Life Uncut - Trimester Zero & What You Actually Need To Know Pre Pregnancy - Uncut with Dr Dev

Episode Date: April 2, 2026

Lately, TikTok and Instagram have been flooded with content about something called “Trimester Zero”. It’s the idea that pregnancy preparation should start months (or even years) before conception. And while some of the advice is genuinely sensible, a lot of it veers into expensive, anxiety-inducing territory: detoxes, organ meat diets, “non-toxic everything,” DNA panels that cost thousands, and the suggestion that if you’re not doing all of this, you’re somehow failing before you’ve even conceived. Today we’re joined by Dr Devini Ameratunga, a board-certified reproductive endocrinologist, gynaecologist and co-host of the Fertility Untamed podcast.We speak about: How common infertility is and whether it’s increasing Is trimester zero marketing preying on vulnerabilities? How common unexplained infertility is Why we are finally speaking about how men’s health can affect fertility Does men’s sperm quality affect miscarriage risk or nausea during pregnancy Myth busting yes or no; folic acid, choline consumption, detox teas, organ meats, cutting out caffeine completely, giving up alcohol, expensive supplements, creatine and stress alone causing infertility Dr Dev’s personal experience of Hyperemesis Gravidarum (HG) and how much it impacted her life You can find more from Dr Dev’s website  Instagram  Fertility Untamed Podcast Life Fertility Clinic  You can watch us on Youtube Find us on Instagram Join us on tiktok Or join the Facebook Discussion Group Hosted by Britt Hockley & Laura Byrne Produced by Keeshia Pettit Video Produced by Vanessa Beckford & Lachy Pugsley Tell your mum, tell your dad, tell your dog, tell your friend and share the love because WE LOVE LOVE! XxSee omnystudio.com/listener for privacy information.

Hi guys and welcome back to another episode of Life Uncut. I'm Laura. I'm Brittany. Well look lately on TikTok and Instagram there has been a big discussion about something that comes to fertility and getting pregnant and it's all around this concept of trimester zero. It's actually infiltrating my entire life like my algorithm maybe because I well maybe because I'm in that point of trying for a baby I don't have kids yet so I guess I've clicked on one or two things about what should I be doing and now it's all I get fed yeah and I mean like there's so much pressure if you have had a baby before if you've ever been pregnant like the conversations around what you're supposed to do in preparation or if you miss the preparation

the fear around well is there going to be something wrong have I not done the best thing for my you know yet unborn child the mom guilt starts before you're even actually a mom like it starts so early. It starts before you're even pregnant. Well, look, there was a really interesting article that was in The Cut recently, and I wanted to read a paragraph in this. It says, in certain corners of Instagram and TikTok, women are convinced it really starts much earlier. Now, in addition to the 40 weeks that your body is actively growing a fetus, you also have to worry about trimester zero, the months before you even start trying to conceive. In this world, the ideal woman can't get enough organ meat and takes double the daily recommendations

of coline to boost her future baby's IQ. She orders her own ferritin tests online so she can see if her iron levels are holding strong. She has no need for an alarm clock or caffeine since she wears blue light blockers after dark and wakes naturally with the sunshine. The air she breathes is filtered and unpolluted by artificial fragrances. Her kitchen is free of plastics and bleach. Physically, she is the strongest that she has ever been because she knows that for the

next nine months, her body will be running the equivalent of a marathon every single day. Today, we're joined by Dr. Devani Amaturunga, a board-certified reproductive endocrinologist, gynecologist, and co-host of the Fertility Untamed podcast. Dr. Devani Amaturunga is here to help us separate what actually supports fertility from what is just algorithm-fueled panic. Dr. Dev, welcome to the pod. Oh, thank you so much for having me. Dr. Dev, what the hell is trimester zero and why do I feel like all of a sudden it's everywhere? Yeah, right. Even on my feeds and I'm not even trying to have a baby. But trimester zero is, I guess it's a wellness and social media construct of the preconception period. So

they're saying about the three months leading up to trying to conceive. So the idea is actually rooted in something quite genuine and sensible that what you do before trying to conceive can affect your pregnancy and, you know, health of your future child. But what's happened on social media that this legitimate medical concept really has been picked up, inflated, and in some cases monetized. So it becomes this, you know, enormous wellness category with its own kind of aesthetic and, you know, language of optimization. So the core idea is not wrong. It's just what's happened since that core idea has been inflated, I suppose. But I guess, how are we supposed to differentiate then between what is real and what will be helpful for someone that wants to conceive

and is trying to conceive against what is just a marketing ploy? It's not easy. And that's, you know, a lot of medical misinformation, I suppose, that's out there. You know, I think always look at websites and sites that are vetted, that are government sites, you know, have a speak to health professionals, have a speak to your GP, your primary healthcare physician, and, you know, look after yourself in this time. Get rid of the feeds. You can automatically say if there's something that is promoting something from their business, you have to just double take. It's like anything on the internet, really. You need to be, I suppose, well-versed and clever enough to figure out what's true from not true. Otherwise, you go down this massive rabbit hole of thinking,

oh my God, everything I'm doing is wrong and this is going to affect my fertility. I think it's so incredibly hard, especially for people who are struggling with infertility, because I think sometimes this type of content gives the illusion of control. It gives the illusion that you can do something that's going to result in a different outcome. For people who have really kind of gone down the rabbit hole of this trimester zero type of content, can you give us a bit of an understanding of like how that adds to the shame or the guilt that women are already feeling and what are some of the things that they can be doing to really help sort of like increase their fertility rather than going through Instagram and trolling like what it is this

trimester zero is saying? Yeah, because I do see that in clinic, you know, poor patients just come in and they've read all this stuff and done all these crazy things and they feel incredibly guilty, like somehow this is their fault. Trust me, if you're sitting in front of me or any fertility specialist, you have tried and, you know, that is certainly not the reason. Infertility is a medical condition. So it doesn't hold true that what you do in the three months specifically prior to conceiving is going to affect everything or really be the cause of your infertility. However, having said that, we know that we've been saying for decades, we all know that leading up to conception, getting healthier and doing some very evidence-based stuff is

really important. So the really boring, non-glamorous stuff that's out there is actually what's true. So taking folic acid, 500 micrograms a day, we know can decrease the risk of neural tube defects. We know that iodine is important for thyroid, for the baby's health. Managing chronic conditions, if you've got diabetes or thyroid disease or any of those things can be affected by what you do. And then the really basic stuff, stop smoking, reducing your alcohol in the preconception period, and obviously stopping once you're pregnant. Marijuana, any other kind of illicit drugs needs to be looked at but the other stuff there's really no evidence that doing all these detoxes and you know organ meat diets actually makes much

of a difference at all so sticking to the basic evidence-based stuff the whole idea of just increasing your organ meat intake but the thing is is it pries on people who are desperate that's what it does it really like exploits people who are feeling so vulnerable and feeling as though they'll do anything or they'll try anything and then I think you then run the risk of if someone falls pregnant afterwards they're like it was the organ meat well yeah and I think when you are desperate you do try anything and that's why there are so many people that go and have sex and then go and eat McDonald's fries you know because that that yeah yeah yeah sure Dr. Dev you've heard that right yeah oh yeah I think we're doing I think we're going to start taking shares off McDonald's

tell me about this what is this what's the theory oh I don't even know what the theory is but it's thing it started by someone just saying that like they couldn't fall pregnant they ended up eating McDonald's fries after there was something to do with the salt intake that it did and I have friends that have had a lot of trouble with infertility that will have sex and then go and eat McDonald's fries because of the point of being so desperate that you're like well it can't hurt right so like it's only either going to work or you know I'm still infertile do you find now with all of this information online that people's paranoia have increased like around their fertility that we're seeing more, I guess, paranoia before it's even something that they

should be worried about? Totally. Like infertility is not uncommon, right? One in six couples or people have infertility, but that's still five in six that don't. And trying to conceive is a really fun, exciting time for most people. And I hate that it gets taken away a little bit by all of this stuff you know and it's hard it is exactly like you said it's preying on vulnerable people and the consult for me starts way before patients come to see me they and that's kind of why I do these conversations with guys like you because people listen and it is nice to you know cut through all the noise and I feel like the guilt and preying on these kind of situations is really unfair for patients and a lot of patients actually do come to their own you know they come and say

oh my god I tried this and it was just too hard and I'm really sorry and I'm like oh my god don't don't say sorry that's great let's just figure out why you're actually not pregnant yeah is this trend of the organ meats I'm also getting fed that a lot no pun intended but I'm getting fed that a lot online at the moment as well but a lot of it's not just organ meat but people that are eating it raw people that are saying like you can't even cook the which I feel like is more dangerous people saying you can't cook it's like a superfood you don't want to cook out the nutrients is there any evidence around consuming more organ meat or I guess even just red meat like it doesn't have to be an organ meat but is there anything to suggest that that helps with increased fertility well no

not really that it increases fertility per se but you know organ meats like for example liver is very high in dense in some vitamins so you know b12 folic acid as well as things like iron and vitamin a theoretically taking a bit too much of that can actually be harmful because you know know, you've got more active vitamin A retinol, which we know is not good for pregnancy and early pregnancy. So you have to be really careful if you're deficient in some. So there are people who are vegan, who don't have enough iron, eating meats and so forth is obviously helpful. But for the general population, it's not really, it's nothing special that you need to do. It's just having a well-balanced, healthy diet, a Mediterranean diet, for example, with the good

oils and things. They're all very much related to healthy conception and pregnancy. But you've got to be a little bit careful about taking, you know, especially raw things. As you know, if you're in early pregnancy, you've got to be very careful about eating raw foods and salmonella poisoning and things like that. So you've got to take everything with a grain of salt, I think. You know, talking about this like paranoia or fear now, that's kind of, I guess it's always been there, but you know, you said trying to have a baby is supposed to be fun. Like it's supposed to be an enjoyable experience. And I feel like for a lot of people that's been taken away. what would you say is an expected amount of time that if couples are genuinely trying they're you

know on ovulation they're actually having sex and all of those like actual physical parameters are in place what would you say is an amount of time where people don't worry if you're still within this zone like you don't need to seek out fertility help yet like this is completely normal up until what point are you like okay now let's start looking into this yeah i think you summarized all of that really well in that if you've got no obvious problems, don't stress until if you're under the age of 35, about 12 months with all of those things in place. And then if not, I'd see your doctor. It's always fine to see your primary care physician for a preconception checkup. You know, they all do blood tests and just make sure that you're healthy and there's

anything that, you know, in the family history that might need to be looked at. So that's fine at any stage but after the age of 35 about six months is when we would say to see someone because it does also depend on family size and you know if you want three or four kids you want to be closer to 35 rather than 40 when you're trying for your third if you can or at least be healthy enough that that's not an issue so yeah so 12 months under 35 and six months over 35 if everything else seems fine yeah I say this because and maybe this is anecdotally I wonder if other people have experience this but I do feel as though I have a lot of friends who when they start trying if they're not pregnant almost straight away or they get to the second or the third month it's like

really emotionally stressful for them because there's this instant fear of like oh well maybe I won't get pregnant on my own and it's so hard to manage because it's not hard I don't mean hard to manage in the friendship but I mean it's hard to reassure someone that that may not be the case that this is just part of waiting and trying and everything else. And I think I've experienced it more and more, but it might also be my age. That fear of the unknown is really hard, I think. Well, I put myself in this category because I'm 38. I'll be 39 this year. I haven't been able to fall pregnant. I have done all the tests. I have nothing wrong with me. I don't drink. I don't smoke. I've never done drugs. I exercise every day. I could not be a healthier person my entire life.

And I cannot fall pregnant. Like I've done, I do it on every ovulation. We do all the tests. I did a round of embryos. I got none. Luckily did another round of embryos and got three. But I also have a medical science degree. And I say that because I am still in the position now where I'm starting to do things and take

things and look at things online that probably I know aren't going to do anything. But you get to the point where you're like, well. It's harmless. I might as well try it all. But then I guess that's what the problem is, right? And Dr. Deb just said it. Sometimes it's actually not harmless. Sometimes we can get sucked into this vacuum of doing something that might not actually be good for us and might be contraindicative to falling pregnant. But I'm even at the point now, and please tell me if there's any science behind this, but I used to love to sauna. I saunered every single day. I don't really sauna anymore because I read that maybe heating up your reproductive system and your ovaries and your eggs and everything else could be detrimental to falling pregnant. Is there any truth in that? Look, I'm sorry you've gone through all of this. I think

unexplained infertility is a really tricky one and it's a very few people really, probably less than 5% of patients who actually have that diagnosis and it's really frustrating. It is, Yeah. So usually it's just that we haven't found the cause, right? But there are evidence-based stuff that you can do to improve your chances. And so I'm really glad you got those three embryos. That's a really good start, I suppose. And I don't know your history, but in terms of things like saunas, there's no great evidence for women not doing saunas. There is evidence for men because the testes sit outside of the body. So we know that heating testes, which is where the sperm stored can definitely cause DNA damage. But we in itself have a mechanism in our bodies to

keep our organs in a certain temperature. So if having saunas makes you feel relaxed, I think you do what you have to do. But if you think that you gain a little bit of control by some things, I think that that's okay too. I think it's quite tricky, that fine line. We know that in IVF and infertility, the lack of control is really what is recognized as being a significant portion of a patient's wellbeing. And so I like to give patients some control over some things because that's great because a lot of this is out of their hands and even out of our hands. So do what makes you feel okay. Just be a little bit vigilant in terms of going overboard because that can stress you out more i'll stop eating my raw organ no and i'll go back to the

sauna but i mean brit it's like it's such an important question and also you know something that has gotten a bit of spotlight recently all the pressure has always been on women right like it's always been that as a woman what's wrong with your fertility what are you you're changing in order to increase your fertility but just recently the spotlight has been moved towards men and the things what are they doing to increase their fertility and their contribution to not just getting pregnant but the quality of what they're providing to create a child can you talk us through what impact I guess like men's trimester zero has on the quality of a pregnancy yeah it's really important actually 50 percent you know of and it's not just a number like literally 40 to

50% of infertility is due to male factor. So the trimester zero probably has more benefit in men's health than women's health because those eggs have been with us our whole life. So it's very few things we can really significantly change about the women's, you know, our oocytes or eggs. But the lifespan of a sperm is about 70 to 75 days. So literally three months in that time, you can actually affect the quality of your sperm. So, you know, things like alcohol, smoking, vaping, marijuana, all of those things, cutting that out is actually going to be helpful. Not taking steroids, testosterone. I mean, those things should be cut out quite early because it can take a long time for sperm to get back to normal. And like I mentioned, the saunas and heat. So if

you're someone who does i don't know 30 50 kilometers of bicycle riding every week or uh you know are sitting as a truck driver or something and increasing the heat in testes they actually can all make a difference so keeping testicles cool in terms of and regular ejaculations so that the the sperm's actually fresh and not hasn't been sitting there for three months that those are all really important things and supplements too actually we got to be a little bit careful because there is some data saying that if you have no problems with your sperm, taking certain supplements can worsen the sperm quality. But if there's an issue with the sperm, there's really good evidence to take things like CoQ10 and other antioxidants for sperm quality. And it has a huge

impact on embryo development. This is so fascinating to me and something that I think is so important to be spoken about more because I think for so long, women have carried the guilt of infertility or the guilt of pregnancy is not working out in the way in which they would hope them to and now we know the men have a lot to answer for i just know and i talk about this from a personal perspective and like you know i'm sure everyone has their own experience with this like i know so many women who have been like i'm not drinking because i'm trying to get pregnant and there's their partner pissing out with a fucking pint of beer you know it's like there's so much responsibility that falls on women to create and to have this like perfect idyllic pregnancy

and it happens it only happens if you've got someone who's coming to the table with the same level of dedication that's because we never had this level of education we didn't know we did think it was just the women's bodies and the women's eggs and it's only the last couple of years that we've started to see traction around I mean even the tests on men's sperm and like what that contribution has to a woman's pregnancy like it was a long time we didn't even bother looking into the men's contribution to infertility I think the frustrating thing though is it's like obviously we are a relatively female focused podcast. We have mostly female listeners, like women listeners. And so you have to question like how frequently are these conversations being

had among men and for men? Like it's one thing for us to know this information and then to have to badger your partner to not do X, Y, and Z. But it's like, this is the sort of stuff that they need to be the ones seeking out more readily so that you can go into this with parody rather than go into it being like, all right, I'm armed with the information and I'm going to have to annoy you until you stop doing the things that I'm asking you to do so that we can you know take some responsibility here I just yeah I really feel for women who are going through it and don't have a partner who shows up with the same dedication that they do absolutely and it's sometimes just getting them to the table because I think it's hard for women to have those conversations it's

already stressful as it is and you don't want to stress the partner up even more because they've already got this kind of barrier about it and then you're trying to have sex at that specific time and putting that pressure on and we like in my clinic I really say that the partner needs to be there with a referral so that let me take the onus of telling them you know what what they need to do if it's too difficult of a conversation but but you're right it's it's really hard and even yesterday I had a patient you know who was like I really don't think my partner's going to do a semen analysis and I was like well you know I think it's really important because we could be doing all of these things and then there's a sperm factor which I can easily fix for you you know one

of our greatest contributions in IVF is using ICSI for example and if that's all it takes you're missing out on being able to fix this in a you know a very quick moment so yeah so you could be missing out that's crazy my husband flew from the other side of the world for two days so that he could come and do his sperm sample and test it like it's like sorry if they want to they will That's awesome. You just said ICSI. What is that for anyone who doesn't know what ICSI is? Yeah, sorry. A lot of acronyms in our world. ICSI is intracytoplasmic sperm injection. So what it is, is there are some conditions where sperm's not moving well. There's a little amount of sperm, the actual concentration. So what we can do in the lab is wash clean and look at that

sperm and under the microscope, look at the sperm moving and what it looks like. Has it got a head, a tail, two tails, and then choose the best looking sperm to actually inject it into the egg. So it improves the fertilization rate because sometimes if the sperm's not in good shape or quality, it might not actually get into the egg. It's almost like, correct me if I'm wrong, it's almost like a step before an embryo transfer. So you're like, I'll take the sperm that I know is good and I'll put it exactly in

the little home it needs to be in and hope that it moves in. And if it doesn't move in and moves back out, then you'll be like, oh, now I'll try and make the embryo and put the embryo in if that makes more sense. Right, it's like cherry-picking the best sperm. That's it. It's cherry-picking the best sperm to create an embryo. So we cherry-pick the best sperm and then we put it into the incubator for up to six days to see if it will create an embryo.

Wow, it's really amazing. We're so fortunate with what technology can do now and what you are able to create and to do in order to help all these families who are in so desperate need or in such desperate want. It's phenomenal. It's incredible. One of my favourite shows was Big Miracles. It was on TV.

Yeah. I mean, they do every season, but I had a girlfriend who was on that show and her experience going through her fertility struggles and you just see the impact that it has for people when they actually have their baby. And we just did an interview with Tanya Hennessy. If you haven't listened to that, guys, go and have a listen. And she'd been through so many rounds of IVF and finally got her baby girl. And it's, yeah, it's an incredible thing.

But then on the other hand, it like, it is incredible. But I say this from a really small, small perspective and something I spoke to Tanya about too. on the other hand that's when it can be really hard for people with infertility and unexplained infertility because you're saying cool even with all the science and technology that we have it's still not working so there's i i don't want to take that away from anyone that's listening right now that's thinking you know i remember walking out of my embryo collection and being like fuck even with science i can't get one and i know tanya felt the same way when she'd done six

rounds and she was doing everything and she's like wow there's like if it can't help me i'm doomed you know but on the seventh round it did and it was successful and that's purely just because of technology but i want to talk to you about something i hadn't actually heard about maha which means make america healthy again like there's this trend of maha influences online there's one specific woman named alex clark and uh she's recommending a lot of things on her instagram and tiktok like don't use any toxic products in your house women if you're trying to fall pregnant, don't wear nail polish, don't be getting your hair done, don't clean with anything unless it's completely natural and organic. Fragrance candles was what we talked about

recently. Fragrance, candles, smells. What can you tell us about that? I'll take it in two steps. Endocrine disrupting chemicals, EDCs, we call them. There is some science behind that and they are things like BPA, phthalates, stuff found in plastics and some chemicals, even in some of the products that we use that can disrupt your hormones and this has been shown in research however again this has kind of been taken to the nth degree so you know doing some sensible things like swapping plastics to glass and having a look at your you know shampoo and things trying not to be too over the top with with chemicals that you put on your body is okay that's sensible that's stuff we should be doing you know in our daily life but going to the extreme of these maha kind

of groups and getting a bit of all of your you know facial products your nail polish you know going completely organic and everything free from all of your hair products is probably not going to make any difference except be a really expensive exercise for people and again you know doing things that are completely unnecessary, which will probably increase your stress in your life. Is infertility increasing? Yes. I'll expand on that. Why, Dr. Tev? Why? Just yes. Next question. No, I think it's increasing for lots of reasons. We are

diagnosing it obviously a little bit more. And the fact is we're older. We're older women. I personally have gone through infertility. I've done all of the surgeries, endo, IVF, all of that stuff as well. And we have the ability to be educated. But one of the biggest things globally across the world about why people are being later in terms of trying for pregnancy is not finding a suitable partner. So that is something that will affect at what stage we start to have our first child. And that age is probably the key. Age is queen always with fertility. We can't reverse that. You might look 25, but if your eggs are 42, it's quite hard to reverse that. So yes, infertility is increasing. The WHO last year actually said that it's now a critical world

problem. So it is something that we're really working on quite extensively. And that's kind of why I do all this extra stuff. As a government, there are policies and procedures that can make a difference to Australia as a whole. We've got one of the lowest total fertility rates and that's why I get involved in these conversations in the hope that we can make a difference. It's funny you say that because you say you might look 25, but you're not. That's how I feel. And I'm not saying that like I look 25, but like in my core, in my brain, in my core, in my brain and in my soul and in my body, I don't feel my age. And I do think that's a bit of the problem because sometimes I have to remember where I'm like, am I really ready to have kids? I'm like, well,

I've actually been phased out almost. So like I'm almost on the other end of it, you know, like I'm at the later end, but it's like, but it's, I don't feel it. But is it, is it true that the quality of men's sperm has a direct impact on the level of nausea, fatigue and morning sickness in a woman's pregnancy? Because there are so many videos on that trending. No, I know. There's really no evidence that the quality of men's sperm has anything to do with nausea it's the hcg it's the pregnancy hormone and estrogen having said that obviously the men's we know that men's quality of sperm can lead to embryo development and the health and you know pregnancy in that sense and there is some evidence now also to show that the future health of the

child can be affected by a sperm quality and so you know i tell my male patients who are drinking smoking and are and not have not well controlled diabetes for instance that you can actually affect the future of your child. However, not really in terms of nausea and things like that. I think we should take that out actually, because I quite like being able to blame the men for the morning sickness things. No, I think it's interesting to debunk it because there's so much misinformation out there. I think an important one, and I know we've kind of danced around it, but maybe not explicitly, does sperm quality impact a woman's chance of miscarriage? Yes, we do think that that is the case. So DNA damage to the sperm can affect miscarriage and

conception so I think blame the man for anything really that's fine but you know whatever you can take I think it's so but that's true not that it's important to blame the man but I do think it's important to take shared feelings into this and into account because for so long so many women who experience miscarriage feel like there's something they've done something wrong or there's some shame surrounding it or if you you know you try and pick apart or work backwards It's like, did I, did I do this thing or did I do that thing? And, you know, sometimes it's, and more often than not, I guess it's things that are completely out of the control of what you, you know, out of your control.

Oh, absolutely. I hear it all the time, actually. And, you know, it'll just be a little sentence at the end of, you know, a consultation of just diagnosed a miscarriage and it's been, you know, so terrible and traumatic. And then just before someone leaves, they'll say, you know, I did move house. Do you think that that was what, you know, did it? And I'm like, no, of course not, you know, and there's these little things in the back of your head you really try and pinpoint and 99% of the time it is nothing to do with what

you've done. Dr. Deb, could we do a really quick and really put you under the pump here? I want to do a quick yes or no myth busting. I'm just going to read out a few things and you just say yes or no if you think it's good preconception. Okay. Folic acid. Definitely, yes.

Choline consumption. Yes. Detox teas. No. Organ meat. No. Cutting out caffeine completely. No. Expensive supplements over basic prenatal vitamins. No. Creatine. Yes. Cutting out alcohol. Yes. Can stress alone cause infertility? No. So let's talk about folic acid. Yes. So folic acid, definitely it's non-negotiable, you know, 400 to 500 micrograms at least about a month before you try to conceive is really important. And we know that it reduces neural tube defects, things like spina bifida. What about for those people? I mean, this is the thing about this trimester zero. A lot of people

don't go into having babies thinking, I'm preparing to have a baby. I mean, I got pregnant by accident. I certainly wasn't taking folate. And then I spent nine months in absolute fear that I was going to end up having a child who had spina bifida because I hadn't taken folate. I guess my worry is that sometimes these pressures around, this is what you had to do, are great in the ideal world, but it doesn't happen for everyone. So what does that then look like? Look, the truth is we say this in the preconception period, but we do lots of checks and balances during pregnancy. So once you're pregnant, we say, just take some folic acid. We know up to three months is important. We do a 12, 13 week ultrasound to make sure

nothing's going on with the spine. So there's lots of things we do do pregnancy to make sure that things are okay. And just remember the majority of pregnancies are going to be absolutely fine. So yeah, you're right. Is folate something that you get in your diet, regardless of having the vitamin supplement? Yes. A lot of it is in your diet as well. Is all folic acid created equal or is there a specific brand or dosage that we need to look out for? No, I think it's all equal. And again, there's a lot of companies that promote activated, non-activated, things like that. And really their study's done that there's no great difference. So I think if you've got it in your diet, it's fine. And the truth is, if you have a healthy diet,

most of these things are fine in your diet. But we do that just especially for people who might be a little bit deficient. And most prenatal vitamins, or should I say all prenatal vitamins, would include folic acid so women don't have to think oh my god how many different things do I need to take is there like what I guess what's your recommendation if you have one for one of the best all-round prenatal vitamins look I don't think you need to worry too much the two real recommended vitamins in pregnancy are folic acid and iodine and all of them all of the vitamin supplements have them the only thing is that there are some people that require higher doses of folic acid. So if you've got a family history of any neural tube defects, if you're overweight,

and if you've got some medical conditions. So there are some people where five grams is better than 500 micrograms, so 10 times the dose. And that again, you would get once you see your healthcare professional. Talk to us about colon consumption. What's colon and why is it important or is it something that's just a bit of a myth? Look, colon again is found in our food. So eggs and meats are good sources. And so once again, it's more for patients who, or people who don't have it in their diet. It's really good for brain development. So supplementation is reasonable, but especially for those who are eating more plant-based diets. So for the most of us who are not on plant-based diets, we get that in a lot of our foods. Caffeine and detox

teas, because a lot of people say that you should completely cut caffeine from your diet. No, I don't think there's studies done again, but one or two standard coffees a day is not detrimental for your diet. There is some evidence that having more than that when you're in early pregnancy potentially can increase your risk of miscarriage. So a couple of coffees a day is totally fine. Just be wary where you're getting the coffees, like double shots is two shots of coffee. So don't...

Double means two. they're like i've got one cup of coffee today and i'm like oh my god that's a bucket but no yeah so so one one one to two is fine yeah one to two is fine i probably shouldn't admit this but i feel like coffee was my vice my coffee was the only thing that got me through i'm not saying i had heaps of it during pregnancy but when i was not but when i was pregnant i was still drinking coffee i was like i've cut everything else out let me have a coffee god damn it anyway also number three i feel like you get a little bit more cash by number three but i think it's i think it's really important to say that, like you just said, Dr. Dev, that there's no, you know, it's okay to

have one cup. Oh gosh, you're doing so much with your life. I mean, I was, you know, very, in a very bad place. I had nine months of hyperemesis and nausea and vomiting. So it was, it was terrible. And I, you know, I say to my patients, do what you have to do to survive. This is about you getting through. The irony of you having to experience that too, when you probably manage it in your patients so much. And then, because there's no way of you knowing that you're predisposed to hyperemesis, is there? No. And I feel really bad saying this. And I guess in our podcast too, we're very much encouraged to talk about our own experience and I don't often do that. So I'm getting a bit better at it, but I can genuinely tell you that pregnancy was the

worst time of my life. I think it's so important to talk about that because, you know, everyone's told, especially when you've gone through fertility, like how you feel this sense of needing to be grateful for what it is that you're experiencing. But for anyone who's had hyperemesis or hg it is like debilitating like it's debilitating enough when you're sick in early stages of morning sickness but i remember we did a podcast called me after you and i interviewed someone who'd had it twice for two pregnancies and she was like i considered like terminating she was like i was just i couldn't fathom living for nine months like this and then she did go and have another baby but it's a horrible thing to experience could you still work dr dev i actually

worked till two days before both of my um deliveries because it's the only time that i could concept the one second that i wasn't nauseous was when i was operating or doing something really difficult because i would concentrate on that but i have horrors and i don't say this lightly i was suicidal like it was it was so so bad and i just remember having i had a cesarean section and i just remember pain and i just the absolute relief of not having nausea and having a different feeling was just amazing it was yeah it's another planet was your experience with it 24 hours a day obviously besides when you said you were concentrating so hard on an operation but like talk to me about what you felt all day all day nausea like

absolutely and the worst thing was I only vomited a few times during the day so it was the nausea that was the worst so people wouldn't know I remember doing a speech somewhere I was giving some presentation and I just like everything was blurring because all I wanted to do was vomit but I couldn't even vomit because that's that feeling of you know and it's distracting it's constant when you're to the point where I remember I took six months off from my public specialist post and I used to do this routine where I'd have a vomit bag in the car I'd vomit I'd park the car and then I'd vomit outside of the car six months postpartum I went back to my public job and I entered the car park parked my car and just vomited everywhere because i had like ptsd because it was just

something that yeah it was it's terrible and i just i understand when people say i just get so anxious even like talking about and i did it twice and i knew it was going to be just as bad you did it again i did i felt sorry for the child i thought he needed a mate that is brave because yeah I've heard a lot of people say that they had to write down in a diary whilst they were pregnant to not do it again because they were they were so worried that they wouldn't live through the next one and they're worried that they would forget that feeling and that when they thought they wanted another one they had to go back through their diary and be like begging themselves please don't ever come back to this yeah I can understand and I do understand some people

terminate because they just can't do it you know and I've seen patients in emergency who've come through and they've just vomited so much they're so dehydrated and lost so much weight that time it's a medical emergency you know so i i understand dr dev thank you so much for sharing that and i i didn't want to speak for the the person that we had interviewed who was explaining her experience with hg i didn't want to speak for her but she described it as though she got to a point where she was also suicidal and you almost feel as though you cannot speak about that you know it feels like it's yeah but it's yeah I mean I cannot imagine what it would be like to go through like it truly sounds harrowing is there anything like what causes hyperemesis is it do we know or are

you just unlucky that you've pulled that card I think you're unlucky and you know all these tales about it's a boy it's a girl it's this it's not really true there is a genetic component so if you know your parent or your mother or you know down the line has had that there is some aspect of that, but it's just the HCG. It's your receptors. So, and medication doesn't really help. You know, I was on strong medications and again, I felt completely guilty because I'd gone through this big infertility journey and wanted to feel grateful. And I, and I did absolutely felt grateful, but it didn't take away from the suffering. No. Yeah. Two things can be true at the one time. Talk to me about stress. I mean, there's so much content online around

reducing your stress and how stress can impact fertility. I think we live in quite a stressful time where everyone is subscribing to hustle culture. Like everyone is busy. Everyone is stressed. How and what impacts does stress have on fertility? And also, you know, if you're someone who hasn't reached nirvana, is that going to impact your ability to get pregnant? Look, I can tell you pretty much every single person that walks into my room is stressed. and most people eventually leave with a baby. So definitely stress in a general sense does not affect your chance of conception. There are some kinds of stress, like if you are training for a marathon,

you're restricting certain things and that's stressing your body out. If you have uncontrolled stresses with diabetes and things like that, that can obviously change your cycle. We know that if you're very underweight or if you're running for marathons and things, it can take your cycle away. So yes, it can affect your hormones, but they're extreme circumstances. Certainly, you know, doing things like stressing every day and stressing for having a baby is not going to affect your chances of pregnancy.

It's also like never in the history of anyone telling someone to relax, do they relax? It's the same with stress. Like you can't just say to somebody, you need to stress less. And they're like, oh, okay. Like loud and clear. I know but it's also that saying where they're like when we were trying we didn't get pregnant the second we stopped we got pregnant like everyone has everyone has a friend who has that story yeah what about um this idea that and I'm laughing at myself I already know the answer but

what about this idea that when you're trying to fall pregnant and you've been struggling you should as soon as he ejaculates you should do a handstand you should be inverted your legs should be up in the air against a wall you know or your pelvis is raised on pillows this idea of this inversion there'd be a lot of uh infertile people in the world if that was the case I think no but to help you fall pregnant because the sperm is then like drizzling down with gravity no but it's it's also it's going back to the mcdonald's fries things right it's like when people are so desperate to do something they're gonna do it I mean I've been hearing about this since I was a teenager doesn't it help if you like stick your legs up against the wall that's

my point dr dev no no you definitely don't need to do that sperm swimmer it gets up they're very quickly and just remember in a droplet of sperm is millions and millions of swimmers we only need one and uh just to give an example when i put an embryo back in so this is an embryo this is you know a 300 cell plus thing that i put back into a uterus we say go and empty your bladder so they go straight out and then they go and we so there's absolutely no um no need to keep your legs up straight away you get them to do that straight away yeah yeah because then we make them we make patients have a full bladder to for the scanning so as soon as they're usually busting I'm not gonna lie I have been known to do a handstand afterwards again there's no harm if you want to

do that go for it I'm not actually hand standing my shoulders can't hold that anymore but I definitely put my pelvis under pillows for sure because I'm like what it's not gonna harm it so I've been doing it and I know that it doesn't do anything but I also make my husband rub my feet I'm like, get him to give me a back massage as well. I'm like, babe, there's new evidence. Dr. Dev said that if you massage my back at the same time. Absolutely. Like I said, do whatever you need to do now.

Dr. Devaney, thank you so much for coming and being a part of the podcast. We really appreciate you. And, you know, it is something that so many women go through. And I think we hold so much shame and guilt when it comes to fertility. And a lot of the online chatter only adds to that feeling of being responsible of being more in control than what I think we are at some times. Yeah, I wish I could fly my embryos up to you. Can you come to me?

Can you come to my embryos? Can you come to Sydney? Okay, great. We'll talk about that later. We'll talk about that later. Yeah, exactly. Thank you so much. Thank you for having me.

We really appreciate it. We're going to link all of Dr. Dev's details, podcasts and Instagrams and everything else that you need to know for you to go and find out more because she's a wealth of knowledge. Thank you for joining us today. Thanks a lot. We'll be right back.