Oversharing - Baby Steps: Fertility & Conception-Your Questions Answered with Emily Oster || Season 3 Ep. 1

Episode Date: August 7, 2025

We’re back with a new season of Baby Steps! In this episode, Jordana is joined by bestselling author and fertility expert Professor Emily Oster as they dive into fertility, conception, and everything in between. They answer your questions, breaking down the real science behind birth control effectiveness. Together they clear up some of the most persistent myths, and tackle big questions about age, lifestyle, and reproductive health. Whether you're just thinking about trying, actively trying, or navigating unexpected hurdles, this episode is packed with clear, evidence-based insights to support your journey. Get the facts, ditch the noise, and walk away feeling more informed and empowered. And for more information on how to start your conception journey, go to https://parentdata.org/  #BabySteps #Podcast #EmilyOster #FertilityJourney #TryingToConceive #ReproductiveHealth #ConceptionTips #FertilityMyths #BirthControlFacts #EvidenceBasedParenting #WomensHealth Learn more about your ad choices. Visit megaphone.fm/adchoices

A quick note before we get into the episode, Oversharing is a podcast for entertainment purposes only. It is not a medical podcast and does not constitute medical or psychological advice. Always seek the advice of your physician or mental health professional. Welcome back to Baby Steps. I'm Jordana Abraham and this is the all new season of Baby Steps, Season 3 launching today. I am here with a repeat podcast guest, a fan favorite, one of my personal favorite people to follow on Instagram and favorite informational books to read. Professor Emily Oster, welcome back. Thank you for having me back.

So excited to have you back. I mean, we first started talking about you coming back when you had told me that you guys were starting a new vertical on parent data all about trying to conceive. Yeah. So we have been writing on parent data about pregnancy and about babies for a long time. But we wanted to sort of go back and take that same like evidence data-based approach to this trying to conceive topic and thinking about both trying to conceive when you're just first start. and then thinking about topics in infertility. And I'm really excited to have this content out because it has felt to me like a space that's full of the same kinds of misinformation and panic headlines and et cetera that

pregnancy also had. Totally. Especially like on the, I mean, we'll talk about this a little bit, but like even on TikTok, you'll see like everyone with their own story or theory about the thing that worked for them. Stand this way and take this one pill out of this side of your mouth. And, you know, that's the secret. And I feel like we got to dial down some of that. Exactly.

I've heard everything from like OZempic to Mucinex's things that will get you pregnant. Yes. OZampic, you shouldn't put them together. Don't put them together. It's not throw everything. It's not just throw everything at the board. Yeah. So, I mean, we're going to do a couple episodes.

This episode is going to be for the person just starting out trying to conceive thinking about trying to conceive. And our next episode together we'll talk about. When things maybe get a little bit more complicated. But what percent of people would you say things go pretty smoothly for? I mean, like, that's kind of a vague way to put it. But should people be concerned going into their conception journeys? I would never tell someone to be concerned.

I think being concerned is not especially helpful way to come in. I think, you know, the main determinant of how easy a time you were going to have getting pregnant is age. And that's just kind of the most important thing to know. There's a lot of variation within people, but how much people should potentially expect to need help depends on how old you are. And, you know, if you are over 40, the chance that you'll need help conceiving much higher than if you are 27. Okay. And so I would never say people should be concerned. I think that a good approach to this is to say if I'm sort of starting and I'm really, I want to try, let me do all the things that, you know, will make it as likely as possible that I get pregnant this way. and then, you know, think about when am I going to evaluate if we need additional, additional help and to almost have a plan rather than a concern. Right. And what do you think of those, like, sort of guidelines that you hear about, about under 35 a year trying, over 35, six months trying? Like, is that something you feel like is oversimplified?

It is definitely oversimplified. I think it's worth explaining to people where those guidelines come from. Okay. The general guidelines are if you're under 35, try for a year. If you're over 35, try for six months. If you're over 40, get help immediately. And the reason for that is really about like how much time do you have left after you get help. So if you are, you know, 27 and you try for a year and then you're 28, there are many, many years of kind of high fertility, potentially high fertility left. And so you have like a lot of time for the things you need for IVF just like to try different things. And so you're sort of more flexible on the time when you're younger. Right. If you're 36 and a half and you try for six months and now you're 30.

37, there aren't that many years. And so you kind of want to get on top of the problem more quickly. And then if you're over 40, the chance that you will need some help is higher. And so we sort of want to get you optimized first. Okay. What's missing a little bit from this conversation is like two things. So one is a year of trying will mean a different thing to different people. Right. So if you said, you know, I went off birth control and we just sort of like didn't really think about it. And it's been a year. That's very different. See what happens. Like that's very different than And we went off birth control and I was tracking my ovulation and we had sex like during the optimal window every month for 12 months and we did all these other things.

Like that that means you really have tried harder. And so I would almost always suggest to people like when you're starting to try here, have a conversation with your doctor. Try to get to the optimized place first. And then you will learn a lot more in that first, you know, six months of trying. And you can always reach out to your OB and say, hey, you know, I know I'm 30. but we've been trying for six months and we've really been trying hard. And I feel like maybe we could use, you know, another conversation.

Right. Or some easier test. Or some easier. Exactly. Some easy tests. And, you know, there are some tests. We need to talk more about this. But when you're thinking about fertility, there's some tests that are easier and some

tests that are harder. Right. Well, that was my next question is like, is there a way before you start trying to kind of know or like have a sense for how easy or difficult this will be for you? Like, is there a way to be like, all right, I'm 20. six and I want a kid in five years, but I want to make sure that, like, if I want a kid in five years, that it'll happen in five years or something like that. Not really. So, you know, there are some tests when you sort of, if you start out with infertility treatment, there are some sort of standard tests that you, they will do when you think about IVF, sort of tests for basically the quantity of your eggs. Wait, let me, let me step back, actually. So when we think about, you know, what does it take to get pregnant? It takes, you know, a healthy egg, a healthy sperm, an open Philippian tube, at least one. And, and, you know, and a and like a uterus that is hospitable to baby development. Okay.

Those are the four things you need. I mean, sort of think about like how, how easy would it be to evaluate those things? And the uterus and the fallopian tubes are, you know, evaluatable with scans. Most people would not have those kind of scans unless something was wrong.

The most sort of infertility is going to be some combination of eggs and sperm or eggs and sperm together. There's one test we can do to evaluate. evaluate the number of eggs you have, really different than egg quality. But when people sometimes talk about AMH, like sort of there's a, there is a test for that, which will give you a sense

of the number of eggs you may have. Again, would not commonly be done outside of IVF. But if you are, you know, 39 or 40, that's probably a test people will do even before trying to conceive. And then the other thing you can test is the quality of sperm. You can figure out whether somebody's sperm

is kind of like moving, moving right. So again, almost none of these things. If you were 26 and you said, I'm just going to start trying to conceive, it's unlikely you would want to have any of these tests right away. More likely is to just try to do the things that would make conception most likely and then give a little time before you do any testing. I've heard 17 different statistics about the percentage of infertility. I've heard one in six. I've heard one in eight. I've heard one in three, I think. Is that kind of taking in all the age ranges? Yeah, those numbers are like the reason that

you're hearing different things is like what does it even mean? Like when you say like infertility, do you mean like the share of of people who have had a kid who needed to use IVF? That number is quite small. Like the number of IVF babies in a given year is quite small. The number of people who sort of meet a particular definition of fertility is going to be much bigger. It's going to depend on age over time, you know, as the as people try to get pregnant in older ages, we're going to diagnose more infertility. That's different from saying that fertility has declined in some population sense. I think the reason those numbers are so different is that they are not well defined. What we can say is that infertility is fairly common and is more common as you age.

Is it that it's more common today in 2025 or is it that people are having kids older in 2025? I don't think we have a concrete answer to that. I think clearly people are having kids older and that has meant that we have more need for reproductive technologies. There are people who will say, you know, there's something else happen. that has meant infertility is more common. I don't think we have any proof of that, but it's, of course, difficult to rule out. Right. Not necessarily having enough data to look back at the historical trends.

You mean, you're saying the age is the number one factor. You don't control that, though, so that's not helpful. Right. I mean, in some ways you can, right? So, like, in cities, a lot of big cities or respect, I'll speak of New York specifically. I feel like there's a lot of women who freeze their eggs at a younger age to have kids at an older age. Does age still matter about when you're implanting those eggs or is it less of a factor?

Much less of a factor. There are some characteristics that will put you at higher risk during a pregnancy when you are older just because your muscles, they're less young and other things like that. Your heart's been working for longer. But the age of the eggs is the sort of important thing for fertilization. And so, yes, egg freezing is one way to partially preserve. of fertility. We may overstate to people how much we know about that as like an insurance policy, but certainly the age of the eggs matters a lot. Right. And in the sense of like, can we control

for anything that's like sort of at least somewhat of a way to control. That's something that you can do a little bit. Yeah. Ish. Let's, I guess, take a step back to I'm thinking of of trying to conceive. What would be like the first thing you would do? Okay. So I think there's a few sort of key things. So one is, in order to conceive, you need to have sperm ready for the egg when you ovulate. Okay. And so in a sort of standard cycle, not everybody has, but a standard cycle is like 28 days, people ovulate in the middle on day 14. And if you want to get pregnant, your best chance is if you are having sex on the day

before ovulation or the day of ovulation, because that way the sperm is like ready there when the egg is coming down the fallopian tube. Right. So I think the first thing is for people to figure out how. how their cycle works, potentially use some ovulation tracking. You know, some people have super regular cycles and they can tell you on the dot exactly when their cycle is going to happen every month. Those people are going to have a relatively easy time ovulation tracking.

Some people have much more variable cycles. They may want to use ovulation pea sticks to tell you when you're ovulating. But having sex at the right time is like the number one thing that one could start doing. Is more and more? Is it like every day better than every other day? More is not more. You want to hit the day of ovulation or the day before. You don't need to hit both of them.

You don't need to hit, no. You don't need to hit all of the days. You know, of course, if you want to hit the day of ovulation and the day before and you don't want to measure, you could just have sex every day. Okay. That would guarantee it that you've hit the right day. If you don't, if you're not sure when you're ovulation. But some people don't want to have sex every day. Right.

No shade on that. And if you track your ovulation, you can make sure you hit those days. One thing people will ask is. like, do I waste the sperm? Like, should I make sure to, like, save it up? But that's not the way it works. Okay. So it's not like the sperm are more powerful if you don't have sex every other day up until

them. No. Okay. You don't have to, like, see, yeah, like, no. Okay. So that way it works. Another thing I've seen is, like, sexual position is like, you know, is there any evidence about any sort of position actually maximizing your chance?

No. And so people, there's sort of a few versions of this. So one is, like, do you want to have, yeah, what is the position during? for the part of sex before ejaculation, of course, it wouldn't matter. For, like, at the end, what is the position? Some people will say, you know, missionary is better because then the sperm is, like, right there at the cervix. These sperm are designed to swim.

So unless you have, like, a bunch of very, very slow sperm where maybe being close to the cervix could have, like, a tiny amount of effect. Like, basically the sperm are intended to get from anywhere in the vagina. Okay. That's their job. So there's no reason to put your legs up. And there's no reason to put your legs up. Or not go to the bathroom. No, we're not to go to the bathroom.

Like, that'll give you urinary tract infection. Don't do that. You know, like, just do the regular sex. So that's having sex at the right time. Any kind of sex you want. Number one. That's number, number one thing. Then there's actually some stuff on the male side, which I think is worth noting

because especially when we talk about infertility and even we talk about conception, it sort of always kind of comes out like, here's the job of the one. Like, here's what women can do to make this possible. And then there's some other person involved. Let's not speak of him. And it turns out there are some relatively straightforward, like sperm is being produced all the time. So in contrast eggs, which you have from birth, sperm are constantly being renewed. Okay.

They're not capped. No. And so your behavior at any given time can affect your sperm count. And so there's a couple of things that men are probably should be aware of. So heavy drinking and heavy marijuana use impact sperm morphology. And what's heavy? binge drinking, like smoking every day. You know, again, it doesn't mean if your partner smokes every day, you can't get pregnant.

But if you're saying, like, my goal is to make this happen, give me the best chance of this is happening. Like, cutting down on marijuana and drinking for your partner is a good idea. What about nicotine or cigarettes or something? Less evidence on that. I mean, you shouldn't smoke because it's not good for your lungs. Right. Your health generally. But less evidence on the sperm.

And the other thing is that sperm do not like to be hot. There's actually these great experiments where they have men wear really tight underwear all the time. And you can push their sperm count to zero. Really? Yeah. So, you know, again, that doesn't mean like if your spouse wears tidy white is like it's over. But like if you are like if you are like if someone is like an extensive like biker, they like are like a cyclist with like a tight. That might actually affect their sperm count.

And so just thinking a little bit about the like coolness of your or if they're like a person who uses a sauna every day. that can affect your sperm count. So your ball's cool. That kind of leaves me into like one of the TikTok things I've seen out there recently, which is like this, well, this trend, well, this thing that I've seen that like everyone's saying that it's all, like any kind of complications in pregnancy are due to the man or more likely to do to the man than we previously got.

I have been a little bit unsure. Sometimes I'm learning these things come up on TikTok. I have been a little bit unsure like where they are coming from. Right. So there is one thing, which maybe is related to this, is there's a little bit of evidence, if you sort of ask, like, what reduces the chance of you of you having preeclampsia in, like, a second pregnancy if you had one before? But one thing is, like, having a different partner.

Okay. Which suggests that it could be something about the partner, like, about the sperm that has some relation here. And this effects are not enormous. But there, and there may be a lot of other things going on. But this idea that, like, the men contribute the pregnancy complications, I'm not aware of. Like, once you're pregnant, actually. Right.

I'm not aware of any of those, of that actually being evidence. based. I mean, again, most miscarriages in the first trimester of pregnancy are due to a chromosomal abnormality. And that, you know, is really a combination of mom and dad and also various, just other things that happen in the conception process. So that certainly they contribute half there, but that's a little different than what people are talking about. Someone asked about increasing male sex drive, if that feels like an issue to sort of the pressure to have sex on these days, or is there a way to increase, like, the male morality in those, in that area. Sometimes having sex to get pregnant is not fun and it's not as fun as the regular. Like,

right, this is an issue. It's not quite as spontaneous. And that's, that I think is sometimes an issue. But there's not beyond, you know, making sure that the sperm is swimming correctly. And what about, like, supplements? I mean, you see a lot about supplements and that kind of thing. Like, is, is there any evidence for any supplements? No. I mean, folic acid. So if you're taking, so yeah. So having folic acid and you're, so having folic acid and you're, you're, prenatal and, you know, having some iron if you're any, like there are some basic things that those are kind of it. But all of these other supplements you hear about, you know, I'm like, KU10. No, no, it's really not a lot of evidence for that stuff. What you're saying is that's probably not going to like really move the needle. It's not really going to move the needle. And, you know, is it going to hurt? Like, I only we have a lot of evidence that that hurts. I think the issue in a lot of these spaces, and this comes up over and over again, particularly when we start talking about

infertility is, you know, this is an audience that's like really subject, like really susceptible to being preyed on by people who are telling them, I have a really easy solution for just $150 a month. You know, you can have this supplement and it'll fix all your problems. And that's, that's just not true. Is there a need for any of those like fancier ovulation hormonal tracking? I think there's like Mira and another one that may claim to be like maybe more precise than your average obelation. So there's a lot of ways to track your ovulation. Some of them are messier than others. So certainly some of these mechanisms like the aura ring or the mirror, like these things, which will sort of track, those are very good at tracking ovulation. And they can make it much

easier for people to sort of figure out when they're ovulating, particularly if you have a kind of regular predictable cycle, those can be really helpful. You don't need them. I mean, you can figure out if you're ovulating by sticking your finger up your vagina every day and like figuring out what your cervical mucas looks like. For some people, that isn't like how they want to be spending their morning. And so, you know, these other solutions are also, are also good. There's a lot of, there's a lot of ways to track ovulation. Right.

So there's, I mean, you could do those. Those would be helpful, but it sounds like you don't need to do them in order to. No, you don't need to them. I think the place where some of this entire tech stuff is very helpful is if your cycle is very irregular. So if you're someone who sometimes the cycle, 23 days, sometimes it's 35 days. It's just going to be really hard to figure out what is the day of ovulation. And so this is where, you know, using some ovulation.

test strips or some other kind of app can just be helpful in getting a handle on like what's what's going on. In terms of non-supplements, other lifestyle stuff, and this is an area where I've heard so many different things. Like I've been to one doctor. I think when I first started trying, she was like, you've got to eat more meat and also more full-fat dairy. But then I've seen other places where they're like dairy causes inflammation. And so cut out all your dairy. Like, Is there like a, is there any of truth to any of that? So if you are really undernourished, like, you know, far underweight, there are people who may not, you may not ovulate and have a period at all.

And so certainly if you were dangerously underweight, gaining some weight through any kind of full fat, anything is going to be helpful. On the other side, the other thing I would say is binge drinking is not good for, it's not good for either parent to engage in in for a variety of reasons, including the chance of conception. But all of these other, like, here's the right diet. Here's it. You know, these are, there is no evidence for those things relating to your ability. I've been told that by doctors. So I was always like. Right. I think it's, I mean, it's an interesting question. So if you ask, you know, what is the, what is the correlation

between diet and conception? My guess is what she would find is that there is some correlation between like the quality of the diet and, and chance of conception, but that it is almost certainly driven by other factors that are that are in fact what is like correlational to that like it's correlation and not exactly correlation and not yeah I think some of this is that people are looking for advice like they're looking for something to do yes right and just telling people basically here's a thing you care so much about that you really want to happen and basically the things you can do to make it happen are like have sex on the right days and make sure your husband's balls are cold And that's basically what we've got for you.

Like that's not what you're looking for. You know, that's not the information you're trying to hear because, of course, like, you want to hear that there's a solution, particularly if it's hard. But even if it's not, like, you want, you just like want a way to make this happen. Just like you want it to happen. You want to figure out what you have to do. Right. And so giving people advice, like, well, here's something that you could do.

It's like, there's nothing wrong with eating full fact dairy. There's anything wrong with having more fiber, eating some more meat. Like, nothing wrong with those things. but it doesn't mean they're going to help. I mean, that's true. I think that's like all, most of this stuff comes around the idea of like you can have a lot more agency and control over a situation, which, again, if there's a negative outcome, is probably not due to something you did or didn't do. Exactly. Right.

Which makes it tougher. But, I mean, it also helps, I think, probably mentally to know that there's not much you can or cannot be doing. Yeah. I don't, I think for different people, that's, it's, it's the plus side of it is that it's not your fault. right? That it isn't that you, you know, if only, and I think this is the, this is the sort of downside of giving this kind of advice. You sort of tell people like, you know, hear all the things you do to make this happen and that it doesn't happen. People are like, well, it's my fault. Because I wasn't, you know, I didn't adhere to this diet strictly enough. I didn't, you know,

have enough sauerkraut. And like, that's, like, that's something was in my control and I didn't do it. And that's why this didn't work out. And that is hard up for people's mental health. Right. And then is there like a genetic component to fertility? I mean, you would imagine just given There's a genetic component to everything. I mean, I don't, this is not a place where you could say, you know, here are the genes or, you know, beyond some genes for sort of complications that are associated with lower fertility. But we sort of know that there is, there's a genetic component to everything. So like if your mother had trouble conceiving, are you more likely to have trouble conceiving? Yeah, you're going to have more likely.

But I don't, we don't know much about like how that link, which like almost certainly is there. It's not something we actually know that much. about because we don't do a great job measuring how much trouble. Like think about even to get a correlation there. Like what would you need to do? You need to have a bunch of people, you know, our mom's age and find out like how difficult it was for them to conceive and then try to relate to their kids. You'd need to hold age constant.

It's like a hard kind of data to get. We know from like everything else that it seems extremely likely these things would be correlated. I suspect we know it from like mouse models. Okay. But that kind of like in-depth data that you that I described there, we do not have that. And then environmental factor. I mean, I just saw you posted something about microplastics today.

We were just talking about how you very little control and like that would. Like is that something anyone should be concerned about? Like, is, you know, is using a plastic Tupperware going to affect your chances of conception? In mouse and rat models, things like very high doses of microplastics have some reproductive. impacts. Okay. But we don't see this kind of, the human doses are so much smaller than that, that I guess it's hard to say like this is zero, you know, like there's absolutely no impact of our sort of global exposure to microplastics. What I could say is that you're not going to affect your microplastic exposure by changing your forks or Tupperware's in a meaningful way.

And the chance that this is a meaningful effect on fertility at the levels we're exposed to is very, very small. Do you see in the data a difference in fertility rates among like, yeah, socioeconomic status? Is there, are those who are poor, do they have worse incomes as fertility goes or not really? It's an interesting question, I think, probably not real answerable in the data because the age factor is really important there. So as people get more education and income, they tend to wait until they're older to have

kids, and they're more likely to have access to fertility treatments. And so if you sort of think about like those things are both going to balance. potentially or move the needles in different in different direction. So if you just looked at, you know, what is the realized fertility across groups, you're going to be combining like how much people want to have kids, which age they're trying at, what kind of access they have to assist reproductive technologies, you're not going to be able to answer this question. And then is there like anything to like, do you feel like the temperature tracking is accurate? Temperature tracking can work great for people. It's not that easy to do on your own.

got to be like a good sleeper. So you have to sort of like take your temperature like right when you wake up in the morning before you've gotten out of bed. And it will only tell you after you ovulate. So your temperature is like, it's like sort of low in the first half of the month. Then after ovulation goes up typically about a degree. I see. And so it will tell you that you sort of, if you were waiting for that, you would have missed your window.

So you want to have sex like before your temperature goes up. This is where, this is where actually these rings, like aura ring kind of things are very helpful because they are quite good at temperature tracking and they will they will give you a good sense of like where your where your cycle is but only for predicting the next what you want to do the next month got it okay and then i mean this is sort of another tick talk probably myth i want to ask you about the idea of like birth being on birth control or birth control um taking that for an extended amount of time does that affect your fertility we have good evidence that does not affect your fertility it takes a little time for your cycle to return to normal after you have been on

birth control. And that may relate to the amount of time you were on it. So if people are on birth control, you can get pregnant the first month. You're off birth control, for sure. But if you're saying, like, my goal is to sort of in, is to start trying to get pregnant in a few months. You want to ideally go off your birth control. Use some other contraception until you're, until you're ready, but give your cycle time to like sort of find itself again and for you to predict it. You know, I think a lot of us, like, I want a birth control when I was like 18. And I was trying to have a kid at 31. And I don't remember.

Like, it's not like I could tell you when I went up. I could not have told you what my cycle was going to look like. And so it can be helpful to sort of go off early enough that you have some time. Right. To figure out your cycle. And then also probably to see if there's any issues that birth control might be masking. Exactly. Yes.

So I think part of it is, yeah, birth control, like, makes your cycle a sort of particular way. It is used as a treatment for some kinds of, you know, intermetrial and other symptoms. And so if you are, in fact, having some of those symptoms and the birth control was masking them, it is good to know that before you are trying to get pregnant. Right. And you can just use other. You can use other kinds of birth control, like condoms. Right.

Sponge. Sponge. All around. Yeah, I use that. Really? Yeah. I thought it was like a... Yeah, I know.

I mean, maybe this was a long time ago, but I do think the sponge may still be around. It's back. Okay. It was back. It was back. Wow. And I recommend it. I thought it was great. Okay. Spongworthy. It was spongeworthy.

At that point, my husband and I were already married, so it was pretty much over. So he was by default. He was by default spongeware. Other lifestyle stuff, I know there's a lot of talk about like working out and its correlation to fertility. And I know like obviously if you're like an Olympic athlete, I think that's a different story probably than your average person who works out five or six days a week. Is that going to affect your fertility? If you are working out so much that you are not ovulating because you are like not replacing the calories that you are burning while you're working out,

yes. But if you are saying, if you are like getting enough calories, if you are like eating a normal amount to fuel your workouts, right. No, I don't think there's any, there is sort of no evidence to suggest that you cannot keep exercising at the level that you are exercising. So, and tell me if I'm wrong here, but what I'm sort of like gathering from a lot of this is that if you have regular periods where you are ovulating monthly, the lifestyle factor is probably not going to be something you should focus on because that sort of says more than any of these lifestyle things. Exactly. That they're eat or dairy eating or whatever that is. Yes. That like basically up to the issue of like you're ovulating regularly, you're having a regular period, the lifestyle that you have is conducive to fertility.

That should be helpful for people here, I think. I know, do you think it is? I mean, do you think it's how, I was always sort of torn about this question of like, do people want more things to do? Or is it helpful to know, like, here are the two things you can do and the rest of it is a little bit up in the air? I think it's more like, am I doing something to get in my own, I think the big fear with someone trying to conceive, especially when it doesn't happen, like right away,

is this feeling of like, I'm getting in my own. own way. Maybe this whole time it's been because I've been running too much. Maybe this whole time it's been all the cheese I've been eating. Or not eating. I don't know. Could be either one. Right. Could be eating it or not eating it. And so I think this is helpful as, again, as it especially relates to like the thing that if there's like one or two things to focus on. And then if those things are having issues, then like maybe examining the other things I think is more helpful than like this idea of like even if that's going like, you know what I mean? Like all things could be equal. All lifestyle factors could be equal, I think is more daunting because then you're like,

well, I can't, I can't do anything then. I mean, I think part of the reason I like the temperature, actually like the temperature tracking is because I think it gives somebody, it gives people a thing to do every day. Just be like, you know what? Like, this is the way I'm investing. Like, this is an important thing to me. I want to acknowledge to myself, like, it's important. And I'm, like, making an effort. And the way I'm doing that is every day I see what my temperature is. And then I have sex of the right day. And that's what I'm putting, like that's the effort, like the daily effort that I put into this. Yeah. I think that's like a great way to think about it or way to point to it because you're taking something that is what you're saying is the most important metric is like when

you're ovulating. You're making it the thing you're investing. Right. And that's the one thing you're investing in. And you're taking out all of the, again, like the meats and cheeses and exercise. And I mean, obviously no binge drinking, but like living your life kind of thing. I also like this sort of framing. Like I think there's more equality of the framing of like we're trying to have sex at the same time. That's a joint activity. I'm tracking my avulation. That's like a me activity. You know, you're like, you know, keeping a handle on your sperm. That's a you. Like, we're all avoiding saunas. You're avoiding sodas. That we're all investing. We're all investing in this. Fertility acupuncture. I've seen a lot about about that. Is that actually help?

Really not a lot of evidence. No evidence. No evidence. The acupuncture. Okay. Yeah. I mean, like, I think many people find acupuncture very relaxing. Right. And, you know, like being relaxed is nice. Like not a lot of strong evidence for that to matter for fertility. Is it another one of those things where like can't hurt if you enjoy it? Yeah, I can't hurt if you enjoy it. I mean, I think there's many of these things, the question of like, what do you mean? We say it can't hurt, but if we stack a billion things on top of each other and tell

you, like, if you didn't have acupuncture, you're, you know, you're a loser. Right. And that's why it didn't work for you. But. Right. Well, all of these things can't hurt. Like can't hurt. Can hurt.

Can hurt. Not drinking at all. Can hurt. Not drinking at all. Can hurt. coffee at all can't hurt. Like it's kind of a... It's kind of a... Acupuncture's not your key to fertility. Okay. You heard it here first, maybe. All right. And let's talk about that two-week wait thing. Because, again, I think this is like something where if you're trying and you've been trying for a bit,

it feels like that's one of those things where you're like, oh, if only I didn't do this, maybe on the second half of the cycle, I screwed this up by having that extra drink at dinner or I took a bath in the two-week wait or something like that. Like, is that, is any of that stuff really going to no i mean so the one that i asked it asked about all the time is is drinking and so you know binge drinking in that period can in principle affect your ability to conceive it's like more than four drinks at a time and so if you sort of think about that that period the the egg is is you fertilized and then it's splitting into many different cells and for a long time those cells are are sort of undifferentiated and the embryo is not connected but if you drink like a like a lot and your body is

sort of overwhelmed with basically toxins that come from alcohol, that can kill enough of the cells that it just does not become an embryo. Okay. But conditional on the embryo, like creating itself, actually drinking in that period doesn't matter. Okay. And having a small amount of alcohol does not have these kind of effects. So people say, like, I'm going to abstain for this entire period. Like, that is unnecessary.

Having some alcohol in that timeframe. And what about like lifestyle changes like retinoids or Botox? I know you got asked about that a lot. There are some, so oral retinoids like acutane, you cannot be on while you are trying to conceive. Right. And so that is like a complete, that's a category X drug that's like one of the, you cannot be on that.

So that you should not be on. You should not be on. But in fact, that will not happen because if you are on that drug, they make you take multiple pregnancy tests every month to make sure you're not pregnant. So that's not a concern. these topical things are do not really go through your system at this they don't get into your system in a meaningful way okay and so like you will generally be told to stop taking stop using topical retinoids and that's like a fine choice but for all of the people who are using them and

then like totally panic like I was using this and now I've ruined everything like there's absolutely no evidence for that no evidence that you know if you are on retinoids and then you miscarry it's because of the retinaway. Right. It's not because of the retinaway. It's not because of the Botox, not because of the massage you had. It's not, it's not those things. And what about, like, laser hair removal, laser face stuff, anything like that? Generally, in the, in the later periods of pregnancy, we do not like to laser like your bikini line. Because of some concerns about sort of electrolysis. I mean, these are, like, quite vague, but in principle, there, there might be some interactions with the, with the baby. What about before you're trying,

if you got Kini laser in your 20s, you're fine. Bikini laser is great. Bikini laser in 20s is fantastic. Okay, a few more TikTok things. Okay, great. And we'll have covered all of TikTok. You know, all of TikTok and all of the advice that. This is to all you creators out there.

All right. Ozempic, does that increase fertility? You will certainly see a lot of discussion on TikTok from people who were taking Ozemp and they got pregnant by accident. We're still kind of working out what's going on there. sense from sort of talking to some endocrinologists about this is that that many people are put on OZemPEC who have PICs, polycystic ovarian, and that the sort of weight loss associated with this can actually like revive a more normal menstrual cycle. And so then it would actually

potentially impact fertility. And I think there are some studies underway now to try to figure out whether treating people with OZEPIC is a fertility enhancer. Even for people with normal weight? no for people who are at least somewhat overweight. Got it. So I don't know. I guess we're going to find out. So it seems like, again, that sort of circles back to what we were saying earlier about lifestyle things are effective to the extent that they change the primary thing that we're

looking at, which is like the ovulatory cycle. Exactly. So yeah, exactly. If the effect of the OZEPIC is to return you to a more standard ovulatory cycle that you do not have that you did not have before, that might impact your fertility. But you should get off at OZempic before you're trying to conceive theoretically. Generally, you're supposed to get off ozempic. Because the half-life got off ozempic about a month before you are trying to conceive.

If you are taking ozempic and you conceive, it's fine. We now have enough of those events, basically see that does not seem to be a negative for the baby. And there's really no evidence even from animal models that that would be problematic. But definitely once you find out you're pregnant, you go off ozempic. It's not the time for weight loss. Got it. But it's not also like the case that, like, like anyone who's struggling with fertility should get on OZemphic.

No. It's not like that's going to be helping you just sporadically. No. Do you have to wait 18 months after childbirth to try to conceive again? No. So the sort of guidelines for this tend to say they're phrased in many different ways. But the one that I think is more standard is to try to have your births at least 18 months apart. Okay.

And so which we mean conceiving, you know, waiting at least nine months to conceive. This is a bigger deal potentially if you had to. a C-section with the first baby. If you're hoping for a vaginal birth with the second, most doctors will not allow you to try for a vaginal birth unless you have 18 months between birth, just because of that healing of the of the uterus. Got it. And there is some evidence if you get pregnant very, very close together, like pregnant

within the sort of three months of the last birth, that there might be a slightly increased risk of preterm birth. whether that's in fact causal or just a sort of association because of who is getting pregnant so quickly, it's not really clear. Okay. But, you know, waiting a little bit of time is a sort of general recommendation. Is that due to, like, your body's depletion of nutrients? Exactly.

Like, that would be the theory that basically you are somewhat depleted and that you need some time to, like, you know, replete yourself before you're ready to carry again. And then, I mean, to bring it back to Mucinx, because we have. have to. Does that actually do anything? I mean, there's like a little evidence about the cervical mucus and maybe mucinex has some positive impact. It's not a direct. It's not like we gave people a muisynics and they got pregnant. It's more like some people say you take it. It anecdotally impacts your cervical mucus. The theory could be true. Right. Is there anything that like would say like if that would

be helpful for someone? They're like, no. No. No. No. No. Oh, I do have a no, no, no on the mucinics. But another thing I should, can we go back to one thing I forgot to say earlier, which is if you are using like a sort of standard set of lubricants, they are bad for sperm. So if you use like people like KY jelly and most of the other like standard vaginal lubricants will slow down the sperm. Okay. And are not recommended if you're trying to conceive. So avoid those. There's a thing called preseed, which does not have this effect, which is a lubricant. What about saliva?

Yeah, saliva is also fine. Good to know. And then our last question. for this episode is gender swaying. There's new evidence, is there evidence on techniques to conceive a certain gender? No. No. You know, people say it's sex early, late, do this position that, no.

No. No. Nothing. Nothing. Okay. Nothing. No positions. No.

No positions. No timing. No nothing. No special drinks. No different apricots or, no. None of those things. Okay. And what is the chance?

Is the chance 50-50 of having? About 51% of births are boys. if a couple has like five daughters in a row, that's just still just chance statistically? Largely, so there's like a little bit of evidence that men that some, so the gender is controlled by the sperm. With men. Okay.

Hear that? Sorry. And there's like a little bit of evidence that some men may be like slightly more likely to father boys. And so if you had, you know, seven boys in a row or conversely, you know, like, then maybe you've like learned the chance of the eighth one being a boy. is like slightly up, but it's all really very close to 50. So even in those cases where like it's, you still could get a girl.

All right. Well, I feel like we covered a lot of ground. Me too. I mean, if I wasn't doing this for so long, I feel like I would be ready to to jump in and know exactly what to do. But I think this is really helpful. And I want to tie back to like, again, just reiterating that statement that you were, that we were making kind of throughout the episode of the number one thing to do is to

figure out your cycle, to figure out when you're on. If you're going into this and all that other stuff seems to kind of be noise unless it's affecting. Exactly. When you're ovulating. I think that is a perfect way to say. Just to close out, because I'm sure people have, are leaving this with more questions, want to know about more myths, more things they saw on TikTok.

Where can they find this? I know like Dewey is your AI kind of like question answerer. Is that the case for the fertility vertical as well? Yeah. So two things. So if you go to parent data. I think the best place for people to start is you go to Parenteata.org and there's a little button that says trying to conceive. We'll put a link. We hopefully can put a link in the show notes.

And then you can get access to all of the content here, a little bit of which is written by me, a lot of which is written by some amazing reproductive endocrinologists. And we have places where I think there's a little segment that's like overwhelmed, start here. And if you are just starting into your journey, this is going to be like, here's the 101 on this. Here's when to have sex. Here's like a lot of the stuff we've talked about and many other things. And if you want to ask questions. Yeah, we have a chat bot. His name is PD now. Oh, sorry. And you can answer. Okay. We changed the name. Well, it's complicated. Among other things, Dewey was not a good guy. The Dewey Decimal System guy. He was like a misogynist. Oh, wow. And it felt like not okay to have your,

your, like, pregnancy chatbot, like, named after like a misogynastic librarian from the 1800s or whatever. Anyway, so we were going with PD. And you can ask a quick question to get a quick answer and links to more of this content. So parent data. It'll be in the show notes. I've I've personally asked, P.D. Formerly known as doing. Many questions that have helped soothe me. Amazing.

And again, if you, by the time you're listening to this, if you've already conceived, there's information about pregnancy, there's information about parenthood, there's information about like all things motherhood related. Exactly. And fatherhood and all the kinds of hoods. So check it out. Thank you so much for coming on. And our, we're going to have you on again.

We're going to do another episode. And this one's going to be about things. that are a little more complicated. So if you're in that boat, stay tuned. That'll be out in a couple weeks. Thank you. Bye.