Tea at Four - Fertility expert reveals leading causes of infertility; iPhones, protein shakes and today's dating scene

Episode Date: May 22, 2025

Why aren't we having babies anymore? We asked a fertility expert and the answers might surprise you...From PCOS and endometriosis to dropping sperm counts and shocking racial disparities in healthcare, part 2 of our 'Future of Fertility' series unpacks the health barriers behind today’s falling birth rates.On Tea At Four we chat why ‘fertility and fajita nights’ are slightly problematic, the lifestyle factors that could be impacting conceiving and the stats around choosing to have a baby in your 30s.

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Goal tenders, no. But chicken tenders, yes. Because those are groceries, and we deliver those too. Along with your favorite restaurant food, alcohol, and other everyday essentials. Order Uber Eats now. For alcohol, you must be legal drinking age. Please enjoy responsibly. Product availability varies by region. See app for details. What do you think the future of fertility looks like? Handmade tail? Oh Oh f*** no! If you're having regular sex, then the uterus and the uterine environment is reminded that sperm isn't a foreign body and that it's okay. So does that mean abstaining is bad?

Only at the beginning of the 1990s were women involved in clinical trials. Isn't that just mad? trials. Isn't that just mad? Hi guys, welcome back to Tea Out 4. I'm Christy. And I'm Lauren. And this is a podcast where we talk all things that normally stay in the group chats. Yeah. But not today. No, no, no. Because for this part of our Future of Fertility series, we are joined by fertility expert Kate.

Woo! series we are joined by fertility experts Kate. Okay we are basically going to rack your brains on these stats around the England and Wales fertility rates being the lowest that they've been since 1938 since records began so hope you don't mind. No you go right ahead you ask me whatever you like. So Kate is there an obvious reason as to why the fertility rate is the lowest it's been in years? You could probably put that into three different whatever you like. So, okay, is there an obvious reason as to why the fertility rate is the lowest it's been in years? You could probably put that into three different reasons. So, economic, changing societal norms, and health.

So if we look at kind of economic, we're in a really unstable place right now, aren't we financially? But actually we've been like that forever. And I think a lot of people feel that they haven't got the finances to have a baby and when is a good time to perhaps create a family so that might prevent them from wanting to try to conceive. The societal norms I think this is the most interesting and I do find this utterly fascinating. I think we always think, don't we? Oh, you know, women particularly want to further their career,

so they're leaving, getting pregnant until later. And that absolutely is a fact, and age is the biggest reason why our fertility rates are declining without question. However, it's actually that women aren't finding a life partner to settle down with. And you might kind of understand this, girls. It's the ghetto out there, Kate.

It's the ghetto. And that's actually a... Do you know what it is? No, no, guys, I have to say this because I do feel like people say, oh, yeah, we want to, you know, be independent, our careers. But the truth of the matter is... Finding a life partner. Yeah.

Skets. But if you think kind of like 1950s, what did you do? You married the boy next door and settled down, had children. Maybe your parents had an influence in who, and you didn't do anything. You didn't move in, you didn't kind of travel. It was just, you're very stable in your village or your town, your small town or your city.

There wasn't much going on, but life is very different now. But even with technology to enable us to find a partner, we're still not finding them. So that is, I think, the interesting thing. And certainly what we know, research shows that not finding your life partner is the major reason why women are leaving it later. And then, as I said, then that comes into issues because of age, not getting pregnant. And then with the third example, health, again, age plays into that.

But we're seeing an increase in women with ovulatory disorders like PCOS, women with other disorders, endometriosis. But also we're seeing a decline in sperm health as well. Male infertility is increasing. I know. I know. We'll have to pull up our socks basically. Well, what does that even look like? So in an ideal world, in a really fertile world,

what would that look like? We all having children at 20? Yeah, I mean, you are most fertile in your teens and in your 20s. Oh my God. But who wants a baby? And actually the UK pregnancy rates a few 20 years ago were sky high, even 15 years ago. Now they're virtually non-existent.

And actually they're quoting the iPhone is the reason why women aren't or why teenage pregnancy rates are so low. It's because we're on our iPhone. We're not going out behind the bike sheds anymore. We're communicating on Snapchat or whatever, or young people, you know, and so they're not actually meeting up. That's so interesting. I know. That actually, I mean, yeah. I think of it like this, the clubs are closing now as well. Like nightlife is scarce. So going to uni now, instead of you, you know, meeting up at the freshers week, you're on your screens on your phone. It's true.

It's true. I can see, I can see, I can see it, but that's actually quite upsetting though. Is it upsetting? Yeah, because if we're getting, if like we're not getting pregnant or not having, you know, meeting people, communicating, we're gonna get into this idle, you know what I mean, communicating. We're gonna get into this idol,

you know what I mean, self-typer mindset where it's just like, focusing on me, so the family thing can be pushed back further, further, further. I think right now it's like 30, 40, that's when people wanna have their first kid. It could push back even further, maybe in their late 40s. So how old do you reckon you can be

to get pregnant with your own ex? How old, what do you say would be the ultimate? It starts at 35, right? Or actually no, I think it's younger than that. Well the media would have you know it's 35, but I think every woman is individual and we're not a statistic. So it depends on how you look after your body,

do you smoke, do you drink alcohol? Have you had lots of sexual partners and therefore have chlamydia? You know, there's lots of different reasons. But what do you think is the oldest age you can get pregnant? I wanna, on average. I feel like I'm interviewing you.

Yeah, I like this, it's making me think. It's the concert time. 41? So yeah, you're not far off. I mean, you can get pregnant in your early 40s. But it's a lot harder. You've got an increased risk of pregnancy loss. My gosh.

But also it can take you a long time. So when you hear celebrities getting pregnant with their, well, they say, oh, you know, I've conceived and I'm in my 50s. They've either throws in their eggs or they've used a donor egg. It's not their own egg. But we kind of think that, oh, well,

if she can do it at 15, then it's okay if I wait. You know, it's not a problem. Yeah. What is the average age then you've seen like people getting pregnant at in 2025, 2024? So I suppose I tend to see women coming to me at around the age of maybe mid thirties to late to late 30s and I wish they would come earlier. Really? Oh God, yeah, 100%. I mean, I love it. I mean, only last week actually in one

week, this is so unusual. I saw two young girls in their 20s, one who does want to conceive, but hasn't been using contraception for 18 months and hasn't had an accident. And she's only 21. And the other one was 23 and no one was listening to her with her diagnosis of endometriosis and she wasn't getting the help that she needed. She wasn't trying to conceive. But for me, the ability for women to come to me early to get the right advice, because I'm so passionate about empowering women

to be knowledgeable about their bodies. So to use the technology advice, because I'm so passionate about empowering women to be knowledgeable about their bodies. So to use the technology to help them. So fertility trackers, for example, not period trackers. Don't use period trackers to work out when you're ovulating, totally incorrect. It's just like a calendar method. So it's like, you could just use a calendar and then go, oh, well, I'm ovulating mid cycle,

but you don't ovulate mid cycle. You know, it's unusual that you would ovulate mid-cycle every month and your ovulation moves around. So this whole perception that a 28-day cycle, you ovulate on day 14, it's- Oh, really? Yeah. Oh, that's interesting.

I just test it from how confident I feel. Isn't that when you feel good? It's not like, oh. Well, yeah, and that's actually, yeah. I mean, it's not a recognized fertility indicator, but it is a way of kind of no understanding your body. But a lot of women will, will use period trackers to determine when they think they're ovulating and they're not.

See, I think this is what I hate about social media, especially when it comes on the health point, because they feed so much money ads on these kind of apps and stuff. So you're like, you know what? I don't need to go to an health expert. I've got everything on my phone, so it's fine. So me hearing that now is like, oh, so all the money I have not spent, but like other people have spent on like, yeah, I use, I use flow. I use this. I use that. How do you know if it's really, really giving you what you really need to hear and find out? So that's an easy one for me to answer

because I'm chief medical officer and CEO designate for a very good, see I've just got a shameless plugin, for a very good fertility and women's health tracker called Ovisense. And the reason why Ovisense is the market leader is that you put in some physiological data into this app. So for Ovisense it's temperature, and temperature can help you identify when you've ovulated or when you are about to ovulate.

And it uses something called core body temperature. and it is the most effective way of monitoring your fertility. Flow and other apps, because there are many, can be useful as long as you are putting some physiological data in. So there's various different things that you can do, like I said, temperature being one of them. Cervical secretions are another one. If you put that information into an app, it's going to give you information about when you're ovulating,

but not if you're just using a calendar method. It's not telling you anything. Coming away from the birth rate, birth stuff, in terms of fertility, what would you say is the leading cause of fertility and infertility kind of barriers and opportunities in the UK? So from a health point of view, I think for women, ovulatory disorders are the leading cause.

So polycystic ovarian syndrome, PCOS, one in 10 women will have PCOS. And actually we think possibly one in seven because a lot aren't diagnosed. And that can be really significant to trying to conceive. Doesn't mean you're not going to conceive, but there it's gonna take a lot longer and they're gonna need help to achieve pregnancy. And there are lots of barriers that go against them. And then endometriosis is another one again, same stats,

one in 10 women will struggle. Yeah, I mean'm coming from a personal point of view I've been on and off with trying to get testing and be taken seriously in the doctors around endometriosis symptoms. Right. Something I've never been able to ask and maybe I don't also want to know is if you have endometriosis that hasn't been treated or been diagnosed for a significant number of years, would that be affecting my fertility? So with endometriosis there are four grades of endometriosis, so one to four, four being the most significant and that's where endometriosis is not just

confined to the pelvis but it can be on the bladder, it can be on the bowel, it can even be on the lungs and the legs. Bizarre. And that's where the cells of the endometrium, the lining of the womb navigate to other parts of the body. And then when you have your monthly bleed, they bleed too, and that causes you pain and discomfort. So what can happen in those situations is that your pelvic organs can be stuck down to each other so your fallopian tubes could be twisted back on themselves, the bladder could be stuck to the uterus, the bowel could be stuck to the uterus and that could cause some bowel or bladder symptoms as well. So in grade 4 endometriosis that's probably the most

significant and you may need some surgery to free the adhesion So free all that scar tissue which can then increase the likelihood of you being able to conceive But you also might need to have IVF treatments, but every woman is very different And so certainly getting that diagnosis Timely and sadly there's a lot of medical gas lighting that goes on with endometriosis a Huge lack of research into endometriosis and women's health full stop, which drives me insane. And therefore getting that diagnosis is difficult. And you mentioned, you know,

you've probably felt that you've been medically gaslighted and you have to keep going back to the doctor and you have to be persistent. And that's really hard to do. It's really hard to do. Yeah. I saw a statistic the other day to say that there's been more research done into male boldness than endometriosis. Totally.

So there's 2% of funding, government funding, that goes into women's health. And I mean, the kind of gender health gap is something that just drives me insane. And the huge disparity in access, treatment, research. I mean, this is just, I don't know whether you know this fact or not, but it just blows my mind. Only at the beginning of the 1990s were women involved in clinical trials. Isn't that just mad? So up until that point, no, but up until that point, all the clinical

trials were done on men. So if we're taking medication, we're taking a medication that is a male dose of medication because we've not had the clinical trials on women. Cool. Yeah, that don't make no sense. And what do you men provide to society? Because we are the ones that birthed the next generation. Well, with 51% of society, our funding is 2% into women's health. That's crazy.

Research and... But could it, not me defending them, but could it be due to the case that rather something goes wrong within the men, then... Rather than the women, it would happen to the men? Yeah, when testing. But then surely it will cause more hurt if the thing did work on the man

and then it didn't work on the man, which is what we're going through now, I feel like. Yeah. It's like in a bit. Well, absolutely. I mean, if, you know, it was a male fertility issue, the woman still has to go through IVF, even though it's absolutely fine.

Everything's fine for her. Yeah, yeah. What is, can you say from your point of view, what is the leading cause of infertility with men? There's so many different factors. Some men will have no sperm at all, which is devastating. Getting that diagnosis is horrendous. Some men will have sperm that is not formed correctly.

And that's quite common actually, when we do a sperm test, unbelievably, only 4% of normal forms, that sperm test, unbelievably only 4% of normal forms, that's the norm to see 4% of normal forms in a sperm test. So 90 what, 7, 6? 96 abnormal. And we think that that's obviously linked to environmental factors as well, but it can also be linked to other health issues with the man.

There's something called varicoseals, which is a bit like varicose veins in the legs, but it's in the testes. And that can be quite common and difficult to diagnose sometimes and we don't really treat it very well in the UK. So that can be a common issue. So there are many, many different factors that impact on male infertility. That's just some of them.

The idea of fertility is something that I pray and pray that I'd be able to have children, but the idea of like having that definite fertility test in my 20s is terrifying. Like, should, from your point of view, should we be getting tested like earlier on to see our kind of, and then are there things that you can be doing to help your fertility

in the long run? Absolutely, so I always talk, as I mentioned before, about it's never too early to start, to come to me or to go to somebody else and to start some investigations. And some of those can be blood testing. And I think it's really important for women to go and get some blood tests done, to check your full hormone profile, your thyroid, your prolactin, your vitamin D levels. All of those can be an impact on fertility.

And I know sometimes it's hard to access your GP in which to do those. And often if you're in your 20s, you might not be taken seriously to do it. But luckily, you know, these days, we've got ability to do that, to have more at home testing. And again, shame this plug, I hope it's okay. But I'm clinical lead in women's health for one of, they're called one-day tests who provide this type of service

and they have their own laboratory. And it's amazing because you can become so empowered with your fertility by understanding what's going on in your body and then make the health changes if you need to. So if you found that things weren't quite right you could look at okay what okay what can I do about this? How can I make this better? I do absolutely feel it's important to get as much advice and as much as information as you can

even in your 20s. So because what you don't want to be doing is delaying that out of fear perhaps and I understand that emotion but then realizing that actually you've got a real uphill battle when you do want to start having a baby. So there's things that you can do if you had like a low egg count to improve it? So that's a really interesting one. Women are born with all the eggs you'll ever have and you lose multiple every month. Multiple, not just one, multiple. So your ovarian reserve, you can't hugely change. So your ovarian reserve is whatever your ovarian reserve is. your ovarian reserve is. You potentially can impact on the quality of your eggs and that's what's important. You know, you want to have good egg quality.

And so you can do that through having a healthy lifestyle, not smoking, not drinking too much, you know, just being generally healthy. You can absolutely do all of those things, eating well. But you can't change your ovarian reserve. And we can't test for egg quality either. You can test for egg quantity, but not egg quality. Is that also the same with, see when people go down the egg freezing route. Yeah.

So you can literally just test in terms of the quantity of how much you can take out, but not how healthy that egg is. Totally, absolutely right, yeah. Interesting. So when you freeze your eggs, you'll freeze as many as you can in your egg freezing treatment,

but you don't know whether those eggs are going to be any good when you put them with sperm. Yeah, I know. What a catch-22. It is a catch-22. And there are so many other factors that impact on that when you then go on to think about using those eggs. Yeah. I just wanted to ask from a personal stance. Obviously you're here to kind of promote

talking about fertility. When we were doing research for the series, I found a fertility of the heaters night in King's Cross. Fertility and for heaters? Correct. Was that about egg freezing? So this is where you go along to this evening and you can have your dinner, but you can also get an 80 pound test

to basically find out about your ovarian reserve and how many eggs that you've got over a sizzling skillet of for heaters. Wow, that's really interesting. My mind is boggling at that fact. Okay, so that's something called an AMH test, which is looking at your own reserve. And an AMH test was initially used and still is used to kind of determine how successful women are going to be with an IVF cycle. So how many eggs are going to get an IVF cycle? But it's been picked up as a bit of a fertility MOT.

So it now is offered to places like this, come along and we'll check your fertility. But actually in isolation, it doesn't tell you a great deal. So you need to have other investigations, like a follicle count scan to see how many follicles are in the ovaries and put that information together Because otherwise, I think it can be really misleading. Well, that's what I mean I just imagine that's something that's quite accessible to the public that you can go and do and if I find something out

That was quite detrimental. It's like oh my god. What do I do that information now? Yeah, I'm sure there is follow-up stuff and not to you would late the event. Yeah, you would hope so I think there's also the the damage that can be done by getting your AMH and going, okay, it's great. And then delaying, but actually your AMH declines, you know, year after year after year. So you could just think, have that false reassurance and certainly no AMH level is a guarantee of a baby.

Yeah. How accessible are these like tests, especially obviously there's the NHS, but I'm pretty sure accessible are these tests? Especially obviously there's the NHS but I'm pretty sure some of these tests you've got to pay for or is it like go private? Yeah like an AMH test is a blood test that can be easily done. An actual Holococcal count scan is a scan so you generally would go to a fertility clinic in which to get those done. And then of course, once they've got you, they then say, Oh, look, your AMH is a bit low. Let's do IVF.

So, you know, that, oh, let's freeze your eggs. So you're in a bit of a, you have to be quite careful when you're going through that consideration. But yes, you wouldn't, you don't get that test on the NHS. Although just recently, although just recently the guidelines for the diagnosis of PCOS have changed and we can use AMH as a diagnostic tool now. So you can or should eventually be able to get an AMH test on the NHS to help with diagnosis of PCOS, but it's not really happening at the moment.

What is the youngest you can freeze your eggs? Well, technically you can freeze your eggs pretty young because if you think about women who, or young women who are going through cancer treatment, that's one of the options that is available for them. I don't know, I genuinely don't know the age of the youngest person that's had their eggs frozen, but certainly of reproductive age, then you could technically freeze your

eggs for medical reasons. I think you would be discouraged at a young age from freezing your eggs for any other reason, for a social reason. But the earlier you freeze them, so if you froze eggs in your 20s, the better. Five years old is the youngest that has ever happened. Oh Jesus. Thank you very much for medical reasons. Yeah, childhood cancer. Amazing. I've learned something today. Women are amazing. Yeah. I guess in the context of a lot of these things like IVF, egg freezing, fertility, we talk about like heterosexual couples. What would it look like for a single person

or a same sex couple? I know they're completely different things, but like to kind of start that journey, where do you go, at what age is the best age to start thinking about it? So I think for a single person, I mean, you know, that they're gonna make the decision at some point that they're not finding a life partner

and therefore they want to think about their future fertility. So that's based on individual, where you are in your life stage, isn't it? I think for any same sex couple, we kind of call that a social infertility because they've got huge barriers in trying to conceive. And so many female same sex couples

will be required by their trust or their care board to self-fund between 10 and 12 IUI cycles, so inter-utero insemination, self-funded before they're allowed to have IVF on the NHS. So that's a huge... How much is that? I think it's around 3 thousand for an IUI cycle. Just one cycle, maybe less. Two and a half, three. Yeah.

Jesus. Yeah. People have enough money for IVF and egg freezing, especially. I know you do want to leave it later in life, but I don't have a spare ten grand lying around. Yeah. Well, if I do, it's going on holiday. Yeah. Well, exactly. And if you think that one one cycle of IVF is around five thousand pounds and actually we're seeing that more couples are now having to privately fund the IVF than ever before because the NHS isn't

providing as much IVF as previously and some some care boards will well the care boards will decide whether they're going to provide three rounds, two rounds, one round or none at all. So there are some counties in the country where there's no IVF provision at all yet. Across the road in another county they might have three. So it's a postcode lottery as far as that's concerned. So that's the expense of it. So many people are having to do private IVF and it costs a lot of money. From what I gather from talking to my patients, they will borrow often from family to provide it

or they will run themselves into the ground on credit cards and loans in which to pay for it if they don't have the money and those that really don't have the money can't do it and I see that all a lot time and time again. It's a bit bleak especially it's like considering different places you might live in the UK that could really affect your chances of how successful you are with getting pregnant. It's actually funny because I was speaking to friends and family the other day,

and especially my family abroad, what they've started doing, they fly to places like Turkey to do a full health check. And let's say you're paying 750 pounds to do this full health check. You go literally through everything, get same day testing, same day results. And then for them, it's preparing themselves for the future.

So it's like, okay, cool, I've done all these tests. I know that this, this count is low, this, I need to work on this. My health is, you know, bad or my health is good. So then it kind of like prepares them to, okay, cool. These are my options now. Whereas here, I feel like you, especially in our friendship groups,

you don't really speak on things like that. And you don't, obviously the resources are there, but unless you've got the money for it, you won't be, you know, prone against the like, let me go ahead and continue doing this. And also, what I think it is, is that, because we know about it, we know it's expensive, we have the kind of like four ways,

like, oh, I'll get pregnant anyway. So it's okay, it's not a now thing. Whereas now we're speaking about it, it's like, no, you should actually be constantly thinking about these things and putting your health and thinking of the future now and not wait for tomorrow. I totally agree with you. Being proactive now and taking that responsibility and allowing yourself the opportunity to become empowered, I think is really important. Yeah. How do you think, from your point of view, the kind of social conversation has changed

from like the last 10 years to now around fertility and you know talking about having babies later in life kind of thing. Well we're talking here aren't we about this and perhaps this conversation wouldn't have happened you know a few years ago it definitely there's more conversation about infertility there's more conversation about pregnancy loss but there's still massive taboos surrounding that. Men find it really difficult to talk about their fertility, particularly if it's a male factor issue and actually I see in couples, heterosexual couples, that often the woman will take the burden of blame, not blame because I don't hate you that word, but will take the burden of

responsibility and tell people that it's there It's the woman's issue to protect their partner. I see that a lot So there's a lot of shame because obviously sperm count is all wrapped up with masculinity isn't it and they can be like cock-a-hoop. Oh, I've got amazing sperm or They've got shit sperm and you know, what can they do about it? I think those those are the conversations that are starting to come out now. There are some great people that are doing some amazing work in the space in male fertility

and getting people talking about it so much more, but there's still so much more that needs to be done. I do feel like it's gonna get better, just because I'm fat, you know, as well. And like, even the thought of having that conversation with my mum about fertility, she's probably thinking, oh, you're gonna have kids anyway, when time's right, you're gonna have your kids.

Whereas now is that the more that we speak about it, the more that we know that there's, you know, there can be some factors that are gonna stop you. It kind of prepares the next generation. I do feel like when we were in school, especially sex education classes, it was basically just like, yeah, the man has a sperm, the sperm does this, you carry the baby, birth it and that's it.

So for guys, it's like, okay, cool, I've got no problem. So as long as I'm masturbating and things are coming out, I'm good. Do you know what I mean? And it's really upsetting the fact that as females, you've got to kind of like take the burden of it. Because at the end of the day, it's like, men also need to know that you can be a factor of why it's not happening and be happy enough to take the accountability of it.

And as you feel like that is, this is the first time I've actually even heard, like, you know, there's men in the affiliate rates cause you don't hear it. It's not advertised online. You see fertility, you don't see any male adverts on the matter. So it's like, why even now, why are we not talking about it?

Or why are there not like platforms that push? Yeah, it's literally still about women. It's very frustrating. It is beginning to change. I reckon if we had this conversation in the 10 years time, we'd be seeing it being a very different landscape. But it's not there yet.

And it's funny because I think men as well have the most myths that they don't want to talk about and hash out. Like, I've definitely heard one thing before that's just like, oh, if you masturbate too much, then you're going to like run out of all your sperm. I've definitely heard a man say that. Whereas the actual answer is the more you do, the better because you're going to have healthy sperm for the time of ovulation. So yeah, go for it guys. So females please send it to your partners, your friends. Keep banking. I think is what I'd really like to touch on a little bit more as well is like endometriosis is so prominent and obviously it's so hard to get those kind of diagnoses and maybe not getting the treatment could have maybe affect your

chances of fertility like how do you be taken seriously and like how does not getting it treated how can that affects your chances of having a baby in the future? So, I mean, to answer your question about how to get taken seriously, it is just being really persistent and keep going back. There are, I think, last count, something like 65 endometriosis specialist centres in the UK. So if you think you've got endometriosis or if you've been diagnosed with endometriosis, then getting a GP to refer you to one of these is the right place to go because they are the experts.

So they can tell you everything you need to know about surgery or what your medical options might be. They can also talk about how to control your pain. You know, I see a lot of women that can't get out of bed for a week of a month and can't socialize. It's impacting on their relationships and their work, you know horrendous. So kind of getting that help early I think is the best thing and then when you have some investigations

hopefully then they'll be able to tell you what the extent of your endometriosis is and then what that means for you and your future fertility. But majority women with endometriosis will go on to conceive and I think that means for you and your future fertility. But majority of women with endometriosis will go on to conceive. And I think that's really important to say that. Push it out there. What about things like contraception? You know, there's stuff like the injection,

there's the pill. Like obviously when you go to the doctor, especially when you say that, oh, you have heavy periods, they put you on the pill, they put you on different types of contraceptions. Do obviously, not to say that we abuse it, but obviously because we're giving it to young females very early, put you on different types of contraceptions do obviously, not to say that we abuse it, but obviously because we're giving it to young females very early, could those impact fertility

rates as well? No, from what we can see, and clearly we've got lots of data of contraception being used since the 1960s now, the pill and the rest of it, is that there is no impact on your fertility for any of those. So I think women can confidently use them. So no long-term 60s now, the pill and the rest of it, is that there is no impact on your fertility for any of those. So I think women can confidently use them. So no long-term impact, but there is a short-term impact. So when you stop the pill, it might take about eight months,

nine months for your fertility to return to normal. When you have the injection, it can take probably longer than that once you've had your last injection. But then some of the others, like the progesterone only pill or the implant, once you have then some of the others like the progesterone only pill or the implant, once you have the implant removed or stop taking the progesterone only pill,

you can conceive straight away. Mm-hmm. Are there any interesting, surprising environmental factors, modern day ones that are affecting fertility? Yeah, so I think environmental factors are really important and this could be, well we certainly think it's one of the reasons why we're seeing more male and female fertility issues because of environmental factors. So there are lots of things that you can think

about doing and this is one thing that I talk to my patients about is, and I say, you know, why don't you do a little audit of what's in your home? So think about your beauty products, think about your cleaning products. Oh yeah, yeah. What do you mean beauty? Beauty products, okay. Literally, I'm just wondering, let me backtrack. Is it not? Don't say it like that.

I just said, oh. So there are, so our skin is our biggest organ and we're not very kind to it. We put loads of things on it, don't we? And a lot of those things will have parabens in them. That's a toxin that's not very nice. So being aware of that and then, okay, maybe doing a little audit of your beauty products later on

and going, okay, what's got nasty toxins in? Next time I need to change it, how can I replace it for something better? So things like nail varnish, makeup, even our hair dye, all of those things can impact. Let me just take off my wig right now. Let me take off the wig right now. Even a ten pound note has got a coat on.

Oh I don't have cash. We don't have those so much, we're cashless. But yeah, so there's so many things. And then plastic, so plastic water bottle. Horrendous, I'm going to drink out of it, but horrendous for you. It's got BPA, unless that's BPA free. Really? Yeah. Yeah, Teflon-Codium. What does BPA mean?

BPA is a toxin that's used to make plastics and it's not good for us. It's what we call an endocrine disruptor. So it disrupts the fine workings of your hormones. That's why it's bad to heat up things in the microwave. Totally, absolutely spot on. Yeah. And cling film.

I haven't had cling film in my house. I can't always use cling film. No, no, no. I got rid of it probably about 15 years ago because it's got an increased risk of breast cancer as well. Hey! Yeah. Don't use cling film.

Use your beeswax wraps or put a plate on top of your food if you're cooking it in the microwave. And same with don't store foods in plastics either. So plastic plastic tupperware unless it's BPA free. But then I think if it's BPA free, what other toxin have they used to create this? What about like deodorants, like spray deodorants? Yeah, yeah, yeah. I banned my husband from using a spray deodorant.

Wow. And well, at me. Not just him. Oh God. That would be me. My boyfriend actually takes the piss out of how many ointments I use, aka my face products and stuff. And now I'm really thinking.

But I think we, you know, beauty-wise, products are much more aware now. So you're probably gonna find that your favorite ones are okay. Okay. But just look at other things that you're using and just be mindful of what you're putting onto your biggest organ.

Wow. I've also got to bring another one up because when we did a similar campaign last year, one of our highest performing shorts was around vaping affecting fertility. Oh yeah, 100%. Yeah, can you share much about that? Yeah, so interestingly, we don't have the research

and the evidence fully yet about vaping, but we're pretty certain that it will impact in exactly the same way that it does with smoking. But what you might not know is protein shakes. Massive gas. The new Mitsubishi Outlander brings out another side of you. Your regular side listens to classical music. Your adventurous side rocks out with the dynamic sound Yamaha. Regular U owns a library card.

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Instacart, groceries that over deliver. Producer, whoa! No, really? Yeah. So protein shakes. No. Right. Producer, whoa. No, really. Yeah, so protein shakes. You know the tubs that men specifically buy? The big ones. The big ones.

Bulk you up. We're seeing a correlation between porous burn parameters and potential protein shake use. So, you know, what's in this? Are some of these manufacturers, particularly if you're buying them online and maybe if not from a reputable place, and maybe they're coming from abroad,

are they sneaking a bit of testosterone? Are they sneaking in a bit of steroid? And those aren't good for your sperm. Oh, shit, really? Yeah, so healthy pea protein, there you go. Pea protein, oh, they sell that in Lidl, I think. In Pamba. Shit.

Holland and Barrett will always have a good team. Yeah. I know that's, that's the, hey, that better be a better performing short. I mean, the Jimbrows are quaking. Flushed. Shaking in their boots. That's mad though.

Is there anything else surprising like that? I'm already thinking about all the plastics I'm gonna throw out when I get home. Yeah, I know. Plastics are a big one. Teflon coated pans. Really? Yeah. Air fryer? Don't tell me an air fryer. Yeah, that's a really good point, the air fryer actually, because that's coated. Yeah, yeah, possibly, yeah. I don't know what they coat them on these days. Do you know what,

this is why I just go back to the, you know, old way of living, barbecue everything, stop cooking indoors. Stop cooking indoors. We're going, we're going. When was, what is a caveman time? In about the stone age, sorry. At this point, because plastic's in it. Shit. Love it. So do you think like, like back since the records began

when they were recording fertility and it was so high, like were people almost always trying for a baby and instantly getting pregnant? I think there's always, always gonna be an element Like, were people almost always trying for a baby and instantly getting pregnant? I think there's always, always gonna be an element of men or women having infertility, but we are seeing that the factors are increasing. And, you know, there's so many reasons why.

And we've touched on environmental there being probably quite a high one. Yeah. I was gonna ask, as a black woman as well, especially because when it comes to like pregnancy, there's always complications Totally and I think that's what scares me. Yeah, obviously I'd know two people that have Like passed during childbirth, but then also are the rates higher was it different than like a you know white women?

Yeah, in regards to infertility when it comes to like ethnic backgrounds. So I Mean certainly black women have higher risks associated with their reproductive outcomes. And I think infertility probably is the same, yet there may be different reasons. But what is really shocking is, well two things, is that black women are less likely to be taken serious compared to white. They're less likely to receive a diagnosis, they're less likely to receive treatment.

But also, society-wise, you're less likely to talk about it and confide in your family or your peers. So then you don't get the support that you need. So the kind of racial disparity is huge. It's a lot because if I think about back home, like let's say for instance if a couple's struggling to have a baby, they'll be like, let's just pray about it, you know what I mean? You know, God will provide, it's fine. Whereas it could be just trip to the doctors, find what's wrong. And then you guys work on that and then boom, the child will, do you know what I mean? Will appear, God willing.

But yeah, I do feel like, I think for me, when it comes to like speaking about infertility, especially because I don't speak about that at home with my mum as well, because obviously they had it, I guess for them, they had it easy. It's not something for them to talk about. It's a bit, I'm always in that kind of conflicting state where it's like, okay cool, I want to speak on it just so I can kind of like express my thoughts on it and what she thinks, but at the same time before I do that I've got to make sure that I am also doing my own research or gone ahead and done it myself before I go and ask for that advice from my mother. You might have to educate your mum to a certain extent

as well if it's something that's not familiar to her. But I think having those open lines of communication, I've got two boys, a 23 year old and a 21 year old, and they talk to me about everything. Amazing. Everything. And they even bring their friends to talk to me about. I've had, oh my God, I've got chameleon.

I've had, I forgot to take my pill, what do I do? I've had all of that. And so that's quite interesting. But also going back to fertility and black women is when you're really struggling to conceive, you don't see yourself recognized in the fertility clinics, beautiful websites and their brochures because you're not often reflected in that. It's weird. tend to especially with my family we tend to go abroad yeah it's easier to get diagnosed abroad so obviously we've got good connections in France so if ever like one of us falls ill or something before we go to the GP here we're like okay cool let's call the GP in France because obviously I'm getting maybe it's

because there's more the diversity is more than the UK, maybe it's that, but also the health professionals there, you can relate to them as well. So I feel like it's so much easier to kind of like, fight your position, fight your point abroad than it is here. And it's kind of upsetting because it's like, I live here, do you know what I mean? I feel welcome here. So where, why am I not represented in those spaces? So yeah, it's that catcher. So some people they can do it, some people can't. So it's like... And misdiagnosing in black women is huge.

So black women have a higher risk of fibroids compared to endometriosis in white women. Yet sometimes that's even not even thought about. So the medical practitioners will think, okay, well, we're probably looking at fibroids here. Yeah. But actually, you could be looking at endometriosis, but we just associate it completely differently. So sometimes you're not taken seriously from that point of view. A lot of work needs to be done.

It does. It does. Yeah. I guess to kind of close up that conversation from your point of view Kate, what do you think the future of fertility looks like? So if I was gonna be really, really negative. Oh. I don't know.

Let's start with the negative because then we can sandwich it and finish with the positive. So if I was gonna be really negative, I would say, handmaids' tail. Okay. Oh, Gail-o. What is that?

That's not light. Oh, Christy. What's hands made of stones? It's like a dystopian world where women are just there to recreate, right? Yeah, and only a certain amount can or do and the rest don't or can't. So that would be the worst case scenario. The bestest? The best case scenario is we're talking more, we're more open, we're

discussing mental health that's associated with fertility issues and pregnancy loss more than we ever were. So I'm hoping cautiously that the future is bright however with fertility rates still on a decline I don't know how we're gonna change that. Keir Stammer, please put some money into fertility. Thank you very much. Women's health. Thank you. We need it. Amen. I read something earlier about embryo freezing. Yeah. Is that a thing?

No. Yeah. I didn't know about this. Why would you choose to freeze? So that's where it's fertilized and then it's frozen. So when you go through an IVF cycle, you might not necessarily use all of your embryos or eggs at the time, so you freeze them. And you can freeze them and then they can be then

kept in the freezer for later. And you might pop back one embryo at an IVF treatment, or you might freeze all and not put any back and then have your embryo transfer a month or two later. So yeah, embryo transfer is something that's done very routinely. So maybe there's options anyway, isn't there? I think that's important, yeah.

I mean, yeah, it's good, but I do feel like don't just rely on the options. I feel like that's what we've been doing, just relying on all these options anyways is fine. Look into your health, make sure you are aware what's going on inside your body as well as outside and I feel like it's just having those conversations. Are there any symptoms, say you were being, you had no idea about fertility, you weren't worried about it at all, but is there anything that your body might show you that might be

an early sign of any issues? Yes, so the things to look out for are that your periods change, so periods could become heavy or painful. Or that your periods start to become less frequent. So, you know, so for some women they might kind of think, well, I've skipped a period, but that doesn't mean you've skipped a period,

it just means that your cycle was more lengthy on that occasion. So if your cycles start to become more lengthy or shorter Then those are things you can those are a real kind of indicators the body is saying okay Something's not quite right here little red flags almost so those are things to look out for What about the men? Well, it's difficult to know because you don't know whether you've got any sperm, because you're always going to have seminal fluid, so you're not going to know whether there's no sperm there.

But lumps or bumps in the testes, I mentioned about varicoseals or varicose veins in the testes, making sure there's no infection, you know, if they're having regular sexual partners, those are the things that they can look out for. Okay, noted. Is there any truth around the myth that if you start your period earlier in life then

you'll start menopause earlier? Not necessarily. So a yes and a no really. It goes back I guess a little bit to you're born with all the eggs you're going to ever have and in fact a little segue here is your egg, the egg that made you was in your grandmother. Oh I love that. Go figure that one out. Yeah well come back to that in a minute. So if you start your periods early and you've only got a finite amount of eggs then you might have an earlier menopause. So you can have what we call premature ovarian insufficiency where you have

a menopause in your 20s, it can even happen, 30s, mine happened when I was 32 or in your 40s and the normal age of menopause is 51 in the UK, 52. So whether or not that really exists, every woman is individual depending on how many eggs they've got. I clearly only had enough to last me until 32. Did you start your period late? If you don't mind me asking. I was 14. 14?

14. So you know, now girls are starting their periods like eight, nine years of age. Really? Yeah. Fuckin' hell. Yeah. That's bad.

No, it's not bad I feel for them. Periods are tough. Very. Yeah, and in terms of egg freezing, what's the kind of mental health, physical health factors that come into that? So when you go through egg freezing, effectively you're going through IVF.

The only thing that you're not doing is you're not having the embryo transferred at the end of your treatment. So when you're having treatment, whether it's for egg freezing or IVF, it can be incredibly physically and emotionally taxing. So physically, because of the medications you're taking, and in some circumstances, the medications you take

put you into a premature menopause for a very short period of time. So you're going to get a lot of those symptoms that you would necessarily associate with the menopause or woman. And some of the side effects that you can have. So there is a side effect called ovarian hyperstimulation or OHSS. And that's where your ovaries are stimulated to create all of these follicles and eggs.

So they grow, they grow really large and you can kind of get quite distended. And I'd say majority women will have some mild OHSS during their fertility treatment or their egg freezing. But it's rare that it is severe. But if it's very severe, it can be life threatening. Although I've only ever, I've never seen that happen. I've never seen a woman die of OHSS, but it can happen.

But not so much these days. But when it comes to the emotional impact, especially if you're doing it alone, you're egg freezing, you're doing it alone without the support of a partner, it's tough. And then if you think, if you're going through IVF, your chances of success in your first cycle are around 33%, that's it.

And so away from this idea that IVF will fix it, because that's often a misconception. So 33% and then by the time you get to the third cycle of IVF, that's increased, that's your best chance. So many people will go through IVF treatment and not have a successful pregnancy. Many women will go through egg freezing and maybe only get one or two eggs

because they've not got a good ovarian reserve. So then you have to repeat it. So the emotional impact is massive. So it's really important to get good support. So what are you both going to do now then? Well, the group chat. Hello ladies. Wigs coming off.

Wigs coming off, yeah. Plastics in my house. Is there anything in like having more regular sex is better for your fertility? If they're the masturb things, I think. So, what we know is that, like I said before, if you're having regular sex and you're changing the sperm over, so it's not sitting in the testes,

so therefore, a time of ovulation, you're gonna have good, healthy sperm. But also there's some research that came out a few years ago that showed that if you're having time of ovulation, you're gonna have good, healthy sperm. But also there's some research that came out a few years ago that showed that if you're having regular sex, then the uterus and the uterine environment is reminded that sperm isn't a foreign body and that it's okay. So it doesn't attack it and get rid of it. So that was quite interesting research.

Ooh. So does that mean abstaining is bad? It's not bad. Well, it's not bad, It's not bad but health wise it could... I think fertility wise, even with a low sperm count, when we don't tell men to conserve sperm. So we don't say don't have sex as frequently,

we still say have... and you have to have sex, ideally, every two to three days when you're trying to conceive throughout the cycle. Right. Not just thinking about the fertile time. Note pads out guys. Yeah, what are you doing after this? throughout the cycle. Not just thinking about the fertile time. Note pads out guys.

Note pads out. What are you doing after this? So I'm gonna take off the wig, definitely. Throw away my plastics. King Film, my love for you is done. I'm sure the wig's okay. It's not be that radical. I don't know now, do you know what I mean?

I'm not too sure now. I'll do my research though, I'll find out. I'm sure it's fine. Wigs cause them facility, I can see it now. I'll do my research though. I'll find out. I'm sure it's fine. Wicks, Causum, Facility. I can say it now. No, I think you'll be okay with Wicks. I feel like it's just, I think for me personally is doing more research, actually having conversations, especially with my mother and my friends. And also, yeah, I think it's time. I'm 30.

It's not fucking seen, Isle. I know, but I still, I feel like I need to know. I need to know. Are you gonna do it then? Do you think you'll do fertility testing? Yeah, I think so. At the heaters and fertility or? Maybe not.

Maybe not. Not for sizzling skillet. Maybe not there, but I feel like I'm more, I think I'm more comfortable. It's done. Yeah. Yeah, and maybe start tracking your cycles so you understand a little bit about what's going on. Yeah.

So if Christy was to do that, would she go to the NHS? Would she go private? You do your research online? So you could go to the GP and ask for some blood tests but the GP will probably say you're trying to conceive and if you say no, then they go, come back love. Come back love when you're, you know, in a couple of years time or whenever.

So you could access blood tests, you know, through other means. And fertility tracking, you you just choose a fertility tracker that you wanted to use, Obviousense. Obviousense thank you, Obviousense got a new subscriber. Love it and then me I'll just hope for the best. No joking, there's so many things that I do that I'm sure that no there's. I look after my body. I think I... You're both slim.

You both look very healthy. I'm very healthy. I think just in terms, the only thing that concerns me is like, yeah, the periods and how that could be affecting. So maybe you're kind of, I'm gonna keep you accountable. Is you're gonna go and get investigated then or go and speech-to-speech? I am. I'm actually in the process of it now.

I'm having an ultrasound in a couple of weeks. So ultrasound is useful for the general, but it's not going to show endometriosis. It can show what we call endometroma, which is if you've got chocolate filled, they call it chocolate filled cysts, so blood filled cysts on your ovary. And that can then indicate that you might have endometriosis,

but you might not necessarily have the endometrioma. So yeah, a scan doesn't give you a diagnosis of endometriosis, but you might not necessarily have the endometrioma. So yeah, a scan doesn't give you a diagnosis of endometriosis, but it will make sure everything else is looking okay. Or what can happen is subscribers, listeners, you watch the podcast, you save, you know, you give us all the monetary views and then we use that to go to Turkey to do a full body check, health check. I did not know where you were going with that. I was wondering where you were going with that. Yeah, brilliant. Take us to Turkey. Take us to Turkey to do a full body check health check. I did not know where you're going with that. You're going with that.

Yeah, brilliant. Take us to Turkey. Take us to Turkey. Get my teeth done at the same time. Great. So this is a part of the podcast where we're going to play facts, stats or fiction, where we hash out a couple of questions and we make ourselves look really embarrassing usually.

Embarrassed. No, we got to try our best. True or false? PCOS is the most common cause of infertility. I think false. I don't think there's been enough research to decipher that. Yeah, probably false. It's the most common ovulatory disorder to impact women with fertility.

Oh wow, so that's true. It's true that it's the most common ovulatory disorder, but probably not necessarily the most common reason why infertility occurs because there's so many different reasons. God, that's shocking because I know so many people who think they have PCOS but haven't. More than 10. Wow, Interesting. But doesn't mean that they won't go on to conceive. No, of course.

But it's just like, I didn't know that there should be way more research and awareness around it than if that's such a big leading factor. Yeah. Wow. Okay, so one in how many couples experience difficulty conceiving? Is that like one in 10?

One in how many? So how many do we think? One in five? Or is it, I don't know. I think it would be less or would it be more? I don't know, more fractions. Yeah, I had to do maths twice, so don't forget to ask me. One in, one in eight? One in seven. Oh, one is Jesus. No, that's a horrible thing to say. I was going to say one of us in this room is going to have... No, no, no, no, no. That was...

Well, yes, but I think that's kind of okay to talk like that because it highlights... That's true. Very common. One in three will suffer from pregnancy loss. One in three. Really? Well, out of us, I haven't and I'm past my reproductive age. I mean, Godspeed, hopefully that never happens to us.

That's shocking, wow. Yeah, that's crazy. True or false, more than 70,000 donor-conceived children have been born since 1991. Donor-conceived? I want to say true. Our survey says... This increase is driven by single patients and same sex relationships. So it's true, a huge big donor conception rate increase over recent years.

And I wouldn't say it's just driven by single moms and same sex because a lot of individuals are like same, heterosexual couples are looking at donor conception either for donor sperm or donor egg because they're struggling to conceive. So, but we're seeing, it's becoming so much more commonplace,

which is great because it gives us an opportunity. It gives you another way of creating your family. Are there enough sperm donors in the UK? UK is quite low on sperm donors sadly, but a lot of people do go elsewhere to perhaps find a sperm donor out of the country. You still can, you absolutely can within the UK, but it's harder.

And then how does that work? Does it come back with you on the plane? Do you go have the baby there? No. So if you, if you chose, say you wanted to go, I don't know, a lot of people go to Scandinavia and choose, you know, choose sperm Scandinavia, they will send the sperm over. So yeah, yeah. And then it's all regulated rather than using your next door neighbor who you don't know whether they've got any genetic illnesses or. Yeah. Oh, people's family members do it these days. Yeah it's a lot a lot that's unregulated but there's risks both you know legally as well for like who's a legal parent and yeah so it's much better to go through a

reputable organized. Okay. What percentage of fertility issues come from the man? Not all of them. No. 40? No, less. 30? 94? Oh! No, maybe like 70? So it's about half and half. Okay. But it is slightly different in the fact that

you can also, a couple can have a diagnosis of unexplained infertility where we don't know what the factor is. You've done all the tests, there's nothing wrong with either male or female, but they're still not getting pregnant. So there's a percentage that is accounted for with unexplained infertility,

and then the rest is evenly divided between men and women, which again is a bit of a misconception because men generally think it's a women's issue, and it's less likely to be a cause of sperm issues. Yeah. Relax, Christy. All right, well thank you so much for chatting to us today. Thank you so much for inviting me.

I've loved every minute of it, thank you. Thank you. And if some of our audience want to find your stuff, where can they go online? So you can find me either on Instagram and I'm yourfortunitynurse on Instagram or my website is yourfortunityjourney.com. Gorgeous, thank you so much Kate.

Let's give her a round of applause. Woo! Thank you. And we will see you guys again next week. Bye! Bye! Woo! Thank you. And we will see you guys again next week. Bye! Bye! Bye!