The Food Medic - S3 E9 - How to get pregnant with Dr Larisa Corda

Episode Date: September 3, 2019

This week's episode, on the topic of fertility, is brought to you by your host Dr Hazel and her guest, Dr Larisa Corda - Obstetrician and Gynaecologist, and Fertility Specialist. Larisa believes in a holistic approach to treating a patient that addresses many lifestyle factors, and is a passionate womens’ rights ambassador with roles on a number of international charities that have included UN Women and The Circle. She is also ITV’s This Morning’s and Channel Mum’s Fertility Expert. As a little disclaimer, the term 'clean eating' and 'clean living' is used in this episode. At The Food Medic, we tend to not use this language when it comes to food and health. However, that is the termniology used by Larisa in the context of her conception plan and, in this case, we felt it was appropriate to leave it within the episode. For more info, check out Larisa's website: www.drlarisacorda.com. Topics covered:- How to maximise your chances of pregnancy- Male and female infertility- Fertility M.O.T.- PCOS and fertility- IVF Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Terms and conditions apply. Visit bmo.com slash theiporter to learn more. Hello and welcome back to the Food Medic podcast. I'm your host, Dr. Hazel Wallace. I'm an NHS doctor and founder of the Food Medic, an educational platform which aims to pick apart the fact from fad when it comes to nutrition and other aspects of health. I'm so excited for this week's episode on the topic of fertility as it has been highly

requested from you guys and I also have an incredible woman joining me Dr Larissa Korda who is an obstetrician and gynecologist and a fertility specialist. Now Larissa believes in a holistic approach when it comes to treating her patients that addresses many lifestyle factors and she's a passionate women's rights ambassador. Larissa is also ITV This Morning's and Channel Mum's fertility expert. As a little disclaimer I just want to mention that the term clean eating and clean living is used in this episode and as you guys might know I tend to not use that language when it comes to food and health but that is the terminology used by Larissa in the context

of her conception plan so I just wanted to clarify that in case it caused any confusion for anyone but before I introduce you to Dr Larissa it's time to share this week's listener question so this week the question is, Dr. Hazel, dairy doesn't agree with me and I've recently cut it out from my diet, but I'm worried about my calcium intake. What are the best non-dairy sources of calcium? So if you're interested in the answer to that question, make sure to keep listening to the end of the show where I will reveal all. Larissa, welcome to the show. My gosh, thank you so much. I'm so excited. Oh, you're welcome. So first of all, can you tell us a little bit about your background? You qualified from Imperial, right? Yes, I did. So

I went to a very scientific college. It was quite new at the time, the medical course when I did that. And I always knew that I wanted to do women's health. I cared a lot about women. And I'd read a lot of books when I was younger, which influenced so much of my decision making. One of my biggest influences being Dr. Christian Northrup over in America who had, so when I was 14, 16, I remember reading her book, Women's Bodies, Women's Wisdom, and that just completely changed my life. So I went down the general route of ONG training. I spent some time in Australia also doing that, which was incredible, almost in comeback. I loved it so much. But that was really the beginning, I guess, of me introducing myself to this whole new concept of clean living as I call it which is

being more mindful of the food that you eat how you exercise how you live your life generally and the impact that that can have because you know the Australians are generally so good at that and having spent quite a bit of time out there, it really, really started to influence me and eventually started to influence my practice and what I was doing. So when I decided to specialize in fertility, it was something that I started to find was really having an important and powerful impact. So a lot of the time when we train down this conventional Western route of medicine, which is so brilliant, by the way, at fixing acute conditions and things. I started to find that actually, when it came to the more chronic stuff, to say, for example, endometriosis, polycystic ovaries, conditions like that, which affect a lot of women,

it really wasn't adequate enough just to have a completely Westernized approach in this, i.e. just give some drugs or do some surgeries to fix it, I started to find that actually we weren't spending enough time talking to the patients about what they could do themselves to help themselves. So things like what sort of diet they should be on, what they should be eating or shouldn't be eating, to fitness regimes and how they should be exercising. And then this whole issue of mindfulness and stress management, which is huge and something that I bring a lot into my practice. So yeah, it all kind of went from there, really. Amazing. So you're an obstetrician and

gynecologist, but also you specialize in fertility. Yes. Now, infertility has been so highly requested on this podcast. So I'm really excited to have you here to chat more about it. And it seems like a lot of women and men are thinking about it even before they're ready to start actually trying to have a baby. Is there any advice that you could provide to people who are maybe thinking about conceiving, and they just want to do the best for their bodies before they kind of get to that point? Yes, there are loads and loads of things that you can do. It's really the reason that I set up my website and the actual conception plan, which stemmed from that, because I was finding through doing a lot of the TV work

that people were asking me more and more questions about how they could take matters into their own hands and what they could do preventatively to help themselves. So I would say when we discuss this, really, we're discussing the idea of the conception plan, which falls into a couple of different pillars. First one being nutrition. You know, it's all about the sort of diet that you should be on. Now, I'm not a fan of any strict diet that involves you basically depriving yourself or having a miserable time. I think that just puts loads of strain and stress on your body and your mind. And I don't think any of those diet plans are sustainable in the long run. I talk a lot about plant-based eating and the fact that we should all be transitioning over into that, or at least be what I call

flexitarian. So a little bit of meat, maybe 10 to 20% of your diet, the rest should be plant based. And this is because plants have a huge range of benefits. I mean, I don't need to preach to the converted here. But you know, they're full of so many beneficial minerals and vitamins. And, you know, trying to eat a good range of different things from all the main food groups. So it's not really dieting per se, it's just cleaning up how you eat. And, you know, there's all sorts of tips and things I share on my website about how you can make this affordable. Because that's the question I get asked a lot of the time, you know, well, it's so expensive buying organic, but there are,

you know, there are shortcuts, there are ways you can get around it, you can cook large batches and then store it in the freezer, defrost, so you can get a couple of meals out of one dish that you make. There's so many little things that you can do, which I share, which are really important. And then the second pillar of the conception plan, which is this whole lifestyle modification is fitness. So making sure that you're exercising regularly, making sure that you are prioritizing exercise. I think that's something that a lot of us find really difficult, myself included. I absolutely confess to that when you're busy and leading a very stressful and busy life, you know, exercise quite often falls by the wayside. But actually, it's really important because not only does it

make you feel good by releasing all those endorphins but it keeps your weight in a normal regular range or it makes you lose weight and also it improves blood flow to the ovaries to the womb to all the reproductive organs as well it helps to keep the hormones in balance so if you have polycystic ovaries for example if you exercise regularly that can absolutely help to improve your rate of ovulation and can improve the regularity of your periods as well. So it's really, really important. At the start of the year, we had some Canadian guidelines come out, which essentially recommended 150 minutes of exercising per week, at least if you're trying to get pregnant or are already pregnant. So that's how important it is.

So that if you distill that down, it essentially means 20 to 30 minutes every day. It's just prioritizing that and making sure you do it. And you know, when they did the studies, they actually found that the benefits were not just for the mother, the benefits were also for the baby as well, you know, in terms of improving obstetric outcomes. So it's really, really important that word gets out about how important exercise is. And then a third pillar of this is what I call toxin-free living. And it sounds a little bit drastic perhaps, but it's about essentially cleaning up your environment, your home, and removing things which could potentially contain dangerous chemicals

that can interfere in terms of our hormones. So what we call endocrine disruptors, and also can negatively impact the sperm and the eggs. So this is a very sexy, very topical area of conversation at the moment. It's called epigenetics. So it's the whole concept of how your genes or your offspring's genes can be turned on and off by the environment. So we're not just talking about the external environment, things like pollution, for example, we're talking about the internal environment as well. And what ultimately impacts on our internal environment is what we're exposed to on the outside. So that absolutely does include alcohol, smoking, food. I've just come out of the biggest fertility congress in the world called esri

so that's been held in vienna and what one of my favorite pieces of research that came out of that was an italian group that had started to look at the effects of various different pollutants in the air that we inhale and how that's affecting the eggs in our ovaries and leading to a faster decline. So are you more premature ovarian aging or earlier menopause? I mean, this is powerful stuff that's coming out. And we've just touched the tip of the iceberg. But I think in time, we're going to see more and more studies show us that there are massive effects that can be had and what we need to do to try and prevent ourselves from being exposed. And then one of the sort of last pillars of this is what I call stress-free living or stress management. So that's a huge area in itself.

This is all about, first of all, recognizing that we're all under this chronic degree of stress. It's amazing, actually, when you stop to think about it, how much stress we absorb. We're all under a certain degree of stress for some people it's all relative isn't it some people are able to cope with a lot more than others but essentially in time what starts to happen is your body starts to suffer and when we talk about external influences the external environment well remember the internal environment is just as important so the messages that we feed our mind, the thoughts that we have, the stress that we carry can absolutely start to affect your biochemistry and your hormones and your cortisol levels, which then start to impact your estrogen and progesterone levels, which of fight and flight which is your sympathetic nervous response is just really really damaging so I think trying to address and look at that is really

crucial and using remedies such as shamanic healing or reflexology or reiki or hypnotherapy even massage acupuncture all of these things are designed to really try and reduce the amount of stress that our bodies are exposed to and therefore reduce the amount of inflammation that's going on which can absolutely increase the amount of infertility that you have or increase you know how bad conditions such as endometriosis and polycystic ovaries are so those are the kind of major pillars or lifestyle changes that you can make. But then there's other things such as sex and relationships, which we can talk about, which are just done really badly, actually. Again, oh my god, I mean, you know, when I see patients,

and they come to me, and I asked them, you know, how much sex they're having, what sort of sex they are having, I've stopped being surprised, actually actually at how bad it is out there really, as in people just don't prioritize it or they only prioritize it during the fertile window. So it can become incredibly mechanical, incredibly strained for both partners. And, you know, no one really likes the idea of being told when to have sex. Yeah, exactly. It kind of takes on the romance out of it. Right. It's like the unsexiest thing you can do. But, you know, the fact of the matter is everyone is so busy. Everyone is so stressed out. It's what they say, you know, we are the sexless

Netflix generation, which is bizarre because everywhere you look, we've got so many reminders and images of sex from music videos to, you know, all everywhere you look, we've got so many reminders and images of sex from music videos to, you know, all sorts of media that we're exposed to. But yet, we ourselves are not getting enough of it. And they're not doing it right, really. And, you know, there's all sorts of things I can talk about them in terms of what do I mean by that. But I mean, really developing that closeness, that bond, that connection, which is so important and which is in a karmic way really important when you want to create life. Because what is sexual energy but creative energy, essentially? It's the creation of life.

And I think we have lost our sense of that. And it's something that I'm really keen to return to people's consciousness. Yeah. And you brought up the conception plan just there. Can you explain a little bit about that? And I know that you've been working with a couple of couples and they've been going through fertility issues or having difficulty conceiving. Have you found good results with them? And what types of things have you been doing? Yeah, so essentially this idea stemmed from

the fact, as we were saying, that there just really isn't enough education out there about how to improve your fertility. But worse still is the fact that really people can't access this care very easily. So we all know that, you know, the NHS is very strained. And sadly, one of the first areas to suffer from that strain and to have serious cutbacks made is fertility management and treatment. And sadly, it means that many, many people are discriminated against on the basis of age, on the basis of their weight, on the basis of whether they've had children before, even things such as if they've been pregnant in the last year, but have miscarried or had an ectopic pregnancy that is actually used against you, which I find absolutely dreadful.

So the truth of the matter is that there is an incredible demand for this care but we're not able to supply it. People can't even go to their GP for basic advice because they don't fit this criteria. So what I wanted to do with the conception plan was really make sure that this information was provided for free. And so that people could access it, could learn, could re-educate themselves, could make these changes in their lifestyles and see how easy it was to do and to follow. Yes, it takes commitment, absolutely. But getting pregnant is not easy, as I keep saying. You know, for some people, they're lucky enough that it does just happen. For the majority of cases, certainly that I see, it is not easy. And so it is a commitment, but it is a commitment that will stand you in the long run. It will ultimately improve your health

and improve your baby's health through the process of epigenetics, as we spoke about. So the fact that what we're doing to our own bodies is having a direct impact on the gene programming of our offspring and the babies that we're producing. So thankfully, this morning, who I work with, saw that, you know, through all the phone calls that we get whenever I do a phone in, there was this incredible demand. So we decided to work together and bring the conception plan to the people really, and to ask people to apply and see if they wanted to be helped and guided by myself and with the conception plan. And so as you can imagine, we were inundated with a lot of requests for this. We had to make some really difficult decisions. We could only select three couples. And that was really, really hard because everyone deserves help. We ultimately ended up going for couples who had a whole range of different conditions,

male and female factor related, that could then help other people who also suffer from this. So, you know, we could have gone down the easy route, I guess, and selected people who were nice, young and slim and hadn't been trying for that long. But we did the complete opposite, actually. You know, we selected people who'd struggled for a long time and who had also been denied this care by the NHS and were suffering from conditions such as polycystic ovaries from being overweight from suboptimal sperm counts whatever that was due to and we took them on and we educated them in the principles of the conception plan so this is what the viewers would have seen in the strand that we ran back in February and March.

It was all about covering all these different pillars and introducing them to certain techniques that they could apply and use. And last week, we announced a pregnancy through one of our couples, which was absolutely amazing. And I still feel so emotional about that, actually. It was just wonderful to see our couple, Catherine and Dan, who are now pregnant, are 16 weeks pregnant. They were so committed to this entire plan from the get-go. And, you know, what people have to appreciate is this was a couple that wasn't eligible for treatment on the NHS,

had suffered from infertility for three years. Catherine had a high body mass index. have to appreciate is this was a couple that wasn't eligible for treatment on the NHS, had suffered from infertility for three years. Catherine had a high body mass index that was close to 40. She has polycystic ovarian disease. Dan has varicocele, which is dilatation of the veins that surround the testicles and can ultimately impact on the quality of the sperm there. He has two hernias as well, which can also impact on that. And this is a couple who dedicated themselves to such an extent that they managed to get pregnant naturally for the first time in their lives. And I'm so proud of them. And I hope and I know from the comments that I've got, it's given a lot of hope to a lot of people. The fact that you can have this holistic approach and, you know,

achieve results like that. Now, I'm not saying that will happen in all cases, absolutely not. Sometimes you do need to have intrauterine insemination or IVF, absolutely. But the conception plan can help to support you with that as well. It can help to optimize your outcome and put your body in the best state possible for that pregnancy. And, you know, as we're going to see with Catherine, we're going to use it throughout her pregnancy as well to try and reduce her risk of any pregnancy related complications and give her the best possible outcome. Yeah, that's amazing. And you just touched on some causes of infertility. I'd love to discuss them a bit more because I think

people aren't really sure about what actually causes them and PCOS has come up quite a lot it comes up all the time with me where women say you know I've just been diagnosed with PCOS does this mean I can never get pregnant and it's almost as if sometimes when you do a little google search it's like a sentence like you're like you know forever infertile you'll never get pregnant and that's just not the truth although it is much more difficult and like you said there's both male and female factors and that's something we also forget that there's two people in the relationship yeah right you're absolutely right i think that going back to that first question that you asked about you you know, common causes behind infertility, absolutely polycystic ovaries are one of the commonest causes that we see.

And it's such a shame that actually when women are diagnosed with it, they are misinformed about it. And what you mentioned about these very drastic categorical diagnoses being given and being told you can never get pregnant is something that I also hear from women as well. And I think we forget as a medical profession as well, you know, when that sort of advice is given the impact that those words have, because someone lives with that for the rest of their lives. And what you end up doing is completely demotivating them and increasing the amount of stress that they're carrying, which is absolutely not conducive to getting pregnant. And the truth of the matter is, you know, I'm a strong believer that there is practically always hope. It's not to say that there are some people for whom getting pregnant naturally or even through IVF may not be possible.

And that is simply because, you know, they may not have the anatomy for it or there could be certain diseases that are impacting on that where we have to use alternative means. But for the large majority of people, there is hope. And ultimately, you know, however you get pregnant, there are different means and routes to getting there. And I think it's about educating people on those and normalizing all those routes and removing the taboos and the stigmas around them. So if you end up needing to use donor eggs, well know actually guess what a lot of so be it yeah i mean lots of people do this but we just don't hear so much about it because there's still so much stigma attached to it and i think the media has a responsibility here as well you know when we report on cases where someone is pregnant you know in their 50s or late 40s, what we're quite often not told is how

that happened. And, you know, whether that woman suffered from several miscarriages before or whether she's ended up needing to use donor eggs, which is likely, but it's just not discussed. And I think we need to set some records straight. And I think we need to normalize that conversation. And I think that we need to make men and women feel empowered enough to be able to have those honest conversations because they will help so many others as well. But yes, you know, the point about male infertility, it's a huge one. I was just talking to someone about this today, that men are quite often excluded from this whole process and are made to feel as if they're just a spare hand

or just a sperm donor, really. And that's simply not true. You know, there are two parts to this puzzle. It takes two people to create a baby. And, you know, we need to start looking at male infertility a lot more seriously. And we need to start recognizing that men are not supported well throughout this process. I think in some ways, you know, men suffer a lot because if they have got their own infertility that affects them, that's one thing. But they're also expected to sort of, as you know, inverted commas, man up, if you like, and to sort of, you know, take on board also the problems that the relationship might be carrying or, you know, to support their partner in this whole process, you know, if it's female factor infertility. And I think that's incredibly hard. I think that's, you know, a tall order for anyone. And

it's simply not fair, because they, you know, typically speaking, and culturally speaking, I think men are quite often made to bottle up their feelings. And it's quite rare that, certainly in the past, you would have seen a man openly discuss his feelings and how he felt. Now that conversation is changing, thankfully, because of the discussions that we're having around mental health. We're normalizing the conversation around that. And so men feel braver about broaching this topic. But I can tell you from my own experience and from the men that I've seen, they absolutely do suffer terribly. And when you do offer them

treatments such as hypnotherapy, reflexology, shamanic acupuncture, you know, I've seen for myself grown men cry in my arms because no one had ever allowed them to express those emotions that they've been carrying. And ultimately, those emotions are not only leading to depression and also possibly having other impacts on their health, but could also ultimately be feeding into their infertility. So I think we need to start addressing male infertility as a serious subject and trying to change the conversation in that as much as, you know, we're doing for women. And in fact, I go so far as to say that I think we should start

advocating for all men to start thinking about having, you know, fertility MOTs like, you know, women are doing. Yeah. And I think that's a really good thing. I'm glad that you brought that up because it's a good segue into my next question. And this is something that I get asked quite frequently. It's, can I test now, even before I went to get pregnant, whether I'm fertile or not? And this is something that I kind of like have a little bit of internal conflict with myself when it comes to just doing full body MOTs

for no specific reason, but just to be curious. Because as you know, like sometimes we find things that we don't necessarily want to find out. It may not mean anything, but then we ruminate on it yeah is this something that you advise when it comes to like fertility should we be doing having like female or male MOTs yeah great question I mean I think like you sometimes you can go a little bit overboard in terms of especially as a medic right we've all done at a medical school when we learn about a condition and you suddenly think oh my god I've got all these symptoms.

I'm in a coma. Right I'm gonna go get an MRI or get myself checked and scanned. Look I think raising and developing self-awareness is a really really good thing and generally speaking I'm a big fan of having an MOT or having an assessment earlier in life, as you say. Why is that? Well, it's because I go back to the facts, which are that we're not well enough educated on the whole subject of fertility. And as a result of that, many men and women find themselves later on in life wanting to start a family and all of a sudden coming across problems that they never expected to come across. I mean, having a baby seems like the most natural thing in the world. And I think a lot of people go through life just presuming it's going to happen to them. But the truth is that a lot of the time, it just doesn't quite happen like that,

and people need some help. So I think trying to re-educate people on that and trying to get the men and women to engage in this process of going to someone to help them to perform that assessment. So when you go and have an MOT, that essentially involves a doctor taking your history, your medical history, so having a conversation with you about, you know, from how old you are to what your history is in terms of any gynecological disorders, to your smear test, to whether you've got any medical history, to whether any family member might be affected by something that could be impacting you, to then having an examination, and then having an ultrasound scan that essentially looks at your ovaries and the number of follicles that you have. So a follicle is a little fluid filled structure. We have several of those in our ovaries, and they all have the

potential to essentially grow eggs. So we look at what we call the follicular count in order to give us an idea of what a woman's ovarian reserve is like, i.e. how fast her biological clock is ticking. And we also do some blood tests that could include the antimalarian hormone, which is something that's made by the ovaries, again, is another reflection of what ovarian reserve is like, so how many eggs you might have. And using the combination of those blood tests, your history, your ultrasound findings, to draw some conclusions and to give a woman some options in terms of what she can do. So for example, if someone is found to have low ovarian reserve, and they're fairly young, that usually is an

indicator that they might go through an earlier menopause. And if the woman's not in a relationship, then you want to be able to empower her and say, well, look, you know, if having children is definitely something that you want to do, have you thought about freezing your eggs? And then having that whole discussion about when is a good time to do that? Is she able to do that? What are the pros? What are the cons, advantages, disadvantages? What are the success rates? All of that sort of thing. Likewise, you know, if someone gets particularly good results, then you can help to reassure them, you know, and they, you know, can then take that information with them. And you can only really test at that point in time. And you can give a prediction to a certain extent in terms of the future.

But, you know, it's something that you need to be keeping a mindful eye on all of the time because things can also change. So starting that younger and sooner rather than later is important. At the moment, we don't really have male MOTs, which is what I mentioned before. But I think that we need to start looking into that as well and getting men perhaps to test their sperm at the very least. And, you know, if there is damage to the sperm and if there are abnormalities, getting them to engage with this whole lifestyle change in terms of improving their diet, improving their fitness, because you can get massive turnarounds in terms of results just by doing that and having this very natural approach but doing it in time before they have any problems or you know anything that could affect them yeah absolutely and i guess it's important to point out to people who may be considering having an mot that this isn't something that you can go to your gp and get done you'd have to go privately unless you were having issues but some of the things that I guess we could do is check that you're not infected with any STIs and that's something that we should be doing regularly because again it's something that we don't really consider is going to affect

our fertility in years to come it's something that you do maybe at uni and then you forget about it but yeah definitely have those that check yeah oh my gosh absolutely yeah stis is a huge one and stis can can totally influence and impact your fertility so the way they do that is they can potentially damage your fallopian tubes and cause some scarring there which then creates a problem when it comes to the sperm meeting the egg in very simple terms so it's really important that if you've had any STDs or STIs, that you do go and get checked and that you perhaps have this MOT. Same goes for if you've had any cervical disease or any treatment on the cervix, which is relatively common. Again, that can potentially cause a problem or an obstruction to the sperm actually entering the womb and then

traveling to meet the egg. As a general rule of thumb, if you've had any condition that you're worried about that's affected you or you have any family history, so for example, a mum or sister have gone through an earlier menopause, it's so vital to go and see someone about that. So if you are trying to get pregnant, going to see gp sooner rather than later or if you're not looking to get pregnant right now but are worried about the impact on your fertility going to get that mot and and seeing what you can do about it it's not to scare you it's to actually give you some resources and options to do something about it yeah that's the whole point absolutely and you mentioned that i know we're discussing like natural ways of

conceiving but sometimes ivf treatments are important an alternative to help people get pregnant i know you support support this so what is ivf exactly for people listening and who is it available to yeah so ivf is a short nomenclature for in vitro fertilization. And what it essentially involves is taking a sperm and an egg outside of the body and fertilizing it, creating an embryo, which is the structure that's going to give rise to the baby, and then implanting that embryo. Sometimes we freeze those embryos for later use, but essentially they end up implanted, whether that happens as a fresh transfer or what we call a frozen transfer. So there are many reasons as to why we may need to do IVF. Some of the commonest that I come across

is women who don't have high ovarian reserves, so they have a low number of eggs. That tends to be older women, so especially women over the age of 40. We all know by now that, you know, once you get above the age of 35, the number of eggs that you have and the quality of those eggs starts to decline a lot more drastically. Now, the rate of that decline is different for every woman. But after the age of 40, it's quite pronounced in a lot of women and so we as doctors find ourselves doing a lot more IVF in older women simply because also women are deferring childbearing until later having you know done a lot of work on labour ward before I know for a fact that you know the majority of women are now having children in their 30s, quite often late 30s, and sometimes early 40s. And so the demography of all of this has changed drastically over the

last few generations. And hence, it's no wonder that people are finding themselves in that situation and needing to have IVF. But you know, sometimes we also need to do it because a woman may not have any eggs at all, we need to use donor eggs. Or, you know, if you've got something like polycystic ovaries and you've tried natural means, you've tried the clomiphene, you've tried intrauterine insemination mainly and it's not working, you know, it's a last resort. Sometimes there are male issues as well. So sometimes perhaps, you know, the sperm just isn't good enough or doesn't swim as well as it should in order to meet that egg naturally. So we then have to select the best

sperm and actively fertilize it with the egg. That's what's called ICSI or intracytoplasmic sperm injection. It's kind of like IVF, but a more specialized version of it because we're directly injecting the sperm into the egg as opposed to leaving them in the petri dish. And yeah, there's a whole range of reasons for why, you know, we need to be offering this to people. But essentially, that's what it is. It sounds simple, but it's, you know, it's a complex science that took generations to develop. But we're getting better and better at this all of the time. And we're gaining new understandings and new techniques. There's a lot of debate as to how IVF should be done.

And it's quite a creative science. People practice it quite differently. I'm a big fan of mild IVF and more natural means of IVF, not surprisingly being quite holistically minded practitioner, but it's all about this concept that more or bigger quantity isn't necessarily best, that we need to be focusing on quality, quality of eggs, quality of sperm. And sometimes that does mean, you know, mildly stimulating someone to collect a lower or a smaller number of eggs, but making sure that those eggs are as optimal as they can be, and they are as good as they can be. And that's where the conception plan comes in. It's all about making sure that you're looking after those eggs,

that you're looking after those sperms. So even if you end up needing IVF, the eggs and sperm are in the best possible condition that they can be. Yeah, amazing. I think that's all we've got time for. I feel like I could speak to you all day though. I feel the same. God, when I start, I can just talk non-stop on this subject. So before you go, where can people if they want to find out more about you or more about infertility and the conception plan? Where can they find that out? Sure. So I think the easiest place is to go on my website. I hope you can share the link, but it's essentially www.drlirisacorda.com. I've got loads of videos and blogs. And the conception plan is actually embedded within that if you want to have a look. But also my social media, I use Instagram quite a lot like you do in order to

educate. And so you can find me on Instagram at Dr. Larissa Korda. And yeah, those are sort of my main portals. But stay tuned. There may be more coming soon. Amazing. Okay, cool. Well, thank you for joining us on the show. And hopefully we'll see lots more of you very soon. Thank you so much for having me. And I really hope this helps a lot of people. Please let me know and please share. Amazing. Okay, guys, so that was Larissa. Hopefully it answered some of your questions and that you found it useful. Now, before I let you go, it's time to answer this week's listener question. Just as a reminder, the question was,

dairy doesn't agree with me and I've recently cut it out of my diet, but I'm worried about my calcium intake. What are the best non-dairy sources of calcium? Okay, so while dairy is an awesome source of calcium, such as cheese, yogurt, milk, it's not the only source and there are non-dairy sources available. So things like fortified plant milks and yogurt alternatives not all of them so you need to check the label and make sure that they're fortified sardines and other fish with bones dried fruit tofu nuts leafy

greens also in the uk white and brown bread are fortified by law. Now, just as a reminder, calcium is really important and not just for your bones. It's important for all of the cells and organs in our body. For example, calcium helps our blood to clot, our muscles to contract and our heart to beat. If you're wondering how much calcium you need, adults need roughly 700 milligrams of calcium a day. Children need slightly less and teenagers need slightly more. There's also some people who may need some more calcium or may have higher requirements. So that would include breastfeeding women

who are recommended to have 1250 milligrams a day. People with celiac disease, osteoporosis and postmenopausal women are also all required to have slightly more so in summary if you don't eat or drink dairy look for fortified plant milks and yogurt alternatives try to get as much fish with bones into your diet but also things like dried fruit tofu nuts and leafy greens don't forget if you have a question you can submit it by tweeting me sending me a facebook or instagram message and just make sure to use the hashtag the food medic podcast okay guys that's all for me I'll see you again next time