a sudden things don't seem so daunting either yeah um cheryl are there any contraindications for ivf or egg freezing like thyroid issues or are there any medical issues that people would have that would make them not suitable for this not usually but it's something that you sort of have to speak to your fertility specialist about some very significant conditions like very serious heart problems or kidney problems and things that may preclude someone from even falling pregnant for example might put women at higher risk if they're going through the egg collection cycle

when your hormones rise quite high during the stimulation time the stimulation of your follicles to grow your hormone levels rise sort of to five to ten times potentially what it normally does in your normal period so i would warn whoever else is around the house at the time so i hope you live alone brin brad and austin can you keep it down back there it's a bit like having a period on steroids it can be some people breeze through it some people respond quite poorly and they get quite a lot of breast tenderness and bloating, can be a bit moody and sort of can be sort of a little bit more uncomfortable with the process. But the whole process takes a month, roughly two weeks of injections and then egg collection. And then with an egg freezing cycle, your period will

come in about 10 days after that. So by the time your period comes that cycle, you can decide to go back on the pill, put your Mirena back in, go back to life. And I'm guessing it's very similar in that ivf where you can't control exactly how many eggs you're going to get and so maybe for some people they may get an optimal amount in one go and then for other people they might have to have several several months that's exactly right hit the nail on the head exactly right and it will depend a lot about how you respond to the medication but by and large what your income number is so and i'm just going to think about this back to cost for a second so for each time that you need to go through that process that's a four thousand dollar outlay cost and then whatever

you're able to collect not harvest you then can then that goes into your like monthly subscription fee correct perfect correct you got to add on the medication cost on top of that as well and how long would somebody have to have been off the pill for to before they came in some people just don't want to be off it for too long because they're on the pill for painful periods and depending on what the results are and things sort of there's always a discussion with the patients whether or not you want to stop the pill and use that bleed to cycle on that's fine some people if the egg count is very very low on the pill there's some thoughts or some theories that it might be better to go off the pill for a bit to see whether or not the response can be better and some people

are happy to do that but again it's a very individualized process because some people like look it's COVID my work is getting me back in the office next year I've just got this window to do it I just want to bang it out fine. I have a question around what the success rate is for someone who has frozen their eggs and so like you've gone through the process of freezing the eggs, thawing the eggs, fertilizing the eggs, putting them back in, that in comparison to a naturally conceived baby or a naturally conceived embryo, is it like, are you looking at similar success rates of it actually implanting as per normal? So generally speaking, the main time in which we sort of tend to lose frozen eggs is from the freezing thawing out process. So if we're able

to freeze 10 eggs, we sort of generally code an 80 to 85% sort of thawing rate, survival rate of these eggs from the freezer so we end up with say eight eggs in which case if they survive the thawing process they behave exactly the same as the age in which they were frozen which means that the same deal where one in four of them should make it to the embryo stage on day five with IVF and your chance of success again is based on the age in which the eggs were harvested or collected and IVF success rates are based on that and the reason people tend to say oh look you know don't listen to them egg freezing is just crazy it's like two to five percent chance of pregnancy per egg you know why would you do it it's a waste of money that's because egg freezing is such a new

area there's only been around for not as long way shorter than IVF so we've got all this data and in Australia and New Zealand we've got to give our data sets to these people in New South Wales uni that collect all of our success rates data and how many women go through what the reason was for IVF, what the success rates are. We know that there was about 18% increase after COVID's restrictions lifted for IVF itself. And because of the number of women accessing fertility treatment, there was, I think, 80,000 or something, this past one, which just got published in September. They know that if you are 35, you're having IVF in Australia, your chance of success is this. Versus eggs, we don't even have that data yet in Australia.

and I guess as well like when you say your success of having IVF is whatever that figure is is that higher than conceiving naturally or is it the same as it can be and especially at 35 is definitely higher than trying naturally month to month and most women that come and see me the thing that's stuck in my mind from one of my patients was that I know Cheryl that it isn't of an insurance against pregnancy I know that there is no guarantee of pregnancy from these eggs are frozen but it's an insurance against regret and to me that struck home because I'm like that's exactly right because if you're five years if you're now 30 if you came to me at 35 and you're now 41 having met mr right and you saw me five years ago and did nothing then you always think what if and it's a what

ifs of the world that sometimes it's difficult for us to live with i think 100 i guess the real question now is after talking to me for the last hour and looking at me in the eyes would you be able to look at my vagina and harvest my eggs i don't know what i do but oh would that be awkward have we become too close for you to i'm not sure would it would you feel bad if i don't recognize your vagina that's a question i should ask you can you pick female or male embryos no no she's shaking her head everyone not unless not unless it's for a medical condition okay do they do that in other countries is that just australia do that in other countries yes but i guess that there's a whole moral implication with that as well you know and i guess like that's when the real sort of

ethical questions around test tube babies and like choosing the bits and pieces that you want um it's actually really funny I met a woman who did go overseas and she went through IVF she chose all the bits and pieces that she wanted and it was a very specialized um she was very very specific about the traits that she wanted and she has twins and they're nothing like what she asked for she loves them completely she was like I thought they were going to be genius but I wanted a six-foot athlete and they're not but that's the issue right I think yeah and if you give people this this idea of choice about something that's not you can't pin that down you can't pin down whether there's going to be a recessive gene thrown in there you know and then

all of a sudden like that I think that that's where there's always been this huge debate around IVF and around like what is morally okay and not okay and obviously the rules and laws in Australia are far more stringent than what they are overseas the last thing I really wanted to ask you Cheryl before we like say thank you so much for all your time but the last thing I really wanted to know is is what is your main piece of advice or take home for women who are in their 30s who are single who maybe haven't really thought about their own fertility yet but think yeah sure I want to have kids in the future I think my main advice for women at any time point in life is just chat about it chat to your girlfriends chat to anybody maybe your mom if you're you've got a relationship with

her chat to anybody and sort of talk about it try to sort of destigmatize it as best you can because i think there's still like you said in the beginning a lot of stigma associated with fertility troubles falling pregnant you know difficulties moving forward because everybody sort of has a happy healthy life and it was very easy for everyone to fall pregnant nobody needed help but that in reality we know that that's not what it is and so have a chat about it and the moment you start opening this pandora's box you'll realize how many people are actually in it together with you and that the more information you can get the better for everybody and for yourself because then you can choose the right path for you it might be just chill out and do nothing hope to meet

somebody that's perfectly fine but at least you know what options are and you're sort of more empowered with information about your own body lots of people have gone through it just the interesting thing is not many people say they have again it's very interesting for me sitting on the other side that sort of it's yeah it's just still so taboo and I can't get my head around it it's 2020 guys it's a very similar conversation and one that we've had on this podcast before around miscarriage as well and that people don't talk about it but as soon as you do speak up and I know I've spoken publicly about my journey with it as soon as you speak up so many women come out and put their hand up and say oh you know you'll be okay like I experienced a similar thing and

there's this huge community that you don't really want to be a part of and that exists but women just don't speak to each other about it and I think that you know all of all of these aspects of what we have to deal with as women and like our fertility journeys our pregnancy journeys our pregnancy loss journeys they're all interconnected and I think the more that we talk about it the more that we are able to destigmatize it the more that you know people will feel comfortable to be able to take control of their lives I know but I think it's also more that like there's a documentary recently that I also sort of helped out with on stand talking about pregnancy loss and how people fixate on like more than 20 weeks like when the pregnancy

is a bit further along but at any time point once you pee on a stick and it's positive it's a baby to you and that's the problem it's that like the whole stigma associated with and I think it's just a matter of as women you know you're the mom you do all the stuff you multitask everything is on your plate and so people feel the need to just I'm strong you know this is fine this happens to everybody no one needs to know you know nothing to see here but I think you sort of by sort of unraveling and unpackaging it and have been knowing that there's a you know a group like this around that you can sort of seek help and things with other people I think it's really important to know that there's support around that's what we wanted this podcast to be and so

many of our audience have written in and said I literally feel like I'm having a chat to my girlfriends when I listen to you and this is why we want to be bringing these issues to the table and having these open conversations so that people can realize they have options they're not alone on their journey um give them information that they didn't even know was out there I know for me personally I I have genuinely learned so much in this conversation Cheryl and I actually not even joking I think I'm gonna book in I think I am I think um just text me just text me I will share the journey with you guys if I do it but it's freezing my eggs is obviously something that's been weighing on me for a long time um and this has definitely put the fire in me to think that

I need to actually I can't just sit here and wait another year in another year because time isn't on our side unfortunately as females and as much as we want to act like that that isn't a real thing it is it's science it's math computer says no thanks so much guys for having me it was a great great sort of afternoon here but just sort of the last bits to reiterate is sort of I think the conversation to be had about fertility and all these issues and about everybody's sort of journey in their life is the most important so I feel free to come have a chat stop by we run information sessions or stop by and have a chat and sort of ask questions and whatever route you decide to take then you know feel that you've got hopefully as much information as you can at this time point

to make the best decision for you right now and guys for anyone who's listening who is interested we're going to pop in the show notes all of the information from Cheryl so if you do need to get in touch or you do want to kind of check in talk about your fertility then you're going to have access to those details there as well go have the conversation guys have it with your friends go to the clinic see a specialist and be empowered take charge of your fertility journey all right guys you know that i normally say we never finish an episode without our suck and sweet however we're gonna we're gonna finish the episode without a suck and sweet okay this is the first time in the history of life uncut i know it's quite unsettling for me brit's having a real

conniption about it she's not okay she was like do we just make one up do we just lie i was like just pretend like we did something on the weekend. I'm cheating on Life Uncut by not doing a suck and sweet. So the reason why we aren't doing a suck and sweet on this episode is because we've had to pre-record this interview to fit around Cheryl's very crazy schedule and also because Brittany's going away this weekend so we decided we would just come in here, we'd get it all done, we'd tie it up in a nice little neat bow for you and we didn't want to lie and pretend like we'd done things that we hadn't done yet because it's actually only Thursday the week prior to when this will come out. And also Brit is going away this weekend. She's heading back to port to

see her family. So we have some big things, but we like don't really know what's happening yet. Yeah. Like there are things coming, but they're not here yet. But don't worry guys, we'll be back on Thursday with our very normal scheduling. Please make sure that you send in some questions for Ask Uncut. We have received so many and like always, we feel so grateful and so privileged that you trust us with all of your deep, dark and dirty questions. We also want those accidentally unfiltered to keep rolling in because you know how much we love them. And I just love that every time something goes terribly,

horribly, hideously wrong in your life, the first thing you think is, I'm going to send this to Brit and Laura and we are fucking here for it. Yeah, before you even put your pants back on, you're just on that DMs. I love that so much. Before the guy has even left the house

and the condom is still fresh on the table next to you, you're like, I'm going to message that to Brit. Whilst you're sipping two glasses of wine simultaneously. Anyway, guys, if you haven't followed the Life Uncut Facebook group, jump on board. It's Life Uncut Podcast. If you haven't joined the Instagram, home it's life uncut podcast as well just helps you keep up to date with all the things that are

happening on the days when there aren't episodes because we know that you can't get enough we can't give you enough i don't know i'll stop and one last enough is enough yeah one last pretty pretty pretty pretty please reminder if you haven't already voted for us in the podcast awards we will be forever indebted to you if you could take two hot little seconds to go to the australian podcast awards and vote for the listener's choice so obviously typing life uncut because that's us that's who you're voting for don't vote for anyone else and then you just have to go and verify it in your email it'll take you two seconds and we'll be forever grateful yeah and this is I mean this is such a big thing for us this is the last week of voting and it's been such a privilege to even

make it into the finalist list to be nominated so like if you've heard us giving a little shout out and asking for this in the past and you haven't yet done it please take this as like your last opportunity to jump on and put that vote in what we'll do is we'll put the link in the show notes so if you're looking for like the australian podcast awards you can type that into google or you can go straight to our show notes and the link will be there and like brit said it literally takes a minute 30 seconds like that's all so we would be so grateful for that and guys you know the drill tell your mom tell your dad tell your dog tell your friends tell everybody whoever's closest to you and share the love because we love love

We'll be right back.